So sorry you are stuck at this impasse. The last few kilos are often the hardest to get on. If you don't mind me asking, what is your child's height and weight currently?
As with so many things with this illness, logic doesn't seem to work. When we were refeeding I actually stopped talking about weight completely. Not a word about it. Our d. went to the dietician once a week during that period, where she was weighed, and portion sizes and what she was supposed to be eating was discussed, and I checked in with the provider once a month or so to see if we were still on track moving in an upward curve.
We also had a situation where LSUYE didn't work. In a broader sense that is what we had to do by placing our d. in a treatment center and pulling her from school and all activities, but before that when I tried to do LSUYE at home it was a dismal failure and we had similar situations, her doing everything to keep busy out of the house and avoid meals.
What type of professional help do you have at the moment?
I spent the first 9 months running after her with a plate of food while she lost weight, and finally it got to the point where she had to be admitted. When she came home we found that we made more progress when I simply just served all the meals and talked about anything else besides the fact that she had to eat and ED and any consequences of not eating. Meals became a sort of safe space where I never talked about anything difficult but tried to make conversation about interesting topics, played some soothing music in the background, used nice dishes, used the time to connect with my daughter and put some flowers on the table. I also bumped up my cooking game and tried really hard to prepare meals that were delicious and looked good. This was of course AFTER she came out of residential treatment where she had been for 3 months. Somehow they made the point to her that if she didn't eat then she would die and after that things were better at home than they had been even if she was still obsessed with loosing weight and was not cured. It took a long time of consistent meals and there were times when it was one step forward and two steps backwards. It was not a situation, for us at least, where she was weight restored and then magically she became well. It took a long time and there was a comorbid depression.
Sometimes anger in a teen can be a sign of depression... has your child been evaluated for that?
They agreed this morning that they will go to programming in 3 weeks if they can't figure this out.
So this is a step forward. You have drawn a line in the sand, and you can follow through on this statement.
You can wait the three weeks and then if there is no improvement, take the steps to make this happen. Perhaps even start looking into it now so that you are ready to move on it if they are not able to become more cooperative about meals during the time period you have described.
One thing that we did when my d. came out of treatment (and I'm not suggesting that this can work for everyone but it did for us) was that we continued what the treatment center had been doing. After patients had been there for awhile and were weight restored, they were given a menu once a week and then ordered their weeks food. I should add that my d. was 18 at that time, so on the cusp of having to figure out how to eventually feed herself. They had a couple of choices for each meal and all meals had the appropriate calories. Before she left we met with the dietitian and she had our d. create a menu for home that she would want to eat by choosing 7 breakfasts, 7 lunches and 7 dinners. The dietitian vetted that they had enough calories and nutrients, and I brought that list home. So when she came home we sat down every Sunday afternoon, created a menu for the week, then I did the shopping and we stuck to it. I hung the menu on the fridge so that she could see. It helped me to organize things and it helped her to know what to expect. What I'm going to suggest is that perhaps you could think about which meals your child seems to be able to eat without too much fuss, and as long as they have enough calories, try to make a list of the meals to serve for the next three weeks. You don't have to share it with them at this point, but just be super organized and have the meals and snacks ready to be eaten. But if you feel that it can be helpful for them to know what the expectations are, go ahead and post a menu on the fridge and open a discussion about the menu with them. I know that flies in the face of conventional FBT however it was something we did when our d. was weight restored or mostly weight restored. Also, talk to them beforehand about their schedule for the week and make sure that you leave enough time before they leave the house so that you can serve meals before, by planning the meal times and letting them know. I too remember those excuses about "I have to get to this activity" and then running out of the house. High school can be a very busy time. I did plan meals around our d's schedule since that is real life: as adults, we have things to do and need to get our meals in around some of those activities and eventually they will need to be able to do this. I know that there is a way forward which can lead to health for your child, and for repaired relationships in the family after this challenging time.
sending virtual hugs and hopes that they will be able to make progress.