Teen Eating Disorders Thread 4

[SoTiredNeedHoliday]

Starting a new thread, no 3 is full

Do anyone else’s children say they feel that they don’t deserve to eat? My daughter says this. She feels she’s a bad person and feels guilt after eating.

Yep Betty guilt after eating is really common. Tabitha Farrah explained it as the brain chucking negative emotions at a perceived threat, in this case eating but theoretically could be anything you've trained your brain to fear.

Has anyone ever had an issue with spitting?? I've noticed my dd spitting a few times and pulled her up on it. Today she did well with her afternoon snack and (as far as I could see) ate all of it. Then 10 mins later I caught her spitting - not food - just salvia. I'm assuming it's an anxiety reaction to eating the whole snack.

She has made an effort today as I was clear again she wouldn't be doing the evening walk without more food going in. Breakfast wasn't great but lunch was good (she ate crisps again and had a decent portion of baguette with soft cheese) plus ate dinner and had a good go at an Oreo milkshake for pudding.

@Bettybarkalot123 this is from mental health.org HERE

People with anorexia often have common traits, including:
- low self-esteem, feeling worthless or like you’re not good enough. - Losing weight can start to feel like a sense of achievement or a way to feel a sense of worth
- perfectionism

Thank you both!
It makes sense. I’m really grateful for all the help and advice.
She definitely has low self-esteem and she is a perfectionist too.

She’a eaten well today (I think). I made the mistake of trying to up her portion of fresh juice with breakfast.. she noticed straight away and rejected it all together. She did eat two weetabix with oat milk. She seems to prefer this and I’ve checked and it’s fortified with calcium and vitamins and actually has more calories and fat than semi skimmed, per 100ml. Hope it’s ok.
She ate a sandwich thin with Mayo, two slices of quorn chicken, loads of cucumber and spinach on the side and a packet of chip sticks. She then had a vanilla yogurt with a banana and grapes mixed in. We went out for a short dog walk this afternoon (along the canal so nice and flat) and when we got home she had an oat milk hot chocolate. For tea she didn’t do so well but had two fishless fish fingers, loads of peas and quite a few fries… she even added ketchup. Best of all she seems reasonably settled and content now. Phew!!
We have an appointment for her physical checks with camhs tomorrow and she actually seems ok about it.

@Bettybarkalot123 I don't know much about Oat milk but the dietician we used has not recommended any milk substitutes and feels that fortified nutrients are nowhere near as good as naturally occurring. Though if your DD will only have oat it's better than nothing at all! My DD would only have almond milk and the dietician said it's basically 'flavored water' , moving back to cow's milk was the first (of many changes) we made.
Oat v Cows

This is all so tricky, annoying, stressful and boring

Wishing us all a great day today, we need it!

I'd be cautious about milk substitutes as well betty the animal fats in milk, cream and butter are essential for brain recovery. Plus with milk you can add cream to it to up the calories, if she likes hot chocolate that can be made with ff milk and double cream which would be a brilliant snack (even better with a couple of biscuits 😉)

I do get that you have to pick your battles though!!

I was using ff milk but she found it in the fridge and went ballistic. Definitely agree though I will be pushing for cows milk from now on whenever I can.

She went to have a physical assessment today at our local camhs centre. Her pulse was 50 so they nurse said she would run it past the team to see if action is needed. They said they would call this afternoon if there were any concerns.
I think it all scared DD as she agreed that from now on she would have the daily fortisip and she even asked for cheese on her jacket spud. I think the thought of hospital has scared her a lot.

Could this be a turning point or is it not as simple as that?!

I think of all the substitute milks, oat milk has the most calories per ml. But most people have found that any change in diet in the months leading up to diagnosis is usually a sign that their child was developing an eating disorder but they just didn't know it. Going vegetarian/vegan is a common starting point for EDs. Animal fats are quite essential for brain repair. Having said that, oat milk is better than no milk.

@Girliefriendlikespuppies

I'd be cautious about milk substitutes as well betty the animal fats in milk, cream and butter are essential for brain recovery. Plus with milk you can add cream to it to up the calories, if she likes hot chocolate that can be made with ff milk and double cream which would be a brilliant snack (even better with a couple of biscuits 😉)

I do get that you have to pick your battles though!!

Hope I wish I could get any cream into DDs diet . She knows as soon as anything extra is added.

DD is nearly 2 years weight restored, milk was a battle, but in hindsight compromise helped. She is now fully vegan. If possible try not to add ingredients, once trust is gone the fight gets harder (which seems impossible). The biggest step she made was when she began to trust that I would only give her what she needed. You all sound amazing and so do your children.

@Bettybarkalot123 it could be a turning point if you feel it is then work with it. Whatever is making your DD decide to eat you should grab onto it and hope it continues. Best of luck!!

@Boulshired - thanks, that’s a really good point. She did say she couldn’t trust me after I’d been using the full fat milk, she had a couple of really down days after that too. I guess as well the whole point of Family Therapy is trust, trust us that we know what will make you better. It’s tricky though isn’t it - we’re all just desperately trying to do our best.

@SoTiredNeedHoliday Thank you!

I made so many mistakes and still do, things that helped us were - she is an individual - one person inspiration/goal is another’s trigger. I read far too many books in desperation, trying to educate back to health. If something or someone is making it worse take a step back. For her it was the dietitian as every time she mentioned a food it became a red list food, she wasn’t ready. Again an individual thing I could not show emotions on a good day, it triggered guilt and continued the rollercoaster. she was better when she didn’t know her weight or if she had gained or lost in percentages as she can work it out.

Thanks @Boulshired for sharing your hard earned knowledge, that all makes perfect sense.

I think the hidden fats is a really individual thing, we would have made absolutely no progress without adding cream, cheese, butter etc to everything. I've always said my dd can 100% trust me to save her life and that's how I see it.

That said I've been able to add the fats because dd doesn't watch me add them and absolutely does not want to know. For her ignorance is bliss, the less she knows about what's in the food the better.

We've made small progress here, since getting stricter again dd has made more effort with lunch and for the last two days ate all of her afternoon snack. It was painful to watch though as the last mouthful is obviously very hard for her and she holds it in her mouth for ages 😕 lots of encouragement needed to get her to swallow it.

We're off to my brothers wedding tomorrow, dd is bridesmaid so hoping she'll cope with that and being away etc.

I've also booked her into an activities camp next week which was done a bit impulsively but was a brilliant offer and looks great. I've already told dd she'll need to up the food to compensate for the extra activity which she grudgingly accepted.

If I feel she's not coping with it I can easily pull her out of it. It's a fine line of finding things for her to do so she's not stuck at home thinking too much but not doing too much and eating too little!!

@Girliefriendlikespuppies I hope the wedding and activity camp go well.

@Boulshired - thanks so much for insight - it is so helpful to have someone further down the road shining the light back.

@Bettybarkalot123 I wanted to follow up on something you mentioned up thread about 'can't she see she's losing all the things she likes' (or words to that effect). It took me quite a while to understand (and by that I mean emotionally understand as much as logically) that the anorexia was giving DD something she needed, something she wasn't getting elsewhere. It was a(nother) kick in the teeth moment for a while.

But actually, after feeling angry and guilty it did help shift my thinking. So instead of seeing it as 'all the things she's losing' I started thinking about how the anorexia was meeting a need in her but using that 'positive' to usher in an all encompassing shroud of negativeness.

Once I'd got my head round that our focus became on how to push back the shroud a bit. So for example in terms of meal plans, sticking to a 20 mins to eat this snack and then move on meant that the anorexia only had DD for the 20mins, whereas the anorexia wants to prolong the meal (the cutting up & smearing) wants to associate the meal with discord etc. Literally carving back time in the day for things that were not food related was pushing back the shroud.

Am not saying it is possible (or even sensible) to tackle at this stage the underlying need that the anorexia is responding to, but it did help me change my mindset - I couldn't win in a straight fight in that boxing ring with the anorexia but I could try to cut off the shroud so there was less darkness and the opening up of space & time & her world eventually helped DD realise that the need in her could be met in other ways.

I'm not sure if that helps at all but your sentence upthread really resonated with me.

We've just had a tricky dinner time, dinner is usually dds best meal and she gets well over half her daily calorie allowance in dinner and pudding.

We had pesto pasta and garlic bread which is normally a safe bet. She picked at it and ate a bit less than half I said she'd need to have some toast to make up for what was left which was refused. I have her pudding which she refused and said what are you going to do about it!!

Ugh finally managed to get her to eat the pudding and drink a small glass of milk after threats of phone/walk removal.

Maybe this is extinction burst?!!

She also whipped me with a tea towel hard enough to leave a mark after I insisted she finish her smoothie at lunchtime 😧

Bloody great.

Thanks @myrtleWilson that all makes sense. Thank you for taking the time the share your experience.
I’m exhausted today, like properly shattered. Yesterday was emotional and just draining. DD has been brilliant but she’s just barely gaining any weight despite eating reasonably well. Certainly more than she was.
She was weighed at her camhs assessment and her wfh was calculated at 78%. She’s 43.2 kg whereas at the gp last week she was 44.5 kg. I hoping it’s just a discrepancy in the scales.

She’s been told no more Saturday job.
Did anyone else find it difficult for their DC to gain weight in the early weeks of refeeding?
We supervise her during and after each meal and snack so she’s definitely not hiding food. She’s also not really exercising.
I’m totally disheartened and so is poor DD.

@Bettybarkalot123 my dd gained lots in the first two weeks (though was in hospital) but then we really struggled for quite a few weeks with minimal gain despite her being completely compliant. It was so disheartening.
This last week seems to have turned a corner (I hope I am not speaking too soon) and her weight gain was nearly 2kg. I think it shows that sometimes these things take a while to have an effect. It means she is now 85% wfh and allowed to do some dance again It does mean I'm concerned that exercise will wipe out that weight gain but dd has promised to eat more to compensate
Hang on in there..,,

Aw thank you. That makes me feel better. When her weight was 45 kg she was 82% and it all felt doable! But now it seems to be slipping further away from us.
She’s incredibly compliant, she’s desperate to get better.
I’m terrified there will be no school in September.
Yesterday the ED nurse did say it can take some weeks for their metabolism to adjust.

I know the Saturday job is a no go but it just feels so sad. It won’t be forever though I must keep telling myself that.
I’m going to try to make contact with her school this week if I can with it being the holidays, to talk about September.

When dd went for her health check yesterday, I was shocked when I realised that I know of 3 other girls who also attend that clinic. None of them know each other but I just know of them from social circles, work etc. The scary part is that all including dd are from the same year group that got their GCSEs cancelled last year Just shows the impact of COVID.

@Girliefriendlikespuppies how did you get your DD to accept that she needs to eat extra to account for the calories used up at the activity camp? I'm trying to get this through to my DD now, that if she does back to sport 1 she needs an additional snack and if she wants to get back to sports 2,3,4 she'll need an additional snack for each of them...... getting very little positive traction here. I'm trying to get her to understand it before school and sports resume. She's desperate to go back to ballet, tennis, lacrosse and netball

Sotired i just said if I had any concerns that she was eating enough/doing too much I'd pull her straight out. The club supplies a hot lunch and snack which I'm anxious about as difficult to know portion sizes etc 😕

There's something going on with dd atm that I can't quite put my finger on, it feels like something has shifted but I can't work out if it's for better or worse!!

Weight gain in the early days is really hard as they have a lot of making up/growing/ repairing to do. If they're not gaining you will need to look at ways to get more calories in, for some kids it needs to be 3500-4000 cals plus a day to gain 😕

I've just contacted the doctor to ask for medication for me. I am in a really bad way and DD isn't great either, I just cannot do this.

Her behaviour is utterly vile and she is eating less and less - the two things are obviously connected. She lost weight again this week. I weighed her backwards and covered the screen with a magazine but somehow she still managed to see her weight! Next week I am going to weigh her blindfolded.

We are seeing a new therapist who is fabulous and has a totally opposite approach to CAMHS. DD loves her and is a different child when she's with her. She's also doing some gentle exercise to try and stimulate her hunger.

But when she gets home she's a different person, the ED is possessing her and I just hate her/the ED.

I am so desperately worried and desperately losing control of my own mental health and I can't see an end point.

I just sat with her for her snack (home made flapjack and innocent smoothie). She threw so much on the floor I had to get more, and inside my head all I could see was me throwing her to the floor and screaming at her and forcing the food down her throat. I mean that's not normal, is it?

I told her that she wouldn't be able to go to her friend's unless she ate and then she just screams at me to stop threatening her and that she feels sick and to shut up, then she mimics everything I say.

At this point I just want her to go away. I have failed as a mother and I am an awful human being.