Does anyone have experience of pre anorexia? Please read and help

[lisalisa]

My dd2 is 13 and we have just returned from a doctor's appointment where we have been told she must put on about 2kg in weight over the next 3 weeks or she must be referred for pre anorexia or anorexia.

My dd2 is the archetypal classic easy child. Popular, pretty , steady , always one that others in need of help or advice go to . Practically brought herself up - no issues. Academics easy for her now and has great social life.

She has always been slim but about last summer put on a little bit of weight - still looked lovely. She said she wanted to lose it so I said i would support her and make some more healthy dinners . We are quite big eaters at home - but healthy- think roast chicken for supper and good hearty soup to start. DD2 has always liked a little snack on sweets/sugary stuff here and there.

I didn't really think anything of it when she managed to lose the weight just told her she looked lovely. However then I noitced she seemed to be too thin and was always looking in the mirror sucking in her tummy.

Short cut is that she is underweight (BMI of 19.6), her hip bones jut out terribly, she is always feeling tired, views herself as "ok" but doesn't want to eat more in case she gets fat and has started eating really tiny portions and not very often. I started noticing when she kept saying she didn't like cereal after having eaten it most of her life and was taking two mouthfuls and binning it . This also developed alongside a bit of an obsession with cleanliness - not her room or herself but not sharing water bottles with siblings or if her sister's hand carried a glass to the table she wouldn't drink from the top bit where her sister's fingers had been.

I am terribly worried as although i don't think its actual anorexia yet as dd is worried herself and wants to eat more but expresses a horror of putting on weight whilst acknowledging that she needs to ( she is not being sick or using laxatives or anything ) but its definitely a step on that road.

Doctor says if she doesn't put on that weight in 3-4 weeks then she'll refer her for help.

We have started trying to help her increase her portion size as she always says she feels sick and can't eat. So we have started a two bites more exercise where, when she says she's full and can't eat more, we get her to eat two bites more each meal to try to stretch her tummy to accept more food easily. I reckon that two bites more per meal is 6 bites per day being 42 bites a week which adds up.

Does anyone have experience of this and were able to stop it before it developed into anything more serious? Any tips advice or simply support please?

Hi LisaLisa, I am really sorry because I don't have any helpful advice to offer you. I did want to say is the Dr alarming you both unnecessarily though? A bmi of 19.6 isn't underweight surely? My dd is 14 and well covered, bmi 18.3 (I only know this because we had to do her height and weight recently for one of those activity centres).

I really don't know whether "making a big thing of it" is what you need to do with anorexia, or whether you should try and be a bit more casual about food and not too alarmist.

Sorry ... I realise this is getting you nowhere.

I'll bow out and hope you find some helpful advice from the rest of Mumsnet.

Thanks Mintyy reassuring to hear about your dd's BMI . I don't think the doc is making too much of it as dd feels sick when she eats and tries not to eat and views putting on weight as scary as she will be fat. She is extremely tall and if she wears a tight skirt looks alarming due to her hip bones jutting out !

Thanks for your comments and support.

Can anyone else help?

My daughter lost a lot of weight because of illness, and as she was getting better seemed to be having trouble with feeling sick, not wanting to eat, getting controlling around food, all of which is VERY unlike her.

I have found that handing her small snacks, leaving things on the table, putting bags of nuts (which she loves) in obvious places, and most importantly trying not to mention any of these things, seems to help her sometimes.

I realise that my daughter has a different problem from yours, but there are similarities. Good luck-

Sorry to hear about your DD. I have no helpful insights but wanted to suggest Beat if you haven't already tried them:

www.b-eat.co.uk/support-services

I appreciate it might not be an ED as yet, but there might be people that have experienced similar. Hoping my post will bump this for you.

Have you also tried the teenagers thread?

Good luck and wishing your DD well.

doctors don't tend to look for problems like this where there are none, no experience of intervening at this sort of stage as things were much further along with my daughter before it came to anyone's attention but she has made a good recovery

there is likely to be a lot of helpful support at around the dinner table

I took my DD last month to the GP for much the same reasons, except it was my DD who wanted to speak to the GP. She was worried that each time she tried to eat she found she couldn't and only managed a couple of bites. We had had issues with her before hiding food that she didn't want to eat but once we became aware of that we discussed the issues behind it and made sure she wasn't hiding the food anymore. It is only now at 14 that she started to show the sudden rapid weight loss.

I also put the fear of god into her with regards to what not eating can do to her body which did hit home with her

The GP weighed and measured her and said she had a BMI of 20 which she said was the absolute lowest that she should be and any lower was heading into a problem.

She referred us to camhs and we are just waiting on an appointment.

It may be the case that this is something that may help?

Eating disorders are coping mechanisms and children haven't learnt how to cope with stress so therefore they can 'cope' in dysfunctional ways.

Keep in mind eating disorders have very little to do with weight but that's what people focus on.

Controlling food intake can be a way of coping if your daughter feels she has stressed or pressures in her life. She probably doesn't even realise she is doing it and may not be able to pin-point what the stress is. She is at an age where she is still a child but perhaps feels she should be able to behave more like an adult. It takes time to gain these skills and we all make mistakes en-route. This is perhaps her making one of these mistakes and her talking more with you (you sound like a very supportive mother) and other friends, aunts etc may help. You may also find one or a few of her friends are using restricting foods to control their weight and it is a bit of a trend.

Overall although it sounds daunting the cahms referral is probably a good thing.

I think the reason the gp has referred, from what you have said, is possibly more to do with the control your daughter is trying to have over food, opposed to her weight (which is fine).

The other thing is that eating disorders are better caught early. People immediately think of the extreme end of anorexia with women looking skeletal but in reality it can be much more subtle and if left untackled in childhood it can become a lifelong dysfunctional method of control and way of coping with stress.

As I said be pleased these behaviours have been caught early and don't worry. I know more easily said than done.

Support your daughter but never make food the battle ground.

Hope that helps and all the best with your daughter

Your daughter sounds lovely, and no wonder you are worried. One red flag from your post is that the Dr is wanting her to put on a LOT of weight (relative to her size) in a very short space of time, rather than focusing on making positive, longer-lasting changes. If your daughter is already frightened of putting on weight, gaining a lot quickly could really freak her out so perhaps there is a middle ground to be found there?

I also had an unhealthy relationship with food as a teenage girl and would second whoever it was who made the comment about control. Are there stresses in your daughter's life that she's (even subconsciously) really struggling with? Is there something else - perhaps a hobby or new hobby - she could put her energy towards instead that could help break the cycle of obsessing about food? In terms of body image, who are her inspirations? Are there any really positive role models she looks up to?

Wishing her the best

We had exactly this last year, except DP didn't spot it/think it was serious until DSD started fainting when out for a walk. She was saying and doing the same as your daughter - an already extremely tall and thin child (5'7") who essentially decided she needed to control her food intake and behaving obsessively around food/clothing/appearance.

There is a major psychological reason behind this all which I won't go into here. But we ended up with her having repeated blood tests, heart function tests and had to cancel our summer holiday as her heart was beating really slowly to compensate for the fact that all the calories she was consuming (500 a day) were going to power her brain...

We put 1kg a week on her over 5 weeks by essentially feeding her junk - milkshakes, chips, burgers, nuggets. The method we used is called the maudsley approach - which involves over feeding to regain weight and then dealing with the psychological once the weight was maintained and all organs functioning normally.

It took 6 weeks from her starting this non-eating to the start of the over feeding. And although the backstory behind it all has not gone away, she has been great with food (mostly, barring a couple of purging incidents) for almost a year now. She is still tall and thin (the envy of all her friends) but she now sees she can eat what she wants and still stay that way. And she knows that wasn't really the issue in the first place.

Many of the girls in her year have eating disorders or food control problems, I'm glad we got it early and she is getting help.

Good luck, do what the Doctor says and hopefully if it is pre-eating disorder, you have caught it early - with counselling, CAHMS support, psychologists at the eating disorder clinic we felt at some points there were too many interventions, but it's reduced now - we can see it was all necessary to stop the eating becoming the focus and bring it back to the emotional/ psychological cause.

crazycatlady is wise. Re-read what she says.

Your DD is subconsciously using food as a way of expressing stuff that she can't deal with. She needs a lot of reassurance and love, and the freedom to not have to be "easy" any more. It's not about food or weight.

The behaviours your daughter is currently exhibiting are beginnings of anorexia and THANK GOODNESS it has been picked up now. I talk from personal experience here. I'm thrilled that the GP has been responsible and actually taken note and not waited until a low bmi presents. BMI is not the only marker on eating problems. You sound supportive and I wish you all the best for you and your DD.

lisalisa I'm just staring out on this road with my Ds and its scary.
His BMI is 12!

We are getting a referral to an eating clinic and how to change this pattern of weight loss.
So I think in we are in the same boat, trying to stop/change behaviours now.