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Eating fears-how to respond?


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My 7 yr. old daughter has been in remission from all symptoms for months on prophylaxis. Her primary symptoms have always been tics and choreiform movements & a little bit of OCD. In the beginning of all this (3 yrs. ago) my daughter's initial symptoms included many irrational fears. Yesterday at dinner for the first time, my daughter began to eat and then said she couldn't because she was afraid of the food. When asked why, she talked about the skeletons that we saw at a museum earlier in the day and that she couldn't stop thinking that I got the food there. Hoping this is an isolated issue, but then she told me that other times she has felt afraid of food when she didn't want to eat. In case his happens again, I want to be sure I respond in the correct way. For those with experience with eating fears, can you give me some suggestions?





Thanks ,


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Hi Amy -


All OCD is frightening, but the eating fears always hit me the hardest. Have you ever done ERP therapy with her? If so, then discussing the fear once, rationally, is generally our first step - and then after that we use ERP. On eating issues, we are usually pretty aggressive, as for us at least, those can build up very quickly. We acknowledge what is happening to her brain & how hard it is, and have a reward for her if she feels she needs it (she's 10 now, so she does not alway need external motivation).


If you have not done ERP, then I'd encourage you to start educating her about these brain techniques now. The book "what to do when your brain gets stuck" is an age appropriate workbook to use.


Generally, as with all fears, if it is severe, or if it is clearly causing her distress, then we start in baby steps. There are tons of ways to break this down, from watching someone else eat, touching the food with your hands, licking the fork only, taking one bite, etc. If you need more specifics for your daughter, let us know.


I generally discuss it right up front at the start, but then see if she can handle it on her own. Sometimes just acknowledging that it is OCD, and therefore an irrational fear, will give the child enough power to take the first bite, and knock ocd on it's booty.

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I agree with everything Meg's mom has said. She has helped me through many tough times.


ERP has helped us tremendously. We are very open with our kids about pandas, and how it needs to be addressed, and a MAJOR component of that is ERP.


It doesn't sound like you are in this position at this point, but I will add, that while addressing eating issues with ERP, and medical intervention for pandas, we also made some attempts to increase our kids caloric intake (which at one time got very low for each kid, due to eating issues). My daughter got to the point where she was eating about 25% of her normal diet. We did this by always having bite size, healthy, tasty snacks out on the table. I tried to make the very appealing meals. When things were really bad, we did dinner in front of the tv (my kids would eat a little more, keep at it a little longer if distracted). I would make a tray up of a lot of variety of small bite foods, not asking them what they wanted, just making it up. (lots of healthy chicken fingers, bite size sandwiches, crackers and cheese, apples and PB, mini muffins, fruit, veggies and dip, etc. We also did daily smoothies made from Kefir, ice, fruit, mango sorbet, and some protein powder.


Once my daughter got "healthy", her food issues disappeared and have never come back. I agree with Meg's mom that food issues are probably the scariest things we have dealt with. It sounds like it is something somewhat minor for your daughter now, so you are doing the right thing by "jumping" on this with ERP.

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Food issues has always been central to our son's OCD - however, he was far too young initially to tell us anything about it (he's only 4 now). But to expand on what's already been mentioned, we too tried anything we could to increase our son's caloric intake. He would go through phases where he would only eat certain foods (in the right quantities of course). We went through a pretty significant corn dog phase, as well as a donut phase.


We too were working with ERP, and we expressed concerns to our pediatrician about getting him to eat well. (Our son only had a 7% BMI at the time - severely underweight).


At that point, our doctor told us that as long as he continues to take the vitamins/supplements we were currently using (multi-vitamin, probiotics, Omega 3, etc...)although it's not ideal to let him have a diet of just corndogs, if that's all he'll eat, let him eat it, and try to supplement him in other ways - one trick we used was using Carnation Instant Breakfast to make chocolate milk for him -it has all sorts of essential nutrients that we were missing.


Our doctor's standpoint at that time was until the ERP had time to work, or we started to come out of that particular episode, getting him to eat something - even if it wasn't the helathiest of choices - was better than the alternative.

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