Re: HELP! Feeding Enrique, a horror story

November 12, 2002

>> He hates this. He was a skinny kid and I figured he was probably

skinny until at least young adulthood as I was. But he seems unable

to help himself in any way.>

Salli,

There is research going on now that indicates that the reason people

can't change their eating habits goes back to brain programming that

is useful for those who live in survival mode (primitive peoples who

forage and hunt)...but is not incredibly helpful for those of us who

live in societies where finding safe food is not a problem; my

thought on this is that children who live in sensory driven survival

mode (like Enrique) kick back to this same thing...comfort foods make

him feel safer. SO the big bugaboo may very well be his stress

level...not his diet. I know that doesn't help much, but perhaps

Enrique would take his meds based on the idea that it might help him

make better food choices? I know that risperdal increases appetite,

but my possibly wrong bet is that the decrease in stress is more

important to his present situation than the increase in

appetite...which usually gets better after being on the med (actually

taking it) for a few months.

The other possibility is that food serves as an oral fidget for

him...the chewing, textures, tastes, and so on are sensory organizers

that help him feel calm. It could be that going through the " engine "

(ALERT) program with him may help him get a handle on managing his

sensory needs in a more appropriate manner...and it will give him a

sense of control that he may really need.

What you might try is to get him some nonedible oral fidgets...chewy

tubing, pencil toppers, etc...even a hand fidget may help a lot by

decreasing his stress level. Assure him that these are things you

can order from OT type sources that are tested for human safety and

can be cleaned regularly to maintain a healthy state if he balks

about possible germ/poisoning issues...

> I feel that he is unwilling to take any responsibility for what he

eats because then, in some twisted fashion, the blame for his

continued weight gain will be mine and not his (mind, he doesn't act

like he blames me; he is not nasty about that; he just cannot bear

the decision-making).>

Probably so. I have a daughter who does the same thing...not with

foods, with everything. I understand your position; it is sometimes

just not worth fighting it out...I often just take custody of her

brain for her so that she has less stress. Possibly not the best

solution, but sometimes survival means compromise...until you can

work other things out.

Raena

November 12, 2002

So sorry Salli! And I feel for Enrique too. I know that nasty side

effect of gaining weight. Well good for some and not others. My

sister is 100 pounds as of yesterday and is 5'8 " . She gained 25

pounds while taking zyprexa. Alec gained 10 pounds in less than 9

months on risperdal and he was only 40 to begin with. A very large

gain for such a small person. Neither Alec or Kiki could seem to

control their appetite, Not one bit. Alec would eat 3 double

cheeseburgers at burger king and still want more and eat everyones

fries and drink lemonade until I thought he would have to pop! Kiki

would eat almost anything she could get her hands on. We went out for

breakfast once and she had a platter of food. No joke, 3 eggs, 4

sausage, 4 bacon, 4 pancakes(the real big ones), hasbrowns, 2

danishes, 2 biscuits, chocolate milk and coffee! ACK! She is a very

tiny girl. I think that for some people these drugs are very, very

strong when it comes to eating and hunger. When we would withhold

food from Alec he would scream and sometimes attack us. It was awful.

The weight gain was too much for us so we took Alec off his meds. We

are paying the price for that now, but diabetes runs on my side and I

dont want to risk it. Kiki had to go off her meds for some other

reason. They have both settled back into their normal eating habits.

What if you no longer had the types of food Enrique shouldnt be

consuming. It sounds drastic but without temptation it would be

easier to handle. I have no good advice I am afraid.

Jacquie H

> Enrique has been on Risperdal for nearly a year now and, when he

takes, (but that's another story) it makes a huge difference.

>

> However weight gain is a side effect and he was already gaining

weight too fast when he started it.

>

> Today he weighs about 220 lbs and he is only about five feet five

or five feet six. He has gained so much weight so fast that there

are stretch marks on his stomac and legs and arms.

>

> He hates this. He was a skinny kid and I figured he was probably

skinny until at least young adulthood as I was. But he seems unable

to help himself in any way.

>

> We visited his doctor and she said that there were other drugs that

might help but he would need to have his blood taken to monitor liver

function. Enrique will not have his blood taken. She sent us home

with some Emla cream to numb his skin and lessen his fear of needles

but he cannot do it.

>

> She made an appointment for us with a dietician, but the dietician

was really no help. She told us nothing that we didn't know already,

and Enrique is completely and totally unable to follow her simple

baby-steps plan.

>

> She just wants him to change what he drinks. We have tried and

tried to find a low calorie drink that Enrique likes but we have

completely failed. He will not drink water or seltzer water. She

told him how many calories he was getting per day from his drinks and

showed him how stopping sweet drinks would ultimately result in

losing weight.

>

> Unfortunately she made some errors in her calculations and Enrique

noticed (natch!) There should still be weight loss from drinking

fewer calories but not as much as she originally told him.

>

> Finally, in despair, she suggested that Enrique drink a half cup of

water before he eats in order to make him feel fuller.

>

> He cannot do even this. He did it once.

>

> Before he eats anything fattening, he first asks my permission. If

I do not give him permission to eat whatever he wants, he rages

around for hours (yes, hours) saying that he must have it, and he

terrifies the little kids and screams at Sophie and to

leave the room (because he is so embarrassed by the whole problem).

>

> If I tell him to go ahead and eat it, first he suspects I am just

trying to shut him up (uh, and that has been true on a few occasions,

but I simply am not perfect), and then, finally, with a sigh of

relief, he eats the desired food.

>

> I feel that he is unwilling to take any responsibility for what he

eats because then, in some twisted fashion, the blame for his

continued weight gain will be mine and not his (mind, he doesn't act

like he blames me; he is not nasty about that; he just cannot bear

the decision-making).

>

> I HAVE NO IDEA WHAT TO DO!

>

> NONE!

>

> Last night I made myself a snack of a couple of quesadillas. He

smelled them and came in the kitchen. He had just had an onion

bagel. He wanted quesadillas, but he said he didn't know if he was

hungry or not and he could not tell any more. I was SO tired last

night and it was just awful. We argued about this for ages and ages.

>

> HELP!

>

> Salli

>

November 12, 2002

> What if you no longer had the types of food Enrique shouldnt be

> consuming. It sounds drastic but without temptation it would be

> easier to handle. I have no good advice I am afraid.

Well, he would drive me mad, of course. Some of the foods that Enrique

overeats are Putter foods (waffles) so we must have them around since Putter

only eats about five or six things.

Other stuff, well, he wants anything that someone else is having no matter

how recently he ate. A lot of the foods aren't that awful; he just eats

when he doesn't really need to. I have tried and tried to find a healthy

and low fat food that he likes but I just don't have one. I have stopped

buying chips and stuff (I bought Doritos a few weeks ago for Putter's

lunches and Enrique could NOT stay away from them so no more Putter Doritos,

but I do not consider Doritos a staple of Putter's diet, unlike waffles...).

It's hard to avoid buying food when you have so many kids! Sophie is skinny

as can be and I am glad to see her eating ANYTHING! And Robbie is also very

small. Actually money is so tight that we really don't buy much processed

food; we seem to eat pastas mostly. No cookies, no chips, no snack foods,

but sandwiches and tacos and quesadillas are pretty easy to whip up. I'd

hate to have to stop buying cheese...

Sigh.

Salli

November 12, 2002

my

> thought on this is that children who live in sensory driven survival

> mode (like Enrique) kick back to this same thing...comfort foods make

> him feel safer. SO the big bugaboo may very well be his stress

> level...not his diet.

Raena:

I KNOW this is right. He definitely does not yet have the right meds too.

I would love for him to try Seroquel, but that is the one that requires

blood to be drawn. I feel as if there is just no way out for Enrique. He

has blocked all his exits and sits helpless in the middle of the room.

Metaphorically speaking, of course. In reality he is eating a bagel

(another one!) in the kitchen...

I know that doesn't help much, but perhaps

> Enrique would take his meds based on the idea that it might help him

> make better food choices?

He says he cannot take his meds if he is stressed out. Because he can never

remember if he has taken his medications, I put them in one of those weekly

pill cases...and then, because he is used to taking his pills out of the

little bottles, he goes and takes them out of the bottles, or he thinks he

might have. So I guess we have to hide the little bottles now...

I know that risperdal increases appetite,

> but my possibly wrong bet is that the decrease in stress is more

> important to his present situation than the increase in

> appetite...which usually gets better after being on the med (actually

> taking it) for a few months.

>

Yes, and we are still working on that one. If I didn't have so much to try

to remember, I'd probably be better about reminding him, but reminding is

frustrating because he does not necessarily take his meds even when I remind

him. Sometimes he says, " Oh, no! " and collapses on the couch, breathing

frantically.-

> The other possibility is that food serves as an oral fidget for

> him...the chewing, textures, tastes, and so on are sensory organizers

> that help him feel calm. It could be that going through the " engine "

> (ALERT) program with him may help him get a handle on managing his

> sensory needs in a more appropriate manner...and it will give him a

> sense of control that he may really need.

Now THIS is a possible idea. I'll let you know and thank you for having

thought of something that had not occurred to me.

>

> What you might try is to get him some nonedible oral fidgets...chewy

> tubing, pencil toppers, etc...even a hand fidget may help a lot by

> decreasing his stress level. Assure him that these are things you

> can order from OT type sources that are tested for human safety and

> can be cleaned regularly to maintain a healthy state if he balks

> about possible germ/poisoning issues...

Ah, I can certainly tell that you have read enough about Enrique to

understand him!

>

> Probably so. I have a daughter who does the same thing...not with

> foods, with everything. I understand your position; it is sometimes

> just not worth fighting it out...I often just take custody of her

> brain for her so that she has less stress.

Yes.

Possibly not the best

> solution, but sometimes survival means compromise...until you can

> work other things out.

We have a lot of other stuff to work on.

Salli

November 12, 2002

Salli,

Sorry to hear that he is still gaining weight. We've been fortunate that

has been simply maintaining what he gained, even with the zyprexa,

which can also cause the weight gain. Perhaps you could talk to the Dr.

about switching to the zyprexa to see if he might not stop gaining weight?

I think they say the 'average' weight gain is 4 lbs. Although we all know

that our kids are not 'average' by any means. Otherwise, I'd start asking

for an appetite suppressant. I feel bad for Enrique. He's got enough

things to create stress in his life without adding this to something that is

good for him!

Sue

November 12, 2002

I totally understand. Greggory only eats a few things as well. So we

couldnt cut those things out. And Greggory willnot drink water so we

always had some sugar drink around(as G cannot drink juice or milk

because they make him sick).Waffles are also part of Greggory's

everyday diet. Alec could go through a box of them. What about trying

to get Enrique more physically active? Probably not an easy task but

maybe he could have a system where he needs to excersise so much a

day. Just to help with the added calorie intake. It doesnt seem like

there is much to be done with the amount he is eating. We never

really could get alec to stop without all the screaming and attacking

and crying at night. He was really hungry.

Jacquie H

> > What if you no longer had the types of food Enrique shouldnt be

> > consuming. It sounds drastic but without temptation it would be

> > easier to handle. I have no good advice I am afraid.

>

> Well, he would drive me mad, of course. Some of the foods that

Enrique

> overeats are Putter foods (waffles) so we must have them around

since Putter

> only eats about five or six things.

>

> Other stuff, well, he wants anything that someone else is having no

matter

> how recently he ate. A lot of the foods aren't that awful; he just

eats

> when he doesn't really need to. I have tried and tried to find a

healthy

> and low fat food that he likes but I just don't have one. I have

stopped

> buying chips and stuff (I bought Doritos a few weeks ago for

Putter's

> lunches and Enrique could NOT stay away from them so no more Putter

Doritos,

> but I do not consider Doritos a staple of Putter's diet, unlike

waffles...).

>

> It's hard to avoid buying food when you have so many kids! Sophie

is skinny

> as can be and I am glad to see her eating ANYTHING! And Robbie is

also very

> small. Actually money is so tight that we really don't buy much

processed

> food; we seem to eat pastas mostly. No cookies, no chips, no snack

foods,

> but sandwiches and tacos and quesadillas are pretty easy to whip

up. I'd

> hate to have to stop buying cheese...

>

> Sigh.

>

> Salli

November 12, 2002

If you don't have any sweet drinks in the house, would he eventually

just drink water to quench his thirst?

Is joining a gym a possibility? Even just walking on a treadmill would

be beneficial. You can listen to music or watch TV while you do it at

the gym too.

Hormones may be playing a part right now too. I can't remember how old

he is, but it seems like he is about 15 right? A lot of boys are short,

and " squatty " for a little while before they shoot up and even out by

the end of their teen years....

I hope you find something helpful soon.

~ Karin

November 12, 2002

> I still think Weight Watchers is the way to go for him, and this is why:

the

> food journal and the point system.

When we looked into this last year, they didn't take kids under sixteen. He

had just turned fifteen so that was that.

However...sixteen is getting pretty close so we'll think about that again.

Thanks!

Salli

November 12, 2002

i am in weight watchers at the moment. i have lost 12 pounds so far (yay me!)

the other cool thing i wanted to add about the points system is that if enrique

wasn't satisfied by the number of points he was allowed you can " earn " extra

points through activity (after the first 4 weeks). i find myself it has pushed

me to make better food choices and i never go hungry because i fill up on lots

of low points foods. in other words i am still eating tons (more than before

actually) but losing at a nice steady rate (12 pounds in 8 weeks). it's worth a

shot.

michelle

Re: HELP! Feeding Enrique, a horror story

He really DID gain fast. Wow.

I still think Weight Watchers is the way to go for him, and this is why: the

food journal and the point system. Every food imaginable is assigned a

point value. To lose from a certain weight, a certain number of points are

allowed. How you spend the points is your choice, as long as you don't go

over your points for the day. A diet soda is worth 1 point; a regular soda

is worth 4 (I think), so it would be Enrique's decision whether to use up 3

extra points on a drink or not. That way, when he bugged YOU about what he

could eat, you could sit down with him and his journal (and the handy points

manual) and come up with a number of choices that would have the same point

allowance.

It could go one of two ways -- he could learn to work within such a

structured program and maybe eventually make his own choices, or he could

still bug the hell out of you whining that 35 points a day isn't enough and

he can't do it. So you do have a CHANCE at success.......???

Jacquie

November 12, 2002

and Jacquie:

Can I show Enrique these messages? He might possibly find them useful.

Thanks for your input.

Salli

> i am in weight watchers at the moment. i have lost 12 pounds so far (yay

me!) the other cool thing i wanted to add about the points system is that

if enrique wasn't satisfied by the number of points he was allowed you can

" earn " extra points through activity (after the first 4 weeks). i find

myself it has pushed me to make better food choices and i never go hungry

because i fill up on lots of low points foods. in other words i am still

eating tons (more than before actually) but losing at a nice steady rate (12

pounds in 8 weeks). it's worth a shot.

> michelle

> Re: HELP! Feeding Enrique, a horror story

>

> He really DID gain fast. Wow.

>

> I still think Weight Watchers is the way to go for him, and this is why:

the

> food journal and the point system. Every food imaginable is assigned a

> point value. To lose from a certain weight, a certain number of points

are

> allowed. How you spend the points is your choice, as long as you don't

go

> over your points for the day. A diet soda is worth 1 point; a regular

soda

> is worth 4 (I think), so it would be Enrique's decision whether to use

up 3

> extra points on a drink or not. That way, when he bugged YOU about what

he

> could eat, you could sit down with him and his journal (and the handy

points

> manual) and come up with a number of choices that would have the same

point

> allowance.

>

> It could go one of two ways -- he could learn to work within such a

> structured program and maybe eventually make his own choices, or he

could

> still bug the hell out of you whining that 35 points a day isn't enough

and

> he can't do it. So you do have a CHANCE at success.......???

>

> Jacquie

>

November 12, 2002

absolutely! i wish him all the luck in the world. there is nothing quite as

bad as not feeling comfortable in your own skin. being a teenager is a

stressful time to begin with - i am sure this can only add to it.

michelle

Re: HELP! Feeding Enrique, a horror story

>

> He really DID gain fast. Wow.

>

> I still think Weight Watchers is the way to go for him, and this is why:

the

> food journal and the point system. Every food imaginable is assigned a

> point value. To lose from a certain weight, a certain number of points

are

> allowed. How you spend the points is your choice, as long as you don't

go

> over your points for the day. A diet soda is worth 1 point; a regular

soda

> is worth 4 (I think), so it would be Enrique's decision whether to use

up 3

> extra points on a drink or not. That way, when he bugged YOU about what

he

> could eat, you could sit down with him and his journal (and the handy

points

> manual) and come up with a number of choices that would have the same

point

> allowance.

>

> It could go one of two ways -- he could learn to work within such a

> structured program and maybe eventually make his own choices, or he

could

> still bug the hell out of you whining that 35 points a day isn't enough

and

> he can't do it. So you do have a CHANCE at success.......???

>

> Jacquie

>

November 12, 2002