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

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matilda_ana
Hi, I'm new here. My daughter is 15, diagnosed with AN/r since September, but the behaviors are at least 2-3 years old. She's been quite cooperative from the start, but I've always suspected her plan is to reach her target weight and relapse. 
After her last CAHMS appointment, she asked what would happen if she stopped going to her FBT meetings. I said that if she kept gaining weight they would probably watch from afar, but if not, it would be IP. I'm concerned she's going to start refusing to eat point blank. At the end of the day, even if my husband and I say she can't leave the table until she's eaten, she can always choose to sit there for the rest of the day. Up until now, we've had leverage by saying to go to school, ballet or out with friends, she must do as we say, but what happens if she's willing to give that all up, in order to prevent us from forcing her to eat?
She's not quite at her target weight, but is in the around 90% of her weight for height (though this fluctuates- losing and gaining the same 1.5kg over and over), so I can't imagine she would be admitted to IP if she were to stop cooperating.
I'm a little at loss, as all of this is merely my feelings, or imaginations of what she might do next. What happens when patients refuse to go to their meetings? What can I do maintain control over her eating if she decides that all the things she currently eats for are not worth it?
Thanks
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Ronson
I think you might be worrying unnecessarily - up until now the leverage you have used has worked.  There is nothing to suggest it won’t remain this way.  You have clearly told her that plan B is that she would go to hospital so she knows that now.  She might be testing the boundaries.  She might find FBT difficult.   My d doesn’t come to therapy sessions - she gets her weight checked and I go and talk through what has been happening.  It works for us. 

If you have a genuine concern that she will reach target weight and relapse then you need to ensure she is monitored for a longer period of time after weight restoration.  The longer she maintains a good weight the less likely she will relapse.  Get that in place now if you can —we didn’t and we had a relapse.  

We also had to get d to 104% weight for height before she reached a healthy state. 

I dont mean mean to dismiss your worries - I’m not at all.  I just think this illness is terrifying enough without worrying about what happens if things get worse.  If leverage has worked up until now it hopefully will continue to.  It did for us (sometimes with huge standoffs but eventually worked). 
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scaredmom
hi Matilda-ana,
I welcome you to the club. I am sorry about the circumstances that brought you here. 
I understand how worried you may be and at this time there is no indication that she will stop eating is there? 
If she refuses to go to meetings, you just act like it is just expected, just like everything else she does. Your confidence in the process will help her feel comfortable. 
Keep getting the food in and weight up and that may help if some of this is ED "talk". With more weight and better state a lot of that talk dissipates.

Please ask all the questions you have.We all wish to help.
XXX
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Foodsupport_AUS
Welcome. 
You have done an amazing job getting her weight back up. It is common and normal for there to be an increase in anxiety close to weight restoration where all her hormones come flooding back to add to the anxiety. There can be an up tick in ED behaviours but it is important to plough through these. 

My D did stop eating at this stage and was hospitalised within 4 days because of medical instability, acute starvation on a not fully healthy body leads very rapidly to instability. That being said using normal leverage will usually help you push through. If she is at this point though I would advise against moving to stage 2 as she is clearly not ready. 
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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tina72
Hi and a warm welcome from Germany!
I would also think you should not worry too much about that question. That does not mean she will do that. She might have only tested the boundaries. If she asks again I would say that no matter if she goes there or not you expect her to eat her 3 meals and 3 snacks and regain the lost weight to a healthy state. With CAHMS or without. She must see that it is YOU who is the captain of that ship!

"She's not quite at her target weight, but is in the around 90% of her weight for height (though this fluctuates- losing and gaining the same 1.5kg over and over), so I can't imagine she would be admitted to IP if she were to stop cooperating."
This reminds me of my d around WR and she tried to crash all my affords to get her over that damn target weight that was not correct until I asked for blind weighing so I suppose you do open weighings at the moment. If that is the case rethink that. When they do not know their weight it is much easier to get them to a healthy weight.
Get more weight on her so that brain recovery can start and you can forget most of your worries in a few months. Her state will change when she is on a good weight and then she will not want to lose the weight again.
Keep feeding. There is light at the end of the tunnel.
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