13 year old daughter has developed an eating disorder

[nearden]

Hi,
Our 13 year old daughter has been skipping breakfast (e.g. pretending to eat it by leaving a bowl out from which she has tipped out the cereal) and skipping lunch at school for at least a couple of months. We eat tea as a family so she has always eaten that without any issues. We had our suspicions she was skipping meals but it only all came to light last week. She also admitted doing extra exercise (on top of activities she does outside of school) Since then we have been in touch with school (who are going to put the relevant support/referrals in place) and been to a GP. It is only really in the last two weeks she showed an aversion to food. Now I am making sure I see her eat her breakfast and I can only trust her that she eats her dinner at school but I am trying to encourage this by ensuring she takes food she likes/agrees on. Eating tea isn't a problem although she is trying to negotiate 'lighter' meals e.g. only having a salad but I am standing firm on having just a normal cooked meal. It has been a very emotional time and I just want to know if anyone has any advice who has gone through this and come out the other side. I have seen such a change in her over the last couple of weeks e.g. from very happy to very moody, very upset when I stand firm on meals etc. Her periods have stopped but hopefully as she gradually returns to a healthy weight they will return. She has always been tall and slim and is growing at such a fast rate so the weight loss wasn't evident straight away and her periods were irregular. It goes without saying that I feel a huge amount of guilt for not noticing it sooner and it is so upsetting that she would feel she couldn't talk to us before it got out of hand. It seems to stem from thinking 'thin' is good....even though she has always been slim! However any advice from anyone how has or is experiencing this would be hugely appreciated. Thank you in advance.

Professional advice here, not personal.

Well done for getting on top of breakfast and tea.

Bearing in mind EDs can rapidly become very severe, and on average last 8 years (you want your dd to have it briefly not chronically.) consider pulling her out to supervise her lunch too, and bear in mind she will need two to three snacks too for normal eating/weight regain.
Invest the time now, dont wait to be told by a specialist to do it or be forced to by a medical crisis. Look up Eva Musby, Janet Treasure, FEaST parent group. Be compassionate but authoritative, the ED is not good for her, no more than if it was heroin or an abusive boyfriend, so put in boundaries like you would in those scenarios, even if it upsets her it is caring. You have done great so far, keep going

Thank you so much for your reply. I will look up those groups. We are currently trying to take a firm approach and there have also been a lot of hugs during the tears but hopefully she sees b/fast as non-negotiable. I want to see how lunch goes over the next week or so but supervised lunch could end up being a possibility. Thanks again for your reply. x

Well done for spotting it and taking swift action!
No substitute for professional advice but whilst you are waiting I second looking up Janet treasure - she has written some excellent books that you (rather than your dd) can read and easily find on eg amazon.

As well as you supporting her to eat, try and get her investing more interest into other things that help her confidence so her identity doesn't get too fused with the ED at this stage.

Also have you talked with her about social media etc there's a lot of really unhelpful stuff out there

I would strongly advise against removing her from school to make her eat lunch.
As someone who had an ED at that age, isolation from peers would not have helped.
I would be careful not not force her to do anything as she can just find alternative outlets- purging, obsessive exercise etc if the main issue isn't resolved. Professional help is what's needed not force feeding- this very very rarely happens even in ED inpatient units.

We aren't force feeding, just treating the evening meal as normal but I do want to be up and around when she is having breakfast. I am trusting her with her packed lunch and that is why I am making sure I have a variety of food in so she can pack something she likes. It is a difficult issue which is why we have involved the gp and a referral to a support system straight away through school. Since opening up we have seen gradual improvements......hopefully this will carry on but I know there will be ups and downs. Thank you for your response

I have no great advice to offer, but just wanted to say that I had a very similar ED at that age and got over it in about a year or two. Obviously I was one of the lucky ones, but it does happen. I'm 46 now and it has never recurred.

For me there were a large number of factors causing it, but in the end it was largely about control. The trigger for me getting better was realising that I was genuinely ill and unhealthy and underweight, and switching my idea of control from "eat to get thinner" to "eat to get healthy".

All this is far too simplistic and probably not helpful to you, but I wanted to give you one person's memory of how it was for them.

Thank you. It does seem to be a control issue. Fortunately our daughter recognised herself it had gone too far and has been willing to talk openly to us about it. Sorry to hear you went through this and glad to hear you recovered. Your response is helpful and also reassuring.

It can be a difficult journey tgsf you ste about to begin. You will need lots of help and support for you do that you are able to offer the support and care that you daughter will need. Definitely get referred to Adolescent Eating Disorder Service - the quicker you and your daughter start working with them, the better chance of recovery. But its very tough. My daughter was diagnosed 6 yrs ago, it's been really hard , good luck

Thank you so much for your reply. At the moment we are due to see the GP again in a couple of weeks and school has made a support referral. Fingers crossed it is looking positive at the moment, breakfast and tea are definitely being eaten every day and she is taking in food for lunch (which I can only trust/hope is being eaten). Her mood has definitely changed for the better and although it isn't a complete return to normal I definitely feel we are heading in the right direction. Only time will tell. Thank you for all of the responses, they have been very useful.

Hi,

My daughter was diagnosed with restrictive anorexia around her 16th birthday. It started in the way you describe - faking having had breakfast, throwing away lunch at school and eating dinner as normal with the family, but trying to negotiate a different meal/not being hungry/ not finishing food. Watch out for an interest in becoming veggie or vegan - I’m not saying that all veggies or vegans have an ED, but often a developing ED will include a dietary change as a method of restriction. Watch out for extra exercise, and try to keep an eye on her for a good hour after eating to see if she develops a bathroom habit after meals. My d didn’t purge as she’s had a vomiting phobia since she was a small child, but it’s quite a common thing. Extra curricular sport might have to be decreased for a while.

Things I wish I’d known at the start - don’t waste time or energy looking for a ‘cause’ - it’s not your fault and it’s not always about being skinny. Most of the ED patients we came across were highly intelligent, competitive, brilliant young people who were a little - over controlled and with low self image, there seems to be a ‘type’ of person that’s predisposed to this. Secondly, take time to look up the NICE guidelines and junior marsipan documents as services are under resourced and over stretched and sometimes you have to push to get what your child needs. Thirdly, EDs are nasty insidious manipulative things - I got through it by mentally separating the illness from my d, as some of the things she said and did at her illest were far from the girl I know, she doesn’t now actually remember much from that time. We have a close relationship now, although she told me many times during her illness that she hated me and she wasn’t ill, I was trying to control her etc etc etc.

My d got down to a BMI of under 13 - she was under 36kg at 5’7”. I spent months driving her to London for a day treatment programme that I had to push for. When she was discharged she relapsed, and spent 20 weeks as an inpatient 200 miles from home. She took a year out of education after her GCSEs, which she hated me for but was the right decision in the long run. She restarted sixth form with the next year group and is now at university studying medicine and loving life.

This can be beaten, but you need to not back away, it won’t go away on its own. One meal at a time, snacks if possible. Nuts are great as are things like latte and hot chocolate. Xxx

Thank you so much......definitely similarities with our daughter. She also falls into the category you describe regarding achievement at school. I know we aren't out of the woods at all yet and yes there has been a mention of going vegetarian etc and big drops in mood. We are back at the Doctors next week and we'll see what comes of that. It will be interesting if he weighs her and if he does whether there has been any change. It's lovely to hear your daughter did beat the condition. Thank you for your response xxxx

My d became veggie before we realised there was a problem, and then pushed to become vegan as she became more ill. We refused to discuss it and by then she had a good team who backed us up. She’s still veggie, but is managing her own food in self catered uni halls.

It’s definitely beatable. She was at a ball in London last night with her flatmates and has spent the afternoon ice skating at winter wonderland with her boyfriend with pizza after, she’s 19 now x

If there’s anything I can help with along the way feel free to drop me a message x There’s also a very active eating disorders UK parents group on Facebook which might be worthwhile looking up xxx

Thanks. We've had a big chat tonight and she is definitely still in the 'eating food is bad' mindset. However, she is eating so I have to take strength from that. I know it is going to take a good while to get back to 'normal'. It's just really rubbish and so frightening that something like this can take hold so quickly. Thank you for your offer of help and for the FB ref. x

My dsd very similar picture, has now been an in patient for ten months.
We went from where you are to critically ill in a month.
Please come over to ' around the dining table' website/forum.
It is an amazing community of parents and carers.
Believe me.. You are only just seeing the tip of the iceberg and you are going to need to push for more help.. Your d needs cahms Ed referral ASAP.

I agree with joining aroundthedinnertable.org and that yes, you have a tough road ahead.

Eating disorders are neuro-metabolic illnesses, and while environmental factors can pull the trigger it’s negative energy deficit that loads the gun, her lunch needs to be supervised at school or she can’t go, I’d also pull her from PE immediately,, she doesn’t have the energy to spare. Aim for three meals and three snacks a day and message me if you’d like to join some private FB support groups.

Definitely buy Eva Musby’s book. This disease is not about control, this is one of the symptoms. Research and knowledge has moved on from these old ideas. Ultimately food is the medicine for anorexia and fats are needed to retire the brain.

Yes, definitely read the Eva Musby book and go on to the Around the dinner table forum. My dd was like yours too. I ended up with her in hospital for 3 long stays then she was sectioned and in an eating disorder hospital for 6 months. She is out now for 3 years, still recovering but I am in charge of her food still. There is an Eva Musby video that helped me to understand how to approach meal times. It is about bungee jumping. It will be on youtube or on her website somewhere. It is a mental illness. At some point in her illness I realised that my dd was at risk - she started to get blue fingers. When that happened I started to take her to the hospital. I don't want to scare you but please dont hesitate to do this. I would never want another mum to go through what I did there but it did save her life in the end. My dd now thanks me and god she means it. For me I had to think of the illness as a possession type mental illness, my dd as a victim of it and me the caring strong mum who had the strength to fight it, for her, on her behalf.

I meant rewire not retire the brain.

This is the bungee jump video

Please also request that she also gets supervised at meal times. She has a need, her food is the medicine and school have to do this. If they won't they are in the wrong.

Apologies have just realised this thread was over a month ago. OP I do hope things have improved.

Hi, things did get worse once the condition was exposed but she is now with CAHMS and sees them on a weekly basis. She had to stop all extracurricular activity and PE at school. School have been very supportive and we bring her home each day for lunch which seems more effective. The more we close in on the ED the more it tries to fight back but we are closing all loopholes we can but trying to balance that with a normal life. We are hoping that she doesn't require hospitalisation but we know it could be a reality. This is an awful disease and we aren't at a stage where we can see any light at the end of the tunnel yet.

nearden it does sound like you have it all covered. I still have to stay watchful. Even now. Looking back I spent a long time trying to work out why it happened but I learnt that regardless of the cause I had to get her better with food. I spent a good two years where I couldn't relax about her food. She now has a set meal plan that she is happy with. Eventually dd was diagnosed with autism (aspergers). This and I now think that my dd enjoyed being a child so much and when SATs came along, work pressure, high school and then worse, her breasts started to develop, dd was horrified. She just wanted to be a child loved and cared for with no added 'grown up' pressures. I do feel for you OP, and I am glad that you are supported. If you ever need any help or advice, please ask.

Unfortunately this is a marathon not a sprint and it takes a long time to rewire the brain, being a teenager takes a lot of calories anyway to grow out into adulthood. We’re two years in, doing great but I don’t think I’ll relax about food for a very long time. It’s said full recovery is 3 years of solid nutrition and that’s the most optimistic timeframe but obviously with huge improvements along the way. High fats for the brain are crucial and unfortunately CAMHs meal plans are often too low as are their ‘target’ weights, there is no target for a growing child.

It’s a horrible experience and I wouldn’t wish it on anyone.

I am glad to hear you are getting help and you sound like a very supportive family. A long weary road. Step by step.

Reassuring stories some have shared. Thank you.

Hello, I had an eating disorder from when I was 16 to about 24. I would often throw food away and pretend that I was eating. Unfortunately, my mum died when I was 10 so I didn't have anyone around to notice or help (as my dad was always working). I am not sure what you could do (sorry if it is silly that I have replied to this thread) but try and help her. I really wish I had someone to help with it. I have ended up having so many fillings and root canals from the damage the disorder did. I also felt like I missed out on going for meals etc with my friends as I always made excuses. Sorry its not much help, but it is so much better that you have noticed, I hope you find some answers to tell you what to do now xxx