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

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sunny6
Our d has been wr for 8 months. She has restrictive an with purging. She has been under tight supervision for purging for a year now. Recently, she lost weight and admitted to purging after we started to reduce the one hour supervision. Her weight was higher this summer and then came down a few pounds and seemed to stabilize. She is back at that weight after her couple of weeks of weight loss, but has become argumentative, refuses to participate in DBT therapy, complains about food (that has never stopped), and refuses to talk about her thoughts or emotions. She is insistent that she can do this by herself. She is 14. She had to do IOP 5 months after wr to try to resolve some of her issues that came with an. However, it feels like her mood is going backwards. I have increased her meal plan, but the weight isn't moving. What do we do at this point?

I fear that she is headed to a residential program as she refuses to stop the behaviors and the arguing. She displays a lot of BPD behaviors and the therapist believes we need to institute consequences for her continuing to engage in the behavior. If this is genetic, how to you implement consequences on something she truly may not be able to control?
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mnmomUSA

Are you SURE she's weight restored? Remember that the initial weight restoration target is often set too low, even by so-called professionals.  We had to push my daughter's initial WR goal about 5kg (10 pounds) higher than was originally set before we found TRUE weight restoration.  Before that, behaviors and thought processes persisted.  Once we add that 10 pounds, the difference was night and day.

At 14, your daughter cannot do it "herself."  We maintained FULL control over my DD's weight and what she ate (she was diagnosed at 13) until she was 16 years old.  Did she like it?  No.  Absolutely not.  But, today she is one month shy of 19 years old, living fully independently at college.  She is happy.  More importantly, she is HEALTHY.  The hell we went through from 13-16 was worth every tear I shed to get her to this point.

If you are feeding her more, and the weight isn't moving upward, there's loss somewhere...ditching food?  Purging?  Secret exercise?  If you are sure that none of the above is occurring, then adding more food is the only solution.

Wishing you much success....hang in there. Persistence is key!

ETA:  What helped us to get us over that last 10 pounds was to use the contract we got at UCSD.  My daughter got "1 point" for every meal/snack she finished in it's entirety within allotted time limits (full meal compliance). That was a maximum of 5 points per day.  If she got 32 points in a week (perfection would have meant 35 points possible), she earned an award.  Something she helped select.  Compliance for 10-12 weeks in a row earned her a BIG award (in her case, a new iphone, but it could be anything motivating to your child).  She also had negative consequences for failure to meet the short term goal...for example, failure to fully finish a meal/snack meant she lost her electronic privileges (phone/computer) until the next meal/snack.  Between the positive rewards and negative consequences, it worked for us.  Note that all of this was negotiated with her as part of the UCSD program so we had full buy in from her from the beginning.

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!
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sunny6
Yes. We put her back on her growth curve and had her bmi at 25 before she grew (which she did after wr). So, her bmi is lower now, but around 24. She is not completely back to her predicted height, so many have argued where she really should be in terms of weight and bmi.
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Torie
I'm with mnmom in questioning that she is (or even was) weight restored.  My d is also among the many who had to go significantly above the number anyone expected.  It just really sounds like your d needs more weight - just my opinion. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Enn
Hi sunny6,
I agree about weights needing to go up in general, so you have done well that she is near her historic BMI. "She is not completely back to her predicted height, so many have argued where she really should be in terms of weight and bmi." Maybe more weight would not hurt?
 It does take a long time for the brain to begin to heal.- years not months to get near recovery.
 
My D has been WR for just over one yr, but that was at the "first WR goal" set by her medical team, I went higher and higher ,she is now at 12 kg more than the first WR but she is only 13 and still growing. At 4 (WR+6 kg) months after WR, I saw her moods get better but still some issues. Now she is a lot better,but I have began to notice that when there is "something new" ie starting school after the summer, new friends, new experiences (ie this week a new hairdresser) her mood is,let's say, difficult, and argumentative. I am trying to figure if that is ED or normal adolescent behaviour (snarkiness) or anxiety or all of the above. I am trying to get her to eat more this past week just to see.So when I saw your post about some similar concerns, I wondered if there may be  something new in your D's life? School, friendships, etc that could be contributing to her stress?

At 14 I hope no one has diagnosed her with BPD as many BPD traits are "normal" in childhood (experimentation, mood lability, etc). These traits get better with maturation and that is a better time to diagnose BPD ( My older D has a diagnosis of BPD- although I still have my reservations).

I wonder if it is a matter of time and more time and more food to see the healing? 

Sorry, just throwing out some random thoughts. Take what resonates with you and throw out the rest. [smile]
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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Enn
sunny6,

I just went back to a couple of your old posts and there was a significant concern about SH. Is she on meds? Does she need meds?

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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Mamaroo
I agree with the others to keep on feeding and supervising for a very long time. My d is now 12 and I'll be plating her meals until she leaves home, same for my other daughter. As for the BDP symptoms I agree with Scaredmom, that they are normal childhood and teenager behaviours. D's sister displayed some of them, always arguing, depression, anxiety etc. We applied rewards and consequences such as whatMnmomUSA suggested for the ED. I addition I changed my parenting style and it made a huge difference. I explain and request less and tell more. For example instead of saying "There are people coming over for lunch and I would like the family room clean so that we can chat there, would you please remove your books etc for me, ok?" I just say "please remove your books, please". No explanation means no arguing. Very similar to the way I speak about meals and food.
D became obsessed with exercise at age 9 and started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. View my recipes on my YouTube channel: https://www.youtube.com/channel/UCKLW6A6sDO3ZDq8npNm8_ww
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sunny6
We took her off the meds this summer. Since then, the sh has reduced significantly and actually the up and down on the moods is much improved. Now, it is a lot of body image and weight gain talk and arguing over the meal plan. Also, just seems like a lot of anger when clothes don't fit right or she is having a difficult day for one reason or another. That is...until she needs something and then the mood is quieter. She eats what is given and can pick out reasonable snacks.

I do feel that the willingness to do therapy was better over the summer than now and I have a feeling it is between the social anxiety of school and these few pounds that she lost while everyone said that this is her body finding it's natural weight
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Mamaroo
It seems she is trying to figure out who she is without ED. My d went into ED as a child and came out a teenager. Even without ED I think it's hard to figure out how to transition to adolescence and even more so with ED. Maybe the therapy reminds her of when she was ill and she wants to put the memory of it behind her. My d doesn't want to discuss anything relating to her illness, saying she was a different person then. I do think it's brilliant that she is able to eat what you give and to pick good snacks, you've already come a long way, well done!
D became obsessed with exercise at age 9 and started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. View my recipes on my YouTube channel: https://www.youtube.com/channel/UCKLW6A6sDO3ZDq8npNm8_ww
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mjkz
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If this is genetic, how to you implement consequences on something she truly may not be able to control?


Having an eating disorder is genetic but that doesn't mean she is unable to curb her behavior.  I agree with her therapist that you need to start limiting how much of the behavior you're willing to tolerate.

Many different diseases have a genetic basis but that doesn't mean the person can't control them.  For instance diabetes has a very strong genetic component.  Can the person with diabetes control the disease?  Yes he/she can by the use of insulin, eating the right foods, exercise, medical follow up, etc.  Just because something is genetic doesn't mean it is not controllable.
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