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

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sunny6
So, we have had some challenges over the last few months with our child staying in their wr range.  They had been maintaining for about 3 months with a few slips but them being able to get themselves back up in a week or so. However, the last few weeks have not been that way.  We allowed a sport with an agreement to stay in range.  The weight slipped and wasn't going up.  We had a week off and agreed that they had that time to get back to be abe to do the sport.  They were able to do that without complaint.  However  a week back from break and back into school and the weight is going down.  Behaviors have skyrocketed again and are all over the board.  They claim they only slip up once in awhile but it doesn't appear that way.

How could we do so well for awhile and then fall backwards?   Even last week looked positive since they worked so hard, but this week there is such denial of issues and refusal to accept consequences.

I have read on these boards that this can happen.  How common is this a year after being in wr range for age (e.g. on historical growth curve)?  How long before these behaviors go away all together?
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Foodsupport_AUS
 How long is always one of those really great questions. For some people it was only a few months for others it takes years, and a few just continue to struggle. We all want to be in the few months group but until the correct treatment for all people with eating disorders can be found we are left with the idea that we don't know. My own daughter struggled for around 5 years before reaching a relatively stable but not fully recovered point. She has just slowly improved from there. It is worth noting that weight continues to need to increase in adolescents to even maintain their curve. Sometimes they still have a lot of thoughts which they are not expressing and what they really need is careful boundaries and support to just keep on eating, as exhausting as all that is.
D diagnosed restrictive AN June 2010 age 13. Mostly recovered 10 years later.  Treatment: multiple hospitalisations and individual and family therapy.
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ValentinaGermania
I see my d struggling again when weight loss  appears. No weight loss not struggling. So maybe it is just due to this sports and back to school. I do not remember how old your d is but maybe she has grown. Or a puberty shot is going on. All that costs weight. So add more food and fat again and Iam sure this episode will fade away again.
How long does it take? I think this really depends on how old they are and wether they can be kept in a good weight range.
Keep feeding. There is light at the end of the tunnel.
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Kali

Hi Sunny6,

We also had some challenges with staying weight restored, complicated by the fact that my d. is a young adult. The best I can say is that it takes as long as it takes and in the meantime meal support and keeping a close eye on them could be a great way to keep things moving in the right direction.

Sometimes it feels like two steps forward one step backward...it is not a straight line. I will say that we stopped all sport for a year because our d. had an exercise compulsion. So when things seem as though they are going backwards, we found that stepping in with increased support was helpful.

warmly,

Kali

Food=Love
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Enn
Hi sunny6,
I think your child is about 14 or 15? As such, there are the normal pubertal/psychological developmental concerns on top of ED. 
So keeping up weight and navigating the “normal” teenage stuff take time, and skill too.
Are there some issues at school that maybe be upsetting? I found when d was stressed at school her behaviours were difficult and she would try to eat less.
No real great ideas, but just throwing out some thoughts.
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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sunny6
Thank you.  We are watching the growth curve and moving as their age goes up.  I believe it is associated with stress at school or a social pressure or some internal thoughts.  They won't share what it is with us, so we are left with simply saying that I am sorry you are having a difficult time right now, we are here to support you, and we remind them that they can't use these behaviors to manage their emotions and lay out consequences if they fall below range.  They need to use the skills they are learning.

While I know they are trying and we see progress, it just feels like this dance is slow.  I appreciate hearing from those where this phase lasted more than a few months after reaching wr.  For so long, we had been told once they are wr and then a few extra months, they will be back to eating normally.  So, having some realistic timelines and knowing that some kids just take longer to move through the illness is helpful.

That is probably my biggest criticism of our health care system. Everyone wants to think that once they are back in a healthy weight, all is good again.  I don't think physicians and therapists and even insurance companies for that matter really understand that this is so much more than getting them back to a healthy weight.
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Enn

sunny6 wrote:

That is probably my biggest criticism of our health care system. Everyone wants to think that once they are back in a healthy weight, all is good again.  I don't think physicians and therapists and even insurance companies for that matter really understand that this is so much more than getting them back to a healthy weight.

That statement is very true!

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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melstevUK
This is an interesting issue and one of the things that is so often ignored in eating disorders is the physiology of the patient.  Sunny6, you write:

"we remind them that they can't use these behaviors to manage their emotions and lay out consequences if they fall below range."

I simply don't buy into the idea of 'using' an eating disorder to manage emotions.  I don't believe it is ever that simple.  I heard Dasha Nicholls (one of top ed psychiatrists in the UK) speaking a couple of years ago and she said that under stress, around 50 per cent of people stop eating or lose their appetite, and the other 50 per cent will want to eat more.   I think that the types who fall into anorexia are probably the ones who lose their appetite with worry and you will often find in the families of anorexic patients that at least one parent has this response.  My own d inherited my h's tendency not to notice that he was hungry, coupled with his cast iron stomach of being able to go without food for a long time.  I want to eat more if I am worried and I cannot go a long time without food as I feel sick and need to sit down.  I simply cannot function with an empty stomach.  I never could have become anorexic in a million years.

So the point I am trying to make is that until anorexic patients are much more mature, have the insight into the illness and want to recover or stay recovered, they may not notice that they are not eating enough or are losing weight again.  I expect that your d, if she was stressed at school, started to lose her appetite or returned to not eating because it alleviates anxiety in the sufferer, with no intention of it happening.  So if patients 'use' the illness in this way - I don't believe it is deliberate.  Also, it may simply be a case of not eating enough.  Appetite which ensures eating enough does not return for a long long time usually and when it does - it seems to come back with a vengeance which is why then patients usually overshoot their natural weight too.  

As parents we have to monitor the situation for a long time, maybe less intensely as the child gets older, and any signs that the illness is rearing its head again nearly always means that the calorie intake needs to be increased.. 
Believe you can and you're halfway there.
Theodore Roosevelt.
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sunny6
I think you raise an interesting discussion.  I read an article awhile back that discusses anxiety and serotonin.  There are newer reports that suggest that those who suffer from anxiety have high levels of serotonin.  When the sufferer doesn't eat, we know this naturally lowers serotonin.  So, it brings relief from the anxiety.  I think there is some truth to this.  So maybe my wording isn't correct, but I do believe that not eating does bring some chemical relief in the brain of those suffering from anxiety.

We never thought of our child as suffering from anxiety until they were wr and since then, the anxiety has been very noticeable.  While using SSRIs can provide relief from some of the depressive symptoms associated with anxiety, for some, it actually makes the issue worse because it elevates the brains response to serotonin.  We saw this first hand.  Every time a SSRI was used or increased, anxiety increased.

There is so much more work to be done in understanding the brain.
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mamabear
We found that whenever my D lost even a couple of pounds her brain would go kerplunk. ED would rear its ugly head starting in very small ways that maybe only we even noticed. Just the way she bit into something or the way she held the food. Only we ED parents can understand those nuances. That ED sense when the hair on the back of your neck stands up. 

And once again- kids in this position can lose weight on a dime. They lose it much more easily than gain. So adding a sport back into the mix, with not enough nutrition to make up for it, equals weight loss. 

Personally I would pull her from the sport. Get the weight back up and ED behaviors under control again and put some more weight on her. Often times the weight is too low and even though ED may seem at bay, there is not enough cushion. A flu, cold, sporting event, missed meals etc. can snowball into a full blown relapse in a hurry. If you choose to keep her in the sport, then there needs to be significant food added. A daily shake perhaps?And she needs to WILLINGLY comply.If she cannot do that, then she is not ready for a sport. 

Also- getting into FULL recovery takes many years. What do I mean by "full recovery"/ I mean being able to completely eat anything, anywhere, anytime with freedom form ANY food related rules or thoughts. Being able to live a normal life. My D is there and it is beautiful. But it took many years. Form 10.5 to about 14/15 it was all about feed feed feed feed (growth, puberty etc) and then from 15-18 it was all about preparing her to go off into the world and be able to feed herself/cook/ know what she needs. 

Again- this is feedback not failure. Your daughter needs more food/fats. The great news is that this can be turned around quickly simply by upping her calories and fats. It is amazing what a change a few pounds can bring! 
Persistent, consistent vigilance!
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Mcmum
You have my sympathies.  I feed my son an extraordinary amount of food but we're  chasing a moving target until they're fully grown aren't we? When recently he was ill and genuinely off his food, I didn't need to weigh him to know he'did lost as all the behaviours came flooding back almost instantly.  It's quite terrifying but I guess this is where the constant vigilance comes in. My default is always Hagen Das ice cream , either in a smoothie or on its own.  That and never deviating from food every 3 hours.  The worst meal for us is school lunch but even then, he is supervised through snack 2 hours before and after . 
We're lucky they are with us for a good while yet to clock the change in state and pump up the calories . 
My advice for what it's worth is to try to avoid thinking about "how long" and just keep going.  Plenty of food, one day at a time . Hope the pounds you need go on as quickly as possible xx
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