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How long to limit hyper-palatable foodsOpen in a New Window

I've been reading Julie O'Toole's book: Give food a change and specifically about her recommendation of limiting hyper-palatable food. In our family (both sides) we tend to binge, either out of boredom or due to stress (even before ED made its appearance). Reading her book and realising that hyper-palatable food could cause binging, I then hid or completely eliminated them from our home, however the binging didn't stop. Apples, celery and even ice got consumed in large quantities. What did help was having 5-6 regular meals a day.
One of my D's greatest fear now that she is eating and gaining weight is that she would start to binge. I reassure her that I would not give her hyper-palatable food (for now) and that binging on celery/apples would not make her fat. Obviously at some point she needs to be able to eat sweets, ice cream, chips etc. to completely recover. Do any of you have experience with limiting hyper-palatable food during weight restoration and how long after weight restoration have you introduced these foods again?


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Tackling OCD behavioursOpen in a New Window


The mystery as to why our D takes so long to drink anything has been turns out she 'has to do things in fives' (therefore five sips at a time only). This is a new behaviour, i.e. since the ED developed, not before it.

I know that OCD symptoms very commonly co-occur with eating disorders. For those of you who who have experienced the same, do the OCD behaviours tend to vanish with the brain healing, or have you found you've needed to work on them separately?

I guess this is quite a similar question to my previous ones about restricted range, insistence on shot glasses etc. (BTW we've totally broken the shot-glass habit).

Thank you x


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Suggestions for care in MN for 14 year oldOpen in a New Window

First post.  My 14 year old daughter diagnosed RAN September 2016.  Have been at Melrose outpatient, then 4 weeks inpatient, and now 3 weeks out patient.  Have been doing FBT.  Upon discharge from IP they suggested an additional CBT, DBT intensive program at another hospital which we are doing also.  Treatment at Melrose and FBT seems to be not working for us.  I had an assessment at the Emily program on Friday and they recommended inpatient but they will not have a bed for 3 weeks.  We are having a horrendous week regarding refeeding.  Can someone tell me about their experience with Childrens?  Do they have an intensive program or partial hospitalization?  Can they offer modified FBT if traditional is not working


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New challenge....Old problem.....Exercise....Exercise...Any ideas?Open in a New Window

My daughter(21) has been ill now for 5 going into 6 years with severe restrictive anorexia. Multiple relapses, hospital stays, IP, Compulsive exercise but turning her life round at a Bmi of 12 last year. She herself with support from us as a family, this forum and feast website has supported her in starting to eat (with all the daily battles and ups and deep downs), reducing her exercise and to now have a Bmi of 16. We are still in the process of daily minute by minute trying to move forward, refeeding the ongoing process and working on numerous issues. The latest (apart from all the other issues) she now wants to join a gym again. I am absolutely against the idea and are trying to remind her of the hell she has been through with the unrelentless urge to exercise before and that all the advice is not to exercise untill patient is well established in weight restoration but she is adamant. Any ideas how we can resolve this matter? Thank you all for your amazing support and please know that my thoughts are with you all in your battles too.


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Are goal weights set deliberately high? My dd is struggling with hersOpen in a New Window

Hi everyone, thank you again for the feedback given here, it is so helpful. 

My 12 dd was dx'd just under three months ago with orthorexia. After a weeklong stay in the hospital, she began weight restoration and is 2 lbs 2 oz from her goal weight. She has made good progress as she is given more freedom over her eating choices and eating with less supervision. 

The issue we are having is that she is so uncomfortable in her own skin. Her weight has concentrated in her belly. She is very athletic, loves sports and did even before she became eating disordered--the added weight makes it hard for her to move. We have told her that weight will redistribute but it takes time. We don't want to overly focus on her appearance (for obvious reasons) but her weight goal gives her an appearance that she never had even when she was healthy. Normally she is a body type that is maybe a tick up from athletic--kind of nicely padded but absolutely not stick thin. She has concerns that she will never look like she did even when she was at an appropriate weight. 

I assume that doctors set a goal weight/BMI that is much higher to allow for relapse? Will she always look this heavy or is the doctor-approved trajectory one that allows her back to where she was on the growth chart plotted by her doctor, where she was "just right" in terms of appearance and growth curve? What leeway do doctors give if she slips a pound or three below her goal weight?

Thanks very much in advance for any feedback.


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Diagnosis and new unitOpen in a New Window

My D is moving to a new unit - her emotional dysregulation in her EDU was not treated and as she gained weight, her moods became more extreme, violent and self-harm has rocketed. Although she is eating breakfast, lunch and snacks she cannot complete dinner and has to be restrained for one NG feed which results in harrowing behaviour followed by an injection because she is no longer complying with medication orally. 

The spiral has been frightening, made worse by a negative view of the psychiatrist who says my D has BPD traits and that my D keeps sabotaging her recovery - which may mean a very long stay in hospital and possibly life in hospitals.

I know that my D really needs DBT support and I hope that the new unit will provide that. DBT is what my D has wanted to do the whole time however she didn't rate the DBT that was specifically for eating disorders .She actually wanted to go to a general CAMHS with eating disorder help because she felt that the mood dysregulation underlies her anorexia. This new unit apparently tailors treatment for each individual however I am worried because the unit that she is going to (an HDU) has mainly long term patients who have been there a year or two (with one patient there for three years). I'm anxious that my D will spiral down further, learn new behaviours and aim for the 'illest' of the all and the 'real' anorexic. 

Maybe I'm being very pessimistic but I had a day of hell at her current unit yesterday. Has anyone had any similar experiences of this? 



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Remembering my first ever post on ATDT & the first person to reply Charlotte Bevan!!Open in a New Window

Dear ATDT,

Today I remember the first post I ever made here & the first person to reply, our dear & darling Charlotte Bevan!!


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Exercise- too much? Too Little? getting the right balanceOpen in a New Window

Can anyone share their experience with balancing exercise with ED?
My daughter is eating okay and has been for the last 3 weeks after a 2.5 week hospital admission. Her weight has been maintained during this time- sometimes a little up and sometimes a little down (`150gms). We walk each day about 3 kms in the evening which gives her time to download about anything that is causing her anxiety. We are aware that she wants to do secret exercise- extra crunches and mountain climbers . I have said she can do 50 crunches with me present but if I find her doing it in private she will have to eat something extra as a disincentive to secret exercise. What are people's experiences and thoughts on this?

Thanks in advance for your input.


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ERC. Greenville SCOpen in a New Window

Any info/ reviews on ERC in SC? They have an IOP and PHP options. Thanks!


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Help for a longer term suffer and familyOpen in a New Window

Hi members, I'm new to the forum and have been suggested i sign up to see if there are any glimmers of hope or advise members can provide for both suffers and the family of a long term suffer in New Zealand.

My sister has been suffering from Anorexia for the good part of 15 years since she began High School. Through out the years she's been admitted against her will under the Mental Health Act approximately 6 times throughout the early years of the illness. After 7 years of this the specialist basically informed us that they had exhausted all options and because my sister was not willing to accept treatment there as nothing else they could do for her. They have since gone down the track of monitoring her vital's by taking bloods and monitoring her neutrophil levels. They will not intervene unless shes hits 0.5 or below.

She resides at home and has breakfast, afternoon tea, dinner and fruit as dessert. For lunch she has a supplement Fortisip drink. Over the recent few years we've caught her throwing up and purging her food. We are vigilant about this and try and take measures to ensure she has the least opportunities to do so, though as many will know, suffers will always find a way to cheat or hide things. Her eating habits are now getting worse, we suspect she is throwing up more, she's leaving more food on the plate, she smears food between her finger tips, as she is not home for lunch we are certain she does not drink her supplement. She is also very weak now, for example when entering a car she needs to use her hands to help lift her legs into the foot well.

We recently met with her main Doctor at the hospital who reiterated that there was nothing more they could do for her. I would also use the phrase that they were scared of her also. Over the years she has been studying at university and has accumulated a fountain of legal knowledge regarding her rights and legal implications of health professionals who currently care for her and her family members. I've recently been threatened with 'Your not my guardian you have not right to tell me what to do'.

So the health system seems to be too scared to do more in fear of any legal proceedings she might do against them and we as a family have our hands tied as the hospital is not willing to do anything to help her and my sister is not acknowledging she has an illness which needs urgent help.

I have a few question for members, after providing you an overview of the situation, they are:

- Are there families out there in the situation as us and how do you cope with a family member with such a long term illness who doesn't accept they have one

- Are there any nuggets of help or support people have found useful for families in our situation

- Can a hospital do nothing, is there anything further they could do? Do we have any legal rights

- I have suggested my parents seek some form of counseling, however this would go down like a cup of cold soup if i suggested this. Are there good techniques to suggest this to them? 

Thanks so much for your time and i look forward to reading your responses.

From a hopeful brother


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Young children with ED - literature?Open in a New Window

Hi, do any of you know of any books specifically addressing EDs in young children (let's say pre-pubertal)?

A quick amazon search has yielded nothing.

I'm reading everything I can on here by members whose children were young at diagnosis. However, I'm finding we are falling between so many gaps in the service because the professionals in our city really have no/very little experience of ED in children as young as our daughter (8).

I'm assured that she's medically stable, but at the same time nobody really seems sure which tests to conduct. Nobody can agree how many calories we should be aiming for (I've asked around a lot). Nobody can assure me that she's growing ok.

It's frustrating.

If there's not a book out there already, I will seriously have to write one myself!


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How long it takes for total recoveryOpen in a New Window

Hi all,

First, thanks all posts in this forum which help me a lot when fighting my d's AN. I was trying to post several times before, but deleted since English is not my native language.

My d was diagnosed AN in June, 2016 when she is 13.5 years old. We were trying to feed her at home for three months, that was darkest time in my life, she was always angry when talked on food or eating, she cries everyday (so does her mom), as Dad, I need to take care both D and my wife (my wife has anxiety too). At Sep, we sent D to inpatient program (19 days) and residential program (60 days). She made huge progress in there, as my option, gained wight (30+ pounds) eliminate most her ED behaviors, and medicine fixed her depression and anxiety. Now she is in home and back to school, life is peaceful again, she can follow meal plan without much push, she even start buy lunch by herself without monitor (she still need talk to me what she will buy in morning, and report me how it is going after school), she is happy all day and make new friends. All seems good, but I knew she is still counting calories and do not want eat extra, not sure how long would take to full recovery?




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Rabbit hole - there you are!Open in a New Window

Yes, my D has found her way back to the rabbit hole.

Combination probably of meds - Wellbutrin takes away her appetite but works kinda for depression. Vegetarianism - I know. Turning 18 - "I have my own money and I'll pay for college or take a Gap year.  And, I don't have to tell you what's going on with me medically because I won't give permission." Denies it, but is lying about food, not eating lunch at school (still a senior). Eats at home because I'm on her, but I have to really be on her.

I've reached out to DBT individual and her dietician. So, the journey continues. Don't worry - I'm up for it. Just not sure how exactly it will go. My poor younger D - her teen years are so affected by our worry about her older sister, and that makes me so mad.

So families with minors... heed our situation. That's why so many families on here advise to be brutal in going after the ED. Hard to do, no doubt, but absolutely vital advice.

I don't mean to be a gloomsayer -lots and lots of families have great success stories. We will too eventually. But, it's to maybe spark realization that there's no negotiating with an ED when you have the power to stomp it out in a minor. Don't wait.


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Zyprexa/Olanzapine medication: for how long?Open in a New Window

our 12 years old d is under 5mg Zyprexa daily since about 8 months to reduce her AN ruminations. It seems to be helping her quite a lot and she does not have any side-effect either. The medical team is advising to continue as long as needed.

As parents we are however worried about long term implications/side effects of such medication...

Are you aware of any study on this? For the ones experienced with this medication: for how long was such treatment used? how was the transition off the medication? anything to worry about?

thanks for sharing your experience,


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'If I couldn't purge I would want to kill myself'Open in a New Window

'If I couldn't purge I would want to kill myself' - that's what our 19-year-old d said to us last night as we talked with her about the evidence we have found of daily purging. We have locked up cereal and sugar  and other things she tends to binge on, I have food in the refrigerator that she will eat that she has been less likely in the past to purge, I work from home so can keep an eye on her that she stays out of the bathroom for 2 hours after eating but she sometimes sneaks food from the pantry and I caught her eating while in the bathroom.  She takes long baths. Also, I sometimes have to leave the house to take the dog out, retrieve the mail, etc.

I have encouraged her to eat 3 meals and 3 snacks but she has not done that since 2014, and won't eat anything I would serve her. She won't eat family meals (only on rare occasion), and then it may only be a salad and not what everyone else is eating. If I bring up eating at all she shuts me down completely. Tells me to leave her alone (or leave the room if we're in her room). If I push her - no, if I question her - about food or nutrition or eating or waiting to use the bathroom it turns into a nasty, loud argument every time.

The DBT therapist will not call us back. We had asked for a family meeting about 6 weeks ago and the one meeting we had planned was cancelled by the T and a new date has not been made. They apparently want to work it out with our D but she's so laid back. And yesterday she didn't go because she was so depressed and feeling ill. I emailed her pediatrician with an update and heard nothing back. We have asked our d repeatedly to engage with a new ED T but she refuses to do so. And the only remaining T's and psychiatrists on my insurance list will not allow me to make an appt for her since she is 19. 

My h and I are wasting all of our energy arguing with each other. I am still so very angry at him that when she relapsed at 16 he would not stand with me to insist she receive treatment instead saying 'it's up to her'. 

She is to start college next week - taking 3 classes at a commuter college close to home. My h won't pull that from her since she's so depressed he says it's the only reason she has to live. Her last social outing with her only remaining friend was in early December. Each day all she has is me, her pets, her computer, her phone, and her dad at night. She's not interested in volunteering, in getting a job. She will test for her drivers license next month only because I set the appointment after she kept dragging her feet. I thought it would be a boost for her to get it - so she'll feel more on equal footing with her peers and can live more independently.

And I know in my heart that all of this depression, anxiety and loneliness she feels would all go away if she would only eat. And I am realizing too that we were foolish to allow her to not eat meat for humanitarian reasons. She's gone without meat for years and that too, I am sure, adds to her depression and anxiety. She has gone without meat since probably 2012. 

I know this sounds like a pity party but I feel such self hatred and hatred toward my H and us together as her parents as she has been so ill served by us. 

When I look to the future I am frightened that she's going to kill herself. She is no longer recognizable as my D at times. Last night I asked her 'on a scale of 1-10, how badly do you want to give up purging?' And she answered 6 or 7. She says she's purging less now than she was in the summer. She is one who has always wanted to take the easy route. 

Does anyone know of a good general practitioner in the CT area who is good with working with ED's? My d's pediatrician has up till now been responsive but I think she's making it up as she goes along and probably can't wait till our D ages out of her care.


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