Please help - my workmates 10yo DD has been diagnosed with anorexia

[postingforafriend]

I've namechanged so that my workmate doesn't know my regular posting name. And posting on her behalf here at work.

Her 10yo DD has always been an obsessive sort of personality and about a year ago she became obsessed with exercise after an initiative at school. That led into her controlling her eating and she's been eating less and less for the last year and now is very thin and withdrawn. The only thing she seems to get any enjoyment from is exercise.

My friend took her to the doctor a few weeks ago and had a referral to the hospital, but it wasn't coming through and then an old friend saw her DD and suggested they take her to A&E. She was referred to the eating disorder clinic from there and given an eating plan and told to go away and get on with it, but that if her DD didn't gain weight she'd have to be admitted. It's the Royal Free so they should know what they're doing I'd have thought. They have also said they can't offer the DD any psychological help until she has gained weight... But that seems back to front to me

My friend is at a loss as to how she is supposed to implement the eating plan, she has been given no advice about how to actually get her DD to eat, that's kind of the whole problem.

She just at a loss really what to make of it all and doesn't know what to do (apart from trying to get her to eat) she's not been told how to do that though.

Does anyone have any experience of this, or advice, or anything that might help?

Thanks

Also, does anybody know of any counselling that she could get outside the NHS? The hospital has advised not to but it's just a case of looking at alternatives I think. Does anyone have experience of treatment for this outside the NHS - good or bad idea etc?

We are in North London.

Bloody hell, that's awful. I didn't even realise that children that young could be anorexic. I know there is a support group for families and sufferers, I just can't remember the name at the moment. It will come back to me and I'll post it, or someone else will. Alternatively Google it. Good luck to your friend.

ok, the psychological help is generaly offered after reaching a certain BMI (body mass index) because not eating does things to your congitive functions that mean it would be very hard to do any kind of psychological work- putting on weight is the priority. There are several specialist eating disorder units in london, most are nhs (which you need a referal for) and some are private. In this age group the NICE protocols often suggest family therapy (don't worry it's not a blame thing but supportive).
BUT if her dd is under the care of a specialist eating disorder clinic (which it sounds like) then they really are the best people to help. Admisions are based on either clinical need (dangersously low BMI) or waiting lists- there tend to be not that many beds available for the demand so outpatient treatment (the eating plan) comes first. Find out what the waiting list/or clinical priority is for a bed. If she does become an inpatient the first stage will be an eating plan for weight gain anyway- it'll just be more regimented as it will be admisinstered by the staff and she will be in hospital. If your friend is not happy with the waiting time and things are not improving at home then she may want to think about private treatment.

Yes the NHS approach can be extremely frustrating for all involved. And one thing I would say about this illness is that it is extremely important that it is addressed quickly and not allowed to take hold in terms of carrying on for years - but I have no experience in how to tackle things pyschologically with a 10 year old. It is very important your friend pushes for a referral to a child psychiatrist IMO. I think the parents should seek a second opinion, I don't think A&E are properly equipped to sort this out - they are just doing emergency measures. I cannot emphasise how urgent it is to get this sorted out - anorexia can ruin families and take hold for decades if not one's whole life. Please urge them to seek proper help.

Thanks all.

Her DD has been referred to the eating disorders unit at the Royal Free, it was them who gave her the eating plan not A&E.

I will get her over to read all your responses when she's off the phone

yes I see, she was referred to the eating disorder clinic. Well hopefully they will know what they are doing, but I'd suggest not waiting too long if things don't change. I think parents have to be really sharp on this issue.

Have just had another chat she says thank you very much for your replies they are really helpful. Especially about how cognitive function is impaired which explains why they are not offering her any psychological help at this point.

She has already been offered hospital admission - her DD could have gone in last week but she wasn't sure. Her DD has now gone back to school - just 1 day - and my friend says that her mood seems to have lifted a lot. She is in a quandry - whether to admit her daughter to hospital or whether to see if being back at school improves things as she already seems a little better (not with eating but with her mood). I suggested that she ask the hosp if she can wait for a couple of weeks and review the situation then. What do you think?

Also, any tips for getting her daughter to actually eat? She has the eating plan but no clue really how to actually get her DD to eat the food. Someone else said to let her eat in front of the telly which has helped a bit, but generally it's arguments and refusal and tears and it's all terribly stressful.

I know that you're not experts (well some of you might be!) but I think that any other perspectives will help as she doesn't know what she's dealing with and us here at work have no idea either - it's one of those things that normally I'm full of bright ideas but I have no idea what to say or do and nor does anyone else.

She is going to call B-eat who are a charity for eating disorders.

Any thoughts or ideas or views are really gratefully received

I would agree that, for the moment, it's probably best to focus on getting whatever help the Royal Free can offer. I had recent experience of another department attached to the RF hospital and, although the clinical care was outstanding, the admin procedures were crap. If I was in your friend's position, I would contact the ED dept at the RF and let them know the difficulties she is having with the eating plan, any change in circumstance eg is her daughter losing more weight and, essentially, what the hospital's plan is. If they've offered some form of intervention (however lame ) they should also offer a review appointment.

Her GP may be able to offer more immediate support and hassle the RF on her behalf.

Good luck.

I think that whoever is in charge of your friend's dd would be happy to have correspondence and update of her mood and behaviour

I would keep a diary of anything she eats and with timing and all events etc - that may be very usefull and also help for the family to get some sense of what's going on

I developed anorexia at an older age - but I didn't get the right help at all and my parents were just flummoxed. I am reluctant to offer any advice though to a 10 year old girl - I think she needs the best professional help.

I am fully recovered now but it took many years of my teens and twenties. Would not wish it on anyone and the effects on long term health can be very serious.

Thanks again everyone. Pofaced I am sorry to hear what you have been through.

My friend is going to go with what the eating disorder people at the royal free say. I don't think she was ever not going to, it's just she's all at sea with no idea what to think/do/try. She has another appt with them soon and so will tell them about the school/improved mood situation, and ask for advice on how to get her DD to eat. See how it goes I guess.

She has found the advice and experiences on here really helpful, anorexia is something that many people don't really have much experience of, and so when something like this happens and it's your daughter and so young, it's just really hard. I have two very young DDs myself and just can't imagine how she must be feeling.

Thanks again all

Your friends DD sounds very similar to me when I was a little girl. I had diagnosed anorexia from the ages of 11 - 15, though I maintain that I was just incredibly controlling about food - not properly anorexic - I never starved myself down to 4stone IYSWIM.
Anyway, looking back - what helped me was when I felt good about by myself - and I needed other ways than not eating to do that. So playing sports, getting interested in subjects at school - feeling confident.
In the end the thing that cured me completely was changing schools for A-Levels to a mixed school where people were far more focussed on sporting achievements than looks.
Also feeling like people were watching what I ate was the worst thing that could happen - so if possible your friend needs to have a really relaxed attitude. Also make sure she has lots of positive role models - Christina Hendricks from Mad men or Maria Sharapova the tennis player - etc etc - people who aren't stick thin but are considered gorgeous and successful.
HTH

the fact that her mum is trying to get the best possible help is a great start. Without trying to put blame on anyone in any way, it is an issue that need to be addresed as a family together, especially parents. Best of luck.

Dee Dawson[Doctor]has a facility where children stay with her[not suggesting that at this stage]but if you can find out about her and contact her she is fantastic! 10 is very young and imo and experience as a paediatric nurse hospital admissions are not the best for children with anorexia.Also as others have mentioned finding out why this has happened is extremely important.Good luck.

About the Maudsley approach to treating anorexia. It's a family-based approach that has been very successful. Maudsleyparents.org link here, with a video clip about the method. Might be nice for support for your friend.

The beauty of the Maudsley approach is that it is family based and encourages the parents to be 100% actively involved in treating the problem. It might be ideal for a family with a 10 year old needing help.

Doobydoo It Rhodes farm. I know someone who works there. Unfortunly the children are getting younger all the time.

Hi there

Wow great info. My friend left work while I was on the phone and I think she was indicating that I should text her if there were any more replies - I'm going to leave it til tomorrow though let her have a rest tonight. She's not a MNer so I don't think she realised she can look at it herself!

Just looking at Rhodes Farm - that's really local. It looks expensive though.

Math that link is fantastic as well thank you

In fact I will text her now that there are more responses and ask for her email so I can send her the link.

Thanks so much

Both Rhodes Farm and the Maudsley approach look very good actually.

Yes the 'new thinking' on eating disorders is apparently that you have to start eating properly (to allow your brain to function properly or something) before they will give you any counselling or help. It is completely stupid. I went to the doctors twice. First time she was really nice and understanding and gave me and eating plan and told me to come back in a month. I went back a month later and had lost a pound or something. She got a bit impatient and told me I had to put on weight before anything could be done. Whatever love. I didn't go back. Luckily I am not a very bad case and I am also an adult, which means that I would have to eat nothing for ages to do permanent damage. With a 10 year old you would think they would be more alarmed, as she could harm her development and growth much more.

My friend has been and read the rest of the replies, she says thank you very much, it's all really helpful. She is going to look into the maudsley and rhodes farm links in detail.

I have told her how wonderful MN is for support on pretty much anything, so maybe she'll take the plunge and we'll see her around...

Maudsley was developed in and named after Maudsley Hospital, in London. My link was US oriented but the method spread from the UK all over.

The maudsley is in london? I thought it was in liverpool [dim emoticon]

I wonder if my friend could ask for her DD to be referred there instead? You are supposed to be able to choose now aren't you. If there's a huge waiting list she could keep up with the royal free until a space became free at the maudsley. Or maybe that would feel like upheaval for her daughter...

Oh, about ways to get her to eat - eating in front of the telly does help because you don't have to concentrate on the food, so there is less anxiety. Also, only a little bit of food at a time as a whole meal is totally overwhelming, and the sensation of being full is really horrible to an anorexic. So little meals, maybe more than 3 times a day if she can manage it. Or snacks like nuts, have lots of good fats but are small and easy to eat. ALso, let her eat whatever she wants, no matter how weird. Don't start imposing rules about what the food has to be, she will just think you're trying to control her

hth

Thanks fuscia that is all very helpful.

I had a text from my friend this morning and she has said she

"wanted some advice as to how to get DD to eat her snack (apple and healthy bar) that I need to give her after school. It will be a nightmare. Please could I to see if anyone has any hints".

So, any hints gratefully received

Fuscia I am sure she will be grateful for your last post.