Support thread 14 for parents of young people with an eating disorder

[Curlyhairedassasin]

New thread as old one is filling up

Thanks everyone. I know in reality one of us is going to need to be home. I guess I will have to see if the GP can help.

Totally agree. Also, things can escalate very quickly. ours went from 'fine' to admission to HDU within 2 days. It's scary how quickly things can tip. Don't take this result as reassuring @SisterMargaretta

@SisterMargaretta I got signed off with stress for 4 months (To be fair, I was very stressed!). Glad you are in touch with Beat - they are great and have so.excellent online courses.

Hello all, I have a 13 year old AN daughter, diagnosed this summer. We have not made much progress with weight restoration (she is currently very low wfh, off school and sofa rest as much as I can manage). Currently struggling to get much more than 1500 calories into her. I’d love some meal ideas if anyone can make some suggestions please. She is vegetarian (partly caused by the ED I think but she’s always had anxiety around meat being cooked properly), and doesn’t eat eggs, bananas, hummus or nuts.

@SendTheNextOneIn We were in a similar position and have been prescribed Fortisip Compact. They're 125ml each, so a small amount, and contain 300 calories each. My DD 13 has 2 of these a day and 3 if she's been at school. It's not a long term solution but just helps us get enough calories in her. She's never been a big eater and has never been keen on cream or fatty foods so these drinks have really helped us. She was at 70% WFH when diagnosed late August and is now at 78%. It's slow but steady progress.
Alternatively I'd suggest lots of cheese, pastry, pesto, full fat dairy! Best of luck

@SendTheNextOneIn Are you home cooking? If so, just enrich the food. Porridge with double cream instead of milk, cook stews and add in oils, butter double cream. when I cook rice, I add a generous portion of butter to the rice water. Will she have smoothies? Again, add couple cream. Just try to create energy denser meals rather than bigger portions. That's what we do. There was also a time when DD had milk regular and we would decant over half of the bottle, fill it up with double cream, give it good shake and back into the fridge. Build it up slowly though otherwise she will notice.

@Itsendless thank you. I wish she would tolerate a supplement drink, I think it would really make a difference. Liquid calories are a big fear for her right now, but I am going to go back to our dietician and see if she can suggest some to try again.
I’m trying so hard to add fats to everything and making sure she’s having yoghurts etc but every other day it feels like there’s something else that she now ‘doesn't like’ and I’m just getting worn down with it all.

My DD is similar, prefers veggie foods - she likes avocado so we do Mexican chili/nachos/tacos with cheese on top and as much guac as we can get her to eat. Baked potatoes are good so you can mash butter or cream in then cover with beans and cheese. She found smoothies more bearable than solid breakfasts for a while and they came with a good scoop of haagen dasz blended in, or honey. Fresubin drinks are more palatable to her than fortisips and I don’t think we would have managed without them in the earlier stages when she wouldn’t attempt meals.

Also, as this is something that’s come up a lot now that I’m starting to be more assertive with the meal plan, what do you say to your young people when they’re getting distressed about weight gain? I’ve not figured out what the right thing to say is for that yet.

@SendTheNextOneIn we are not talking about weight of weight gain in any shape or form. I just reiterate that she needs to eat the plan. It don't work always for us and we had hospital admission for refeeding (including NG tube). Does she find distraction during and after eating helpful? DD likes to watch clips on her phone, we sometimes go for a mini stroll afters or watch somewhere together. just anything really that distracts from the fact that she has been eating.

@SendTheNextOneIn Eva Musby has lots of advice (on YouTube or in her book) about practical strategies, what’s right for one child may not work even at the next meal, let alone a blanket approach. I had to sincerely promise DD I would not let her get fat, but I would always give her what her body needs to be healthy. Over and over and over…

@SendTheNextOneInif she liked a food pre ED I would ignore any protest about not liking it now as being purely ED led.

Eva Musby is good for strategies on what to say/not say.

Can you make things like flapjacks with butter, this would pack a lot of calories.

There is a 1000 calorie porridge which is made with double cream with blitzed fruit.
Is she having 3 meals and 3 snacks?

All meals need to be at least 800 cals and snacks 200 to get to 3000 calories a day. This should give you a decent weight gain each week.

Is your dd on any meds? If you’re stuck there is a medication that can help quieten the anorexia voice a bit (my peri menopausal brain can’t remember what it’s called though 🤦‍♀️)

She’s having 3+3 yes but we’re nowhere near those numbers. I can usually get approx 200 cals into her for a snack but meals are more likely around 400.

I have the Eva Musby book, and some others, but literally nothing I can say will compel her to eat more. She is on olanzapine, currently 2.5mg every other day, but I’m not sure it’s making any difference. We have an appointment with our psychiatrist on Monday so I’m going to ask about increasing that.

she will just not accept she needs to stick to a meal plan, plus with so many foods on her ‘no’ list, I’m fast running out of ideas.

we’ve just had a couple of weeks in hospital as her heart rate and blood pressure are low, and she managed to do well enough with her eating to get discharged, but now we’re home it’s just all gone to shit again.

Also doesn’t really help that my husband is not coping with this situation. He feels pretty useless as it is, as I am her safe space and the one doing all the food and appointments etc. I’ve been signed off work for the last six weeks so far, he’s still working. Daughter got distressed at lunch today and told him to fuck off and go live somewhere else, as he was trying to diffuse the situation, but obviously that’s hurt him a lot and he’s not happy with her. So she’s upset because he’s upset and it’s just been a crap day all round.

@SendTheNextOneIn I used to tell myself it’s not her talking, she’s ill. It’s really important- and really hard - for the adults to stay calm in the face if abuse and sometimes violence from our children . They are not in control of themselves and they need us to be their rock.

practical things : 2.5 mg is a low dose of olanzapine, 10mg is a common maintenance dose. That can make a difference. Many will also take antidepressants but again important to take a clinical effective dose or might as well not not bother.

we also use food supplements - was all je time, now just a snack. Useful because they are balanced food and she lnows exactly what they are

Its so hard. Animal fats are best. So as others have said, full fat dairy is a must. Add double cream to everything. It is very calorific. I added it mash, smoothies, porridge, milk drinks, yoghurt, creamy pasta sauces, anything really.
There is no right answer to the weight gain question. I used to just say something like, i can see this is hard for you, but this is what you need to eat, to makr you healthy. Now please eat. On repeat. And blind weigh. And up the olanzapine. We started at 2.5mg and went up to 5mg quite quickly.

@SendTheNextOneInI think if she’s not following the meal plan and is at such a low wfh I’d be thinking about whether she needs an inpatient bed.

It is exhausting and I’m not surprised you’re feeling worn out, caring for a child with anorexia is relentless and soul destroying 😢

My dd could be absolutely vile when she was in the grips of anorexia but I knew it wasn’t her talking, has your dh also read the Eva Musby book?

@Girliefriendlikespuppies I think inpatient may be where we’re heading to be honest, we just can’t seem to manage it ourselves. If anyone has any experience of this and can give me some insight I’d appreciate it thanks

@NanFlandersdd was inpatient for a while, from memory it definitely helped turn things around but if Nans about she’ll definitely be able to give more information.

I remember each day there would be more things my dd wouldn’t eat. She has been an inpatient for ten months but out now. She eats all her food now but won’t tolerate any oil or fat at all. The ED is still there but she just has these big meals full of veg and weight remains stable.

@SendTheNextOneIn DD was impatient a few times (1 month and 6 weeks). duration depends if you get a place at en ED unit which tend to be much longer. We were only ever admitted to general paeds for physical stabilisation and re-feeding. DD is on olanzapine (10 mg) antidepressants. 2.5mg every other day seems very little. I would discuss an increase of dose.

@SendTheNextOneIn Ahh it's so tough and stressful. Would it help if someone in authority (dietician etc) told her she needed Nutritional supplement drinks in order to ensure she's getting all the vitamins that her body is short of? The focus being on the vitamins rather than calories.
If it's a firm no to the drinks then it needs to be a full veggie diet that includes nuts, hummus, eggs and anything else she's trying to exclude. You're stuck in limbo at the moment

We do lovely so please feel free to message me x

That clumpy sweet granola is good with full fat yogurt. Also lied through my teeth to Dd about all muesli being “non fattening”, Avocado and cream cheese on bagels.

We work at home and the diagnosis of AN coincided with gcse study leave so between us and using musby magic plate method we broke the AN. She’s now 91 wfh eating normally off her own bat but we will never be complacent again.

@SendTheNextOneIn As @Girliefriendlikespuppies says, My DD was inpatient in a general ward 8 times and in an ED unit (that she absconded from twice, ending up in another unit when the police picked her up). I'll PM you my number and would be very happy to chat. She is now doing great - started at Oxford uni to study experimental psychology last week and enjoyed pizza night last night. Inpatient wasn't nice (in fact the unit has since been closed down), but it was what she needed - rock bottom was her trampoline. She also made a couple of lovely friends and there, one of whom is travelling the world and the other is studying mental health nursing - so also doing great. Don't give up hope - it can really be a turning point.