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

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It's been a bit since I posted.  D is weight restored as of Sept. Dr. and therapist are wowed by the progress, however I'm sensing a relapse.  D is in peak of stress...college applications due, homework, etc.  D is in phase 2 and I think without realizing it, she is slipping back into old ways.  She only knows the anorexia way of eating independently and it's not good.  Therapist called and said we need a weight check.  She's back to her crabby, everything is an argument, super sensitive, perfectionist ways, and this is how it all started.

How did everyone transition to phase 2?  I don't think she knows how to prepare food properly!  She was trying to make her own dinner one night, and I said...you will eat what is prepared for the family. period.  She was agreeable to it, although, she is sneaky...before phase 2 I could barely get her to table to eat before she left for school.  Now it's the first thing she does before she gets dressed.  She eats before anyone is awake. Her period has started however she has yet to have a second one.  

Any advise about relapse and how to handle phase 2 would be greatly appreciated.

Happy Holidays!

I don't know if this helps but we are just beginning to transition into phrase 2, but only doing supper.  Our dd is allow to chose her own supper and have a go at the amount.  We have told her that if we notice any ED behaviours i.e wanting to have low fat foods etc we will take the reigns again.  She has begun asking for other foods when at the supermarket this week (not low fat) so we seem to be going in the right direction.  She has needed some support which the amount of food required for her supper but has got the hang of it now.  I don't think my dd could do more than one meal at the moment, so supper is enough and I have read on here that phrase two may take a long time and sometimes you have to go back to phrase one, I am sure others will have more useful advice.  Congratulations on getting to phrase two and have a good Christmas.
17 years old, well into recovery and taking full control of food herself and gaining weight, she's loving life at the minute, it does get better!!
Phase two is by far the hardest phase.  For us, it's been trial and error. We started by giving back control over a single snack, then two snacks....when weight dipped, we tightened the reins again.  It's like two steps forward, and one back (or maybe two).  Then, slowly give back control to her.  It's definitely a process.

And, as I said elsewhere just now, my D can slip right back into ED thoughts and behaviors with only the smallest of weight losses (a couple of pounds).  Keep her above the 50th percentile, and her mood is good and she makes good choices.  But, even a tiny slip back, and BAM, it starts all over again.  The difference now is that she is getting better (better, not perfect) at recognizing this and self-correcting with larger snacks, larger portions, etc. 

Also, I will just say this.  If I don't see it (portions and food), it's a good guess that my D is exaggerating or flat out making up what she eats.  She must SHOW me all portions she is eating.  She can choose, but it's a "trust but verify" system here.  If I don't make her show me, her ED will mislead.  But, if I make her show me (hold her accountable in other words), she chooses much more wisely.  
D, age 18, first diagnosed March 20, 2013, RAN, at age 13 Hospitalized 3 weeks for medical stability. FBT at home since.  UCSD Multi-family Intensive June 2015. We've arrived on the other side.  :-)  D at college and doing great!

Go slowly. One tiny step at a time, and only when d is consistently able to do that without difficulty, proceed on to the next. A good first step would be: have her pour her own drinks. Or, have her plate her own dinner. It is AMAZING how hard these things are at first, how long they take, how hard ed will try to take less. 

Remember, and repeat to your d, that both you and she have the same goal: for her to be able to take care of herself on her own. She wants the "on your own" part, you want the "take care of yourself part". IT works. You both want the same thing. Just repeating that got d and I through many a tough discussion.

I weighed d weekly at home. I don't understand how it would have been doable otherwise. You need the feedback. You have to wait until you go to the t? And it's only every few weeks, randomly? Wouldn't it be better to weigh BEFORE the t suspects a problem? Consider changing that plan.

It took d a LONG time and a LOT of steps to be able to completely eat independently. 2 years. If that sounds long, well, it was, (read some of my old posts if you want to find out how crazy impatient I got) but I point out that in those two years d's weight stayed stable and she did not relapse ever and she is now in remission.

Do you have plans for how or whether your d is going to transition to college? IT sounds like she will need a very great deal of support, if she is even ready at all. 

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.
Dear TM,

Based on our recent experience with Phase II and III (got there and then had a little dip), you have gotten very good advice.  Similar the wise ones above, my list would be
  • take it very, very slowly with the independence
  • Don't let the T push too fast
  • Keep an eye on the weight, even if you have to do it at home.
  • Make very sure that D (or S for other parents) understands that 'WR' is temporary, and that the number will continue to go up until well into young adulthood.
  • Keep up with the medication if that has been in place.
  • Continue to work with any unchallenged fear foods
  • Consider switching to blind weighing if weights have been known. (I just think that it was too early for my D to see such a 'high' number as her weight was naturally creeping up. And I think that it would not have been an issue after a few more months of brain healing, but it's all speculation, of course.)
  • Set goals that must be reached and conditions that will be in place before moving out.  Regular monitoring will, I think, ensure my D remembers how important it is for her to keep her weight up.  And she knows that she will have our financial support only as long as her weight is good.

Do remember that you have done a really good job so far, and you want to continue to make even more progress.


D in and out of EDNOS since age 8. dx RAN 2013. WR Aug '14. Graduated FBT June 2015 at 18 yrs old. [thumb]
After discharge from 4 months IP in Oct '14 we very quickly rushed into trying to allow my d to prepare breakfast and then lunch. But after a month or so it became abundantly clear that she just couldn't manage to prepare her own food. Gradually she started choosing the smallest glass, the smallest portion etc etc. We simply told her that she wasn't well enough to prepare her food just yet and regained control of all meals. We thought we would have tantrums n tears but she just quietly relinquished control back to us. I think deep down she knew she couldn't do it or was relieved to not have to deal with the guilt that AN made her feel for feeding herself. Looking back now I think we were trying to rush the process. I now think stage 2 simply takes alot of patience and time. I have accepted she cannot feed herself and mostly cannot make any decisions regarding her food intake. Thankfully she has accepted our control over all food related matters. Of course weve had our fair share of bust-ups over food but the bottom line is that my d knows that if we say something needs to be eaten she will habe to eat it. I would advice to keep all control of food, supervision of meals, keep your d away from all food prep or preferably out of the entire kitchen altogether. Don't rush the process until you are entirely sure she can handle it. And if she can't, simply regain control until she is. I don't know when,or if, my d will ever be able to feed herself but I'm hoping that if we patiently give her all the time she needs at this stage I'm hopeful she will eventually move on. For us, things started calming down once she was truly WR...not the usual 50% the medics were happy for her to remain at. I found judging the health of her face more than on her body coz whilst her body was a lovely shape her face was still looking ghostly. So we were guided by her weight charts and the healthiness of her face to find her target weight. As I see it, stage 2 is just a waiting game whilst ensuring that you maintain your brick wall defences at all times and shoot down any attack from AN whenever it chooses to rear it's ugly head. Well that's how I'm fighting the battle. Hope its the right war tactic to defeat the enemy. Hope some of this might help. Wishing you all the best in your fight.