Sometimes, when an issue pops up within our families, we don't want to share information with others just yet, as it feels very private. Other times, the issue at hand feels so overwhelming to us, that we simply don't have the energy to deal with the comments and input from others. (People say stupid things at time, meaning well, of course. But it's draining to have to deal with inappropriate "advice" AKA criticisms.) So we work within our small group, privately, until we've reached the point that what other people say won't affect our overall approach to the issue.
I've wanted to share some of what our family has been dealing with, here on my blog, for a while. But it just wasn't the time. Presently, I feel we've reached a good place in recovery, and it's "safe" to share.
My purpose in sharing this is to 1) possibly reach out to someone else going through a similarly difficult time in their family's life, so they will not feel so alone in their struggle, but also 2) some information from the recovery process for our situation could be helpful to another family.
One of our daughters has struggled with an eating disorder for a couple of years. She is actively restoring weight right now. It's not an easy process. Many individuals who find themselves needing to regain weight also find themselves requiring an enormous amount of calories and nutrients each day. When you combine this with loss of appetite, the situation can seem daunting.
Eating disorders are just one reason an individual may need to restore weight. When my mom was sick with cancer, weight loss and appetite were a huge struggle for her. Often times, the elderly lose their appetites, and weight loss is a health risk for them, as well. Sometimes, it's just a picky eater in the family with a small appetite to begin with, that necessitates a bit of intervention to put on a few pounds.
It's so hard for us, as eager eaters, to understand the frustration of needing to put on weight, isn't it? I look at a donut, and it magically jumps onto my mid-section.
But, for those who are trying to help a child, parent or other loved one put on a few pounds, I'm going to share some of our methods and "recipes", over the coming month or two. As always, take what works and leave the rest.
The number one tip I can offer other families trying to restore weight with an individual who just doesn't seem to have an appetite, is to set up an eating schedule. For the underweight individual, it can be so easy to go through an entire day subsisting on an amount of calories/nutrients which result in further weight-loss. Before you know it, it's the end of the day, and a daunting amount of food still needs to be consumed. So, for us, having a schedule of 3 meals, 3 snacks works.
We adjust our calorie and nutrient needs based on weekly weigh-ins. The safe amount to gain per week seems to be 1-2 pounds (similar to weight loss recommendations). If we've gained the appropriate amount for the past week, then I look at the next week's activity level, and add or subtract a small amount from each day's requirements. If we over-gained, then I reduce the next week's requirements, and if we've under-gained, then I increase, but all based on the math of 3500 calories equals 1 pound of weight.
I keep this information in a small notebook, so I know for sure what I'm supposed to be doing for meals each week, and we can track progress. I'm getting forgetful in my "old-age"!!
For us, we minimize anxiety around foods and ingredients if I put together meals for my daughter, and she gets her snacks. There will come a time when we transition to more intuitive eating. This is all part of the process of recovery.
Each meal and snack has it's own calorie requirement. To give you an example of how it unfolds for us, for a week when my daughter needs 2800 calories per day, we do 750 for breakfast, 200 mid-morning snack, 700 lunch, 200 mid-afternoon snack, 750 dinner, and 200 evening snack.
Snacks can be hard for us to get in, so we set the calorie requirement for those somewhat low. Another family might do better with fewer calories at meals, and more at snack time, for 6 mini-meals each day.
When my mom was battling cancer, she had similar calorie goals for each meal. Working within these goals helped to keep her weight from slipping dangerously low.
So, one of the biggest obstacles for us with meals is getting in a nutrient-dense breakfast in a short amount of time. There are meal replacement shakes that I know a lot of families use. Working on a tight budget, I'll share what we do that packs the nutrition, while keeping our costs reasonable.
The Nutrient-Dense, High-Calorie Breakfast Smoothie
I plan the next morning's breakfast the evening before, as I'm cleaning up the kitchen. If my plan is something like muffins and milk, my daughter's milk gets boosted to a smoothie. I calculate the calories of the muffin portion, and figure how many calories the smoothie needs to contain.
I set up all the ingredients for her smoothie the evening before, then in the morning, she or I dump it into the blender to whirl it smooth. She often expresses a flavor she's in the mood for, and I work with that.
I use a 1-pint canning jar, and begin adding ingredients to the jar, until I meet the calorie requirement. Cap and refrigerate overnight. Here are some ingredients that we use in our smoothies, but not all of them in the same smoothie!! :
- milk (whole milk if possible, 160 calories per cup)
- peanut butter (90 calories per tablespoon)
- dry rolled oats (yes, that sounds weird, right? I found that ingredient on a list for body-building smoothies)
- bananas
- tofu
- frozen and fresh fruit (chopped for items like orange segments or apple slices)
- cocoa powder
- sugar, honey, molasses, agave
- canned pumpkin
- applesauce
- leftover cooked winter squash
- cooked sweet potato
- dry milk powder
- whipping cream, oils
- spices (cinnamon is a favorite for us, but also nutmeg is good) and flavorings (vanilla and maple are both yummy in smoothies)
- leftover cooked brown rice
- homemade Greek yogurt (300 calories per cup, adds a lot of protein and calcium, and good with frozen berries)
We work within the guidelines of 30/30/40 with respect to fat/protein/carbohydrates. The oils and whipping cream may sound over the top, but in a person with high nutrient needs, including lipids, the whipping cream and oils sometimes add that little bit extra to bring us into balance. We also try to incorporate a wide range of foods into the weekly plan, so the components of our smoothies vary from one day to the next.
I don't calculate ratios (the 30/30/40) on a daily basis, but every 7-10 days I do a mini-audit of one day's meals, just to see if we're on track.
A suggestion for coming up with a blend of flavors -- think about other meals/foods you've eaten and enjoyed. I make a delicious sweet potato/orange zest and nutmeg casserole. So for one smoothie variation, I add sweet potato, a couple of orange segments, nutmeg, and sweetening to the milk. Apple pie smoothies are good, too. Some applesauce, cinnamon, oats and sweetening added to the milk. And of course, we love peanut butter-chocolate. I add 2 tablespoons of canned pumpkin to these, at my daughter's request. Some cocoa powder, peanut butter, sweetening, canned pumpkin added to the milk -- yum. In an issue of Prevention magazine, several years ago, I found a simple tofu and orange juice smoothie recipe. I've done these for myself many, many times. (I like a bit of sweetening in mine; I believe the Prevention recipe was just tofu and oj.) My daughter likes tofu and frozen blackberries whirled into milk.
On extraordinarily busy mornings, sometimes the smoothie IS the whole breakfast. So adding grains in the form of oats or cooked brown rice, plus fruit or vegetables, milk, tofu, peanut butter for protein, and we have a meal in a glass. I've even taken to doing these for myself, when I know I've got a demanding morning ahead of me and no time to cook or eat a hot breakfast.
There you have it -- our version of a nutrient-dense beverage, based on real foods. For a price comparison, Boost nutritional drinks retail for about $1.50 for each 8 oz serving. A nutrient dense, home-made breakfast smoothie like what I serve, containing anywhere from 400-600 calories, costs between 40 cents and a dollar, depending on just how "fancy" we're feeling that day (and how inexpensively I've obtained ingredients).
And I won't even get into some of the "added" ingredients in commercial nutritional drinks. Ugh!!!
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