F.E.A.S.T's Around The Dinner Table forum

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3sweets
My d is a vegetarian who just left ISL after 11 days for RAN.  She restored some weight but is already pushing back about eating.  Anyone have some vegetarian meals that are loaded with calories and are tasty?  I am worried that she is going to fall into her symptom use now that she is home.  In the ISL she compiled with all meals and snacks and was a model patient.  At home is a different story.  She wants all control of meal choices and snacks.  Our therapist agreed that she could have two choices but had to choose one.  It works most of the time but not always.  Anyone have any tips on how we can get her to eat when she runs out of the room and blocks us from her bedroom?  We have two younger sons that are seeing all of this too.  Feeling very overwhelmed here.  

14 yr old D dx with RAN Nov. 2015
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OneToughMomma
3sweets,

Firstly, big hugs for what you and yours are going through. 

Secondly, what you describe is completely normal.  I think the vast majority of us have had very similar experiences.  Don't worry, we can give you lots of advice, and you are sure to find something that will help. You know that she can't have control of her meals, don't you?  She is just not able to make good decisions, and choices often make our kids very stressed.  You can best judge if d needs 2 choices or none.

Our kids' brains and bodies have a particular need for high fat foods to heal the damage done.  I pretty much aimed to put as much fat in a dish as it could possibly handle without being really obvious.

One important question is, how long has d been a vegetarian?  If she has historically been vego, then fair enough.  But most of us found that our d's and s's became vego when ED first started.  So often vegetarianism is an ED behaviour.  If that is so, then at some point that behaviour will have to go so that d can be completely free of ED. You might chose to tackle that a bit further down the track, and again, we can help.  For now, you just might want to not commit to continuing permanently with the veggie meals.  Keep your options open for later.

One of the most important things you can do is keep d out of the kitchen when you are prepping meals.  Find something else for her to do during that time.  It was hard at first, but if my d came into the kitchen I would just down tools and lean against the counter until she left.  She raged, yelled and made a big fuss at first, but eventually accepted the rule.

High fat veggie meals are relatively easy.  Just sit down and make a list of what d or your family used to eat that is veggie (NOT what is acceptable to her ED now.  That list is likely to be way too short.).  Lasagna, soups, toasted sandwiches or quesadillas, pastas, stir fry, curry, chili, fried rice, potato salad, risotto, etc.  Then make the highest fat version possible.

Get yourself a mega-sized container of canola/rapeseed oil and a discreet little dispenser bottle.  Fill (and top up) the little bottle whenever d is not around and casually leave it on the counter near where you plate up.

If I had a baked dish, I would discretely add extra oil, cream or cheese to one corner, and mark it with a toothpick.  Pull out of the oven, remove the marker, and serve d's plate from that spot.

You can add extra oil (don't be shy--you'd be surprised how much you can add) to many dishes like this: have everything ready and the family's plates/bowls lined up.  Get out an extra small bowl. Dish up the rice/pasta/whatever as usual except put d's in the little bowl.  Stir through at least a tablespoon of oil. Plate it like all the others. Repeat with anything that goes on top--the stir fry, curry, etc, adding extra oil each time.  Quickly put the extra bowl in the dishwasher.

If my d was looking like running from the table, h and I sat either side.  If she did escape I would follow her with her food.  I sat on her bed with food for many hours, saying, 'You need to eat this.  I'll leave after you've eaten.' (note, my d never purged and did not need supervision for that.)  We took the lock off the door. We made sure that we got as much as humanly possible into her at each meal. 

It was really hard.  But now she is doing so well, maintaining her health and cooking for herself at university.

You can do it, and we would love to help.

xoOTM



D in and out of EDNOS since age 8. dx RAN 2013. WR Aug '14. Graduated FBT June 2015 at 18 yrs old. [thumb]
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cnkinnh
Others here should be able to offer advice regarding resistance and food suggestions, I just wanted to mention that I believe my D's ED was triggered when she went vegetarian, and as part of her recovery we did mandate that she give it up.

As OneToughMomma said, if your D has always been veg then it's probably not an issue, but if it started as part of the ED, then meat will need to be reintroduced at some point - you will have to judge when she's able to handle that.

And a note on choices: my D *definitely* does better the more choice she has. Within reason, of course - H and I make sure that all choices presented to her are acceptable. But the more choices and the more control she has, the better her mood is. By far.
15yo D, first diagnosed 2015 with RAN. Diagnosis changed several times along the way, they are currently saying lifelong mild ARFID, complicated by major depression and AN starting age 13. Everything is atypical with her. FBT less and less effective after 2+ years. 
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mdmama
The rule of thumb at the hospital where my D spent 6 days in the early stages of refeeding was that if the vegetarianism was relatively new (3-6 months), it was not an option anymore-- it had emerged as an ED behavior and wasn't enough a part of the patient's healthy and normal personality to justify the lack of protein/fat and the restrictive behaviors it entailed. My D had been a vegetarian for three months to the day when she was hospitalized, and it ended right there. She had turkey or chicken a few times in the hospital and since coming home (three months ago) has had turkey, chicken, or a hot dog just as often as she did before getting sick-- maybe 2-3 times a week. My family has never been big meat eaters, and I don't eat or prepare red meat, so it was never a major part of her diet, but the goal was to reestablish normal eating, and normal for my girl WHEN SHE WAS HEALTHY AND NOT IN THE THROES OF ED THINKING was not to be a vegetarian. Maybe we can revisit that idea in a few years. 

If your girl has been vegetarian for a long time, you may feel differently about letting her continue, but if it's a pretty recent development, I think you should strongly consider ending it (though she'll likely be furious, just as my D was).

In the meantime, though, here's one recipe that you can make very high-cal and high-fat by using even more heavy whipping cream, and using extra butter in the first step.

Corn and Potato Chowder

ingredients

  • 1 large onion, finely chopped
  • 2 tablespoons unsalted butter
  • 2 teaspoons ground cumin
  • 3 tablespoons all-purpose flour
  • 4 cups vegetable broth
  • 1 large boiling potato, peeled and cut into 1/4-inch dice
  • 1/2 cup heavy cream
  • 10-ounce package frozen corn kernels
  • 1/2 pound sharp Cheddar, grated

preparation

Melt 2 TB butter in heavy stockpot. Add onion to pan and cook, stirring, until onion is softened. Add cumin and cook, stirring, 1 minute. Add flour and cook, stirring, 1 minute. Whisk in broth and bring to a boil, whisking occasionally. Add potato and simmer, covered, stirring occasionally, until just tender, 8 minutes. Stir in cream and corn and return to a simmer. Add Cheddar, stirring just until cheese is melted (do not let boil), and season generously with pepper.


_______
D diagnosed with AN November 2015 , the week she turned 12. Gaining slowly but steadily, fingers crossed...
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momtobeauty
Hi 3sweets,
More hugs for you. My d is also a vegetarian and we have a few yummy, easy dishes that she is very likely to eat. We are still tackling eating regular meals and I think she is getting enough calories but still has a very strict perception of what is "safe" and healthy. I've spent one full month pretty much only doing meal prep and meal supervision. She started limiting eating meat a while ago but became much stricter with the ED. I'm not sure if we'll push her to eat meat again as she is so adamant about all the ethical reasons not to and I can't tell if that's her or ED. Yesterday she was offended by the smell of some salami on the table and couldn't eat her meal while it was there. Here are a few that we can usually count on being accepted:

Lasagna roll ups:
http://allrecipes.com/recipe/25075/lasagna-roll-ups/

Taco salad- chopped romaine with tomatoes, black beans, corn, peppers, cheddar cheese, ranch dressing and crumbled taco shells

Curry stir fry- any favorite vegetables (we use carrots, peppers, broccoli, cauliflower, peas...) stir fried with canola, add a can of chick peas, boiled potatoes (optional) and mix in a prepared jar of sauce (butter chicken, tikka masala- they are high cal) from the grocery store. Serve with rice.

Veggie stir fry with cashews and tofu with your favorite stir fry sauce (ours has ginger, soy sauce, garlic, hot sauce...) I pat the tofu dry and bake it before adding it to the stir fry.

Black bean burritos:
http://allrecipes.com/recipe/14041/delicious-black-bean-burritos/
Cream cheese brings up the calorie count and they are very tasty.

Some high end grocery stores have yummy prepared vegetarian soups that are prepared with cream or coconut milk that d usually is happy to eat.

She will also eat tortillas filled with cream cheese and rolled into spirals, peanut butter delivered on celery and loafs made with vegetables.

I find giving her a choice between two items is helpful and she now understands there is no getting around a meal or a snack with sufficient nutrition.

I hope it gets easier for you and your d.


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Psycho_Mom
Hi,

My d gave up red meat at age nine. (And up until then she LOVED beef, it was her favorite food.) She was diagnosed with ed at age 15 1/2. After I managed to get her entire growth chart history, I saw that, although she had stayed on a reasonable looking curve right up until the precipitous decline before diagnosis, it wasn't the right curve, it was lower. Her entire weight trajectory was slightly lower starting at....age nine. 

I think this illness can start really slowly and sneakily, a lot earlier than we think. 

There are also studies that show that one of the best predictors of lasting recovery is variety of diet. 

I'd say, don't make any promises to your d. IF you think being vegetarian has nothing to do with ed, let her know that she can try to continue as a vegetarian and you will support that, but that if in future it seems like it would be better for her health to have a more varied diet (ie if she's not gaining weight or her symptoms aren't abating), then she may need to give up vegetarianism. 

ps. It was part of a long journey with a lot of fights in it, but my d had seconds of beef stew when I made it last week! And I never have to go to the health food store now and buy stupid Tofurkey products. yeech!


best wishes,

D diagnosed with EDNOS May 2013 at age 15, refed at home Aug 2013, since then symptoms gradually lessened and we retaught her how to feed and care for herself, including individual therapy, family skills DBT class, SSRI medication and relapse-prevention strategies. Anxiety was pre-existing and I believe she was sporadically restricting since about age 9. She now eats and behaves like any normal older teen, and is enjoying school, friends, sports, music and thinking about the future.
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3sweets
Psycho_Mom wrote:
Hi,

My d gave up red meat at age nine. (And up until then she LOVED beef, it was her favorite food.) She was diagnosed with ed at age 15 1/2. After I managed to get her entire growth chart history, I saw that, although she had stayed on a reasonable looking curve right up until the precipitous decline before diagnosis, it wasn't the right curve, it was lower. Her entire weight trajectory was slightly lower starting at....age nine. 

I think this illness can start really slowly and sneakily, a lot earlier than we think. 

There are also studies that show that one of the best predictors of lasting recovery is variety of diet. 

I'd say, don't make any promises to your d. IF you think being vegetarian has nothing to do with ed, let her know that she can try to continue as a vegetarian and you will support that, but that if in future it seems like it would be better for her health to have a more varied diet (ie if she's not gaining weight or her symptoms aren't abating), then she may need to give up vegetarianism. 

ps. It was part of a long journey with a lot of fights in it, but my d had seconds of beef stew when I made it last week! And I never have to go to the health food store now and buy stupid Tofurkey products. yeech!


best wishes,

14 yr old D dx with RAN Nov. 2015
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3sweets
Thanks for all of the insight and helpful suggestions.  I am going to try the recipes you all shared.  Just reading your posts and knowing there are other parents who have children that struggled with ED helped me to not feel alone in this process.  I appreciate the hugs [smile]
14 yr old D dx with RAN Nov. 2015
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Elena
My d eventually has decided to eat fish again, but so far will not eat other meats. The vegetarianism came with the ED in our case, but I haven't been tough enough to eliminate it yet. I rely on a lot of Quorn products ( found in freezer section of supermarket), which is a fungus based source of protein that my d seems to be able to tolerate , so when I make a stir fry for the family, I put all the same vegies in both pans, and chicken in ours but the fake Quorn chicken for my d. The Quorn absorbs oil quite well. Basically i add oil and or cream to everything I can!
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Jax1
Hugs and understanding to you xx My daughter is 20 now and was really dangerously sick for three months while I was away caring for my Auntie with cancer. When I got back she was nearly dead. Upon refeeding she ate meat quite a lot and seemed to need highly fatty foods like stir fry noodles with beef etc. Following weight regain after a tortuous 18mths-2 years She went vego. So yes it is ED I believe but as I was vego for six years at Uni I had lots of highly nutritious meals to make for her weight maintenance. Red lentil lasagne is great with lots of cheese and full fat milk in the sauce. Nut roast with roast veggies esp sweet potatoes using extra virgin olive oil. It is so good for you that's all we use as her ED resulted in heart problems and extra v olive oil is very good for heart. I find she likes lots of herbs and garlic. I also make falafels with a chilli salsa and tabbouleh. Lentil burgers can pack quite a lot of cheese I use brown canned lentils for those. Also I make banana apple chia bread with honey instead of sugar which she finds acceptable. Halloumi has been a favourite pan fried in olive oil. Mexican flavoured brown rice is a quick microwave option to have with that. My daughter is always trying to cut out carbs so I buy lovely multigrain bread or fruit bread and she'll eat that. Granola is good with Greek yogurt and looks healthy if you add strawberries and blueberries! We are nothing if not devoted us ed parents!! Main prob is that I went from normal to uncomfortably big myself by eating with her when sometimes not hungry!! I figure it's a small price to pay for my daughter's health and life! Still battling but she has just got a boyfriend so that is positive I think ???
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