DSD eating disorder - long

[Asking4AFriend]

Long term poster, NC, but I know all about pom bears and center parcs and t-rexing in supermarkets.

Posting for a friend who isn't on MN.

This friend, lets call her Judy, has three adult children from her first marriage; they have all moved out of the family home. She lives with her husband, who has four children from his first marriage, three are adults, and one is 16, and up to last summer ago was living with her mother. In order to go to a local college, the 16 year old moved in with her father and Judy.

The step daughter, lets call her Rosie, has been regularly throwing up after meals, and bingeing between meals. She's naturally very thin. When confronted about this she didn't deny it, but didn't want to do anything about it. With some convincing she went to a GP appointment with her father and Judy. They are currently waiting for Rosie to go to some counselling, but in the meantime she is continuing to binge and purge.

Judy has seen Rosie's facebook messages to her college friends; some seem to be telling her not to make herself sick, others seem to be claiming to do it to (not sure entirely on the details here - I told Judy I didn't think she should be reading her step daughter's private messages, but do believe it comes from a place of real concern.

Does anyone have any experience step-parenting a teenager, or supporting a teen with bulimia that I can pass to Judy and her husband? I think they're finding it hard as they've not had a big a part as they would have liked in raising Rosie (complicated story, Rosie's mother is very much a narcissist and was diagnosed with some sort of personality disorder, which resulted in some nasty problems around access/custody.)

[cannotlogin]

I can't help but wonder if there is a better forum for this query - it's quite specialised and is probably best handled by people who have experience.

These people might be useful as a first port of call: b-eat.co.uk

Very hard thing to deal with and not necessarily anything to do with what may/may not have happened with mum and dad.

[Bananasinpyjamas1]

I too don't have direct experience, but I'd be phoning around the local CAMHs team (mental health team), looking at the NHS website for info, phoning MIND for info, basically getting a whole lot of advice. The local GP may be good and refer on, or may not be, it all depends.

If it is full blown bulemia it is quite a tricky, difficult thing to treat and they will need expert help.

I seem to remember some advice that in the household - that no one else is obsessing about food in the house, even continually talking about healthy food, that kind of thing. Make food a non issue. Mealtimes should be relaxed.

I guess for your friends it would be also trying to gently work your way into the childs trust, not by quizzing her, but building up time and support so that you are more aware of where all of this is coming from.

[Quietlygoingmad67]

My DD1 is in recovery from bulimia! It's very very complicated. It's taken 3years to get to this point and a fair amount of money. We couldn't get help on the NHS or via Camhs so found a lovely counsellor who deals with eating disorders in teens.
We were told not to try and stop her from vomiting as this can need to anxiety attacks and in my DD's self harm. Also not to monitor or watch her - not to mention how much food she is eating - provide normal sized meals but allow for eating in between (as she would most likely to have induced vomiting). Never comment on weight or appearance! We didn't actually go to her counsellor sessions as she was 16 so didn't want us present, which was very hard but she wanted and needed to work this out herself. I really would try and get some help and urgently because after 3 years of induced vomiting my DD is now likely to need surgery for damage to her hiatus (suspected hernia or widening - so under investigation as she now has severe reflux).

[Asking4AFriend]

Thanks for the advice. I'll suggest my friend looks at specific forums dealing with bulimia/eating disorders, and will be sending her the link to this thread so she can see the advice about meals and not making a big deal out of food-related things.

I know CAMHS have been in touch with them, after the GP referred them, and that they're waiting for counselling availability, and are definitely keen to support their (step)daughter through this.

[dependadultundergarment]

Hi OP. I'm recovering from bulimia and one of my good friends went through the same thing.

It is important to get specialised help. As she's a child she may be in a better place to get this than as adults (though the poster above didn't have this experience! Postcode lottery?). My friend was under CAMHS for her ED and had a lot of input from specialist paeds ED services. I suffered from 15 but didn't tell my GP until I was 23, after failing to quit long-term on my own, and I found it hard to receive treatment. I only got an assessment because I had another mental health issue that meant I was already under a consultant, and she referred me.

Her friends are not in a position to deal with something as serious as bulimia, it really can feel like an addiction much like self-harm and problems with drugs. It is hard to admit that you're vomiting because it also feels incredibly disgusting. I would try to avoid blaming friends for encouraging the ED as they're young, too, and might have their own problems.

It would be good if her mum could give her privacy re: the messages.

You can get "books on prescription" and targeted CBT for bulimia, both of which have high success rates. I used this one - www.amazon.co.uk/dp/1572305614/ref=pd_lpo_sbs_dp_ss_1?pf_rd_p=569136327&pf_rd_s=lpo-top-stripe&pf_rd_t=201&pf_rd_i=0898621798&pf_rd_m=A3P5ROKL5A1OLE&pf_rd_r=1ZT4TQJBBT33SDS6CHXS&tag=mumsnet&ascsubtag=mnforum-21. Stopping the binges was key for me, because then purges weren't "necessary" any more and I had some mental space to realise how illogical purging activities are. Some people worry that giving up purging will mean they'll keep bingeing and gain weight. The book is good for addressing those binge impulses.

Dental care is another big concern. My friend and I both bit the bullet and went to see a dentist once we engaged with bulimia treatment. She had to have eight fillings and I somehow emerged unscathed. The stomach acid can really do a number on your teeth, so it's just something else to consider. If mum could ask the dental practice over the phone if they're experienced in dealing with bulimic patients, it would ensure that the dentist is sensitive (like mine was) and won't make her feel ashamed.

Bulimia is hugely about shame, purging is a response to the shameful feeling of being fat and have broken "the rules of eating", or for not looking perfect, for many people. Anything that makes her more ashamed will likely make the ED more entrenched. Reading private messages, being too blunt in discussing the ED etc. could make her feel worse. Sensitivity is definitely needed but equally the problem needs addressing.

I hope she does really well. It's such an awful condition for the patient and family to cope with, very stressful.