is it anorexia..really, really worried..

[timetosmile]

My wonderful nearly 12 year old daughter.
She is a normal-to-slim build.
Happy, thoughtful, doing well at school, enjoys sports and ballet (at hobby level, not 'pressured') It's a pretty unpressurised life. 2 brothers, good circle of friends. Hasn't done the typical preteen stroppiness and has always had a remarkably equable temprament.
We live in a developing world country and she goes to a pretty 'wholesome' and old-fashioned in a good way International School which means there is not the 'appearance' peer or media pressure to the same extent that there is in High Schools in the UK.

Last week she didn't eat any packed lunches but threw them away, this week she has skipped at least one main meal a day and not had any snacks. She has lost at least a kg and has taken to weighing herself every day..frankly, I am surprised she even knew where the scales were because none of us weigh ourselves and tange from average skinny to average plump..but no 'issues'.

Two days ago she said, a little tearfully, that she hates herself because she is so fat and she will only cheer up if she can lose weight to 'not be fat'. She is adamant she is overweight. We did the NHS BMI index together which shows she is just above the 'underweight' border..apparently 'it is set up wrong' and 'I know you love me Mum, but you are lying to me about my weight and I don't know why..'

I am so pleased she could confide in me but now what to do? I talked about how 'feelings' and 'facts' battle for space in everyone's mind, but she won't 'hear' it.

Today she enjoyed her dance lesson, hanging out with friends and baking cupcakes for her friend's burthday tea tomorrow. Apart from 'food' stuff, she is almost her normal happy self.

I am utterly lost. Is this a 'phase'? I fear it's a lot more than that because of her obviously disordered thinking, but do I go in heavy and demand she eats, or pretend nothing's going on and just see how things pan out over the next couple of weeks (we are going back to UK soon anyway)

Any thoughts and help really gratefully recieved...

[KittyandTeal]

I'm sorry you and your dad are going through this.

It does sound pretty disordered, especially the 'you love me but you're lying about my weight' comment. This is how I used to feel when people told me I was skinny, looking back on photos I was!

I guess what you do next depends on how the medical system works in your home country but I would get her to a gp or similar to have a chat about disordered thinking and dysmorphia.

In the mean time try not to comment on what she eats or doesn't eat. Are there any areas of her life that are tightly controlled? Control, or lack of it, is what triggered my eds. I know it sounds odd but is there anywhere in her life you can give her a little more control? (Not instead of medical advice though)

[Hottypotty]

Does she spend time online? Could something there have triggered this?
Or is she feeling uncertain about moving back to the uk?

[timetosmile]

Thanks, she does go online but I know her device passwords and have been through instagram, facebook etc/online searched and its all pretty benign popstar, kittens, pouty-selfies stuff. I don't know if its the ballet thing, or coming up to puberty changes...

It's a trip back to see friends/extended family, I guess it could have triggered, but its not a big 'life event' type of trip, we do it every year.

Within 2 weeks we'll be back in the UK so I can try to set up some assessments there. Frankly, there's no health system here to shout about.

So those of you with experience, going in hard with a "Three square meals a day or your grounded" approach is unhelpful? Even in someone so young?

[PeaceOfWildThings]

It's called the Maudsley approach. :-)

Timetosmile, you sound like you're doing all the roight things. The relationship you have with your saughter is important. We can't diagnose on here of course, but you do have cause for concern, I think, and a good idea to get her checked out. There are long waiting lists though, and priority is given to more urgent cases, for obvious reasons.

Do join us on this thread:
support for children with very low weight or anorexia.

To answer you question...it isn't so much 'do this or else' it is more 'do this for a week and they you'll be able to do that'. Grounding completely is discouraged, as activities, school, meeting friends, parties and sleepovers can all be reasons to keep going. However at extremely low weights, sports and exertion and exercise is banned and only reintroduced slowly. (for my shirt and small frame DCs it was under a BMI of 17-18). Contact with friends is positively encouraged, but not if the friends are having a very negative influence. Normal teenage common sense still applies!

[KittyandTeal]

Does she enjoy ballet? Would a 'you need to eat well so that you have energy for ballet' type conversation help I wonder.

Everyone is different but for me I think a 'eat 3 meals a day or your grounded approach would have made me sneaky rather than stopped it'

It's really hard to explain dysmorphia, putting on a pair of size 6 jeans but looking in the mirror and genuinely 'seeing' a much larger person is so confusing. I still (and I generally have my disordered eating and thinking under control) look in the mirror some days and see a woman who is considerably larger than the woman who went to sleep last night.

Setting up appointments here sounds like a plan

[babynumber3eek]

Hi,

So sorry you and your daughter find yourself needing to ask that question. As already said, we can't diagnose on here but what you are describing sounds exactly like my daughter, diagnosed with Anorexia Nervosa a few months ago.

Everything you've mentioned regarding her thinking and behaviour sounds like AN, right down to the baking of cakes! AN doesn't need any life crisis or dysfunction, there is no requirement to be a certain age or disposition, there is no weight limit. AN has turned my happy, polite, honest, intelligent and confident child into a shell of her former self. It happened in front of my eyes following a 'legitimate' diet. She went from eating totally normally to starting to restrict food types and portions until she was only eating 30 calories a day. I had the same debate with myself as you are having, could it be a phase? Could it do more harm than good to talk about eating disorders? The best thing you can do for your daughter is act on your gut instinct NOW. Don't wait it out, things can go downhill fast and the quality of recovery is affected hugely by the speed at which a sufferer is diagnosed and starts treatment. My daughter suffered because I waited.

Treatment in the UK is often known as the 'maudsley approach' or Family based Therapy. The basic premise is that families don't cause anorexia but they can be the main part of the treatment. It basically means that you take control of your daughters eating totally and utterly, 3 meals and 3 snacks a day, she has no choice over what she eats (or she'll choose the lighter options) and you REQUIRE her to eat everything you give her, she MUST eat it - supervised with you ensuring the food doesn't get 'lost' anywhere. You then supervise her afterwards to ensure no purging- vomiting or exercise etc.

I wish you well xxxx