Last night, after a pretty good day for N. He started rattling on about how many calories he had eaten. He was throwing numbers around like 3000 and 3500. I've been paying attention to his caloric intake, generally, but had not been adding every little thing -- and I certainly didn't think he was even in the area of 3000 calories. So, we sat down and added things up from his day. I was so surprised to find out that he overestimated his calories significantly in almost every area. The reality was that he had barely had 1900 calories -- which is only enough to maintain his weight. He has "allowed" himself to eat up to 1800 calories with not a lot of resistance. But he has been fooling himself. I've got to be extra dilligent now about counting the calories for him.
N has had a good 24 hours. His anorexic obsessions/thoughts have still been there -- but are much more muted. I can tell he feels better (and that's just with 1900 calories). I've limited his food choices to two per meal and I don't negotiate. That's already eliminated half of the meltdowns. N had a little blip this morning when choosing his clothes (another example of too many choices right now). I think I will have him set his clothes out the night before. He had a great breakfast (shake, sausages, toast). It's the first time I've seen him really full in a long time.
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When you say you limit him to two choices for meals, what kinds of choices does he usually have there? Are the meals similar/really different, and do they include all the food groups or just some?
I'm trying to include all of the different food groups. But the meals end up being a lot the same each day -- especially breakfast. Breakfast has been a shake, sausage, and toast. I'll let him replace the toast with a bowl of cereal. I'll also let him choose his shake flavor -- fruit or chocolate. For lunch, I let him choose school lunch or PB&J. For dinner, we sat down together and made a menu for the rest of November. I let him choose the main course every other day (and no repeats for two weeks). Everything else is not negotiable (like fruits, veggies, starches, etc.). I have been letting him choose any snack. That may be too broad and he sometimes struggles to make a decision. I probably need to limit it to two choices. I'm trying to give him as much control as he can handle.
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