Teen Eating Disorders Thread 4

[SoTiredNeedHoliday]

Starting a new thread, no 3 is full

@DarkBlueEyes take her to a&e tomorrow. Seriously. For you as well as for her.

Dark I'm sorry Camhs hate being so useless, it def sounds like your dd would benefit from an admission, it might make her realise the seriousness of the situation if nothing else.

Tupperware sorry you've had to find us, your dd sounds really unwell as well. Has she had baseline obs done? How much is she is eating currently?

Sotired I've not got a lot of knowledge re bulimia either but I would be very wary about dd befriending anyone with an ED. My worry would be it might give dd ideas she'd not previously had 😕

All okay here really, dd happy she's in school and we're plodding on. Life is 100% easier when she's at school for both of us. Got the psychiatrist on zoom tomorrow, am thinking about sacking off the weight checks for a bit, will see what she says...

What do all your children have for snacks when at school/college? This is our biggest battle atm. There's no way she'll have a nutritious drink and a decent snack in the five minute break from one lesson to the next.

@NCTDN shortbread, crackers that sort of thing. DD had to go to sit with a teacher and eats her snacks supervised at break times. Prob not the best snacks nutrition wise but I just want her to eat something every 3 hrs.

@Girliefriendlikespuppies at the doctors she’s had B/P standing and sitting and her bloods done which just showed a slightly low VitD. First day back at school yesterday after Covid. I bought an Oximeter and I’ve been observing her oxygen which was normal throughout. Currently she says she is trying to eat 100-500 calories a day and doesn’t see a problem with this. Today for example at breakfast about 5 grapes, refused the toast and asked for chicken fridge raiders instead. Nothing for lunch at school. 1 egg and 1 dry toast for tea. Refused pasta and garlic bread I made later. She literally will not eat anything she doesn’t want to, it’s all on her terms.

@tupperwaretowers welcome, sorry you find yourself here. Your daughter sounds very similar to mine. I’m fairly new here too but I’ve had so much good advice already.

Tupperware on that level of restriction she shouldn't be at school as she'll still be loosing weight. Are you doing FBT?

Personally I'd pull her out of school and focus on refeeding 24/7, nothing happens until she eats, use whatever leverage you can etc. She needs to be having 2500-3000 calories a day which I know feels a million miles away!

Teens compensate fairly well physically until they suddenly can't anymore 😕

@Girliefriendlikespuppies had to google FBT, this seems like something that would help. I’m going to ring BEAT when they open and try get some guidance/help. I feel totally lost.

Tupperware you might need to consider taking your dd to a&e as she may be at risk of refeeding syndrome. Otherwise you need to start gearing up for FBT which is what the ED camhs team will tell you to do. Do you work? You'll need to get signed off for a while to get started. Your dd needs to be off school and on sofa/bed rest.

The principles of FBT are you take complete control of all your dds food decisions, she eats what you tell her to eat, you don't back down, 3 meals and 3 snacks a day all high fat and high calorie (these can be hidden), your dd stays out of the kitchen and is not involved in any food prep. You use whatever leverage you can.

Your dd will massively kick back, you will see her behave in shocking ways, she may scream, swear, threaten suicide, self harm but you stay calm and contained and keep pushing food.

I have been on this journey for 18 months now so have been through the process, it is hideous I won't lie, but your dds life literally depends on it. Also hold onto the fact that deep down your dd wants you to take control. At the moment she is controlled by the Ed and that's terrifying for her, she wants you to force her to eat.

For tips on getting them to eat and what to say/don't say have a look at Eva Musbys book and resources on YouTube.

@NCTDN DD is not having her morning smoothie at school as she says literally nobody else drinks them and she feels self-conscious. The same goes for the yogurt she would usually have as part of her lunch. We have re-jigged things around and she has those items for her afternoon snack instead. That’s fine with me as means I know she’s actually eating them rather than binning them.

@tupperwaretowers welcome and sorry you find yourself here. Such a supportive thread though and full of lots of vital advice. Restricting to below 500 calories for more than 2 days is one of the criteria on the Marsipan checklist should you decide to take your DD to A&E. This is why I took my DD and she was admitted and spent 5 days in hospital where they started refeeding. We were then referred to the CAMH’s ED team from hospital. This really sped up the process for us as hospital referrals have to be actioned within 5 days whereas I think it’s 2 weeks for GP/self referral. Just an idea.

@tupperwaretowers I’m about 8 weeks into FBT through our local camhs - the referral was super quick and we had an assessment within a couple of weeks of them receiving the referral. Your daughter sounds very poorly, just like mine was. We followed a meal plan and she’s about 82% wfh now. She’s off school and won’t return until she’s 85% wfh and then only part time.

I still can't figure out how to get DD to eat. Morning snack today was a muffin. She pulled a bit off, threw it on the floor and took a nibble. Then pulled some of what she'd chewed out of her mouth and wiped it on the seat. It's disgusting. If she ate what we gave her she'd be fine. I looked under the table today which broke my heart. I'm goi g to make her clean it later when we are back from the schoen. She's eaten one bite. That's it.

With my DD I remind her that she’s very poorly and that this is her medicine and what she needs to get better. To get back to school, back horse riding and to her old life again. I also tell her (rightly or wrongly - I’m not sure) she can either eat the food made by me and her dad, with me and her dad or she can be fed by strangers in hospital. Sometime I shout and sometimes I cry. I feel that she hates me but I know that’s just the anorexia.

I also am trying to stick to a rota of snacks and meals that I think for now she is most comfortable with and gradually increase the variety over time. I also do give her a little choice of what’s on the meal plan so for snacks I say you can have this, this or this!
I’m sure you’ve already tried all of this though, sorry I can’t offer more. Hope you get something positive from the clinic later today.
Today DD has completed a change balance sheet where she lists the pros and cons of continuing the patterns of eating she currently has.

@DarkBlueEyes I think it's normal for them to behave like this when they are really really unwell, it's a 'symptom'.

My DD would do similar things, whereas prior to the illness she would have been mortified to even consider half the things she ended up doing.
The black fog of the ED voice changes them, they can't see it, in their head everyone is wrong and lying ...... that's what makes this illness so wretchedly difficult to deal with.

@tupperwaretowers I hope you have had some success in finding strategies/help with BEAT.

@DarkBlueEyes - as others have said, it is a symptom. The other thing I'd add is DD needed to "show the anorexia" how much of a fight she'd put up before eating. So she'd majorly kick off, throw stuff, self harm - partly her ability to self control had gone -she'd go from green to DEFCON 1 in the blink of an eye but also it meant that when she finally gave in and ate something she didn't feel as guilty as she would have done without all the anger/violence/drama beforehand.

Dark agree with the others you have to separate the ED from your dd, the illness will make her behave in God awful ways. I think re the muffin I'd of kept repeating 'this is what you need, please eat this now, start with one bite' if she chucks it on the floor - replace it and repeat as above.

I personally wouldn't make her clear it up, it's not her fault and it is a symptom of the illness.

Had an appointment with the psychiatrist this morning, not much new to report except that the ED CBT lady is going to join dds normal CBT therapist on Friday. The psychiatrist mentioned that she's likely going to want to tell dd her weight which freaked me out. I said I absolutely did not consent to that and believed the consequences of telling dd her weight could be catastrophic 😢 She said she'd email her to tell her my views. I pointed out that I honestly don't believe that dd even wants to know as for her she can't get stressed about what she doesn't know!!

Why do they want to tell DD her weight girlie - am not sure why they see that as helpful? DD did get told her week at each obs because we agreed that the absence of the information would allow the ED to fill the gap with made up figures. However, if your DD hasn't been told her weight for a while what benefit will it bring?

DD doesn't want to be weighed at all anymore, in any setting. She recently had to go to the Dr for her pill and we had made sure the receptionist flagged up in the appt that no weight to be measured and helped DD practice how to say it if the Dr pressed (the Dr didn't). I did read on twitter of one GP in a consultation with someone in recovery who didn't want to be weighed because of ED and the GP replied "Thats fine, what can we agree on together as an assessment/measure for your good health" which I thought was fabulous

DD got told - not gets told - past tense myrtle!!

@Girliefriendlikespuppies that's what I do. Over and over. But she just won't, or if she does she spits it out or hides it. Or drops on the floor. Or holds it in her mouth and won't swallow. I just don't understand how to make her do it! She used to. Now she won't. This is how much she spat out tonight. Not to mention what was on the floor.

Sorry dark but I still truly believe that a&e is your only option. I apologise for saying this over and over but hospital really was our turning point.

I agree with NCTDN in that I think A&E is the best option for your DD after exhausting all other avenues. But I get the sense you are reluctant to take her Dark? Is it because you don’t think they will take you seriously? I honestly think that there are very good grounds for admitting your DD. But even if they don’t surely the very act of taking her and being seen by doctors will show your DD that you are actively taking control.

How did it go today btw at the private clinic?

The way I see it is that whenever you get your DD to hospital, that will be 'day 1'. You can choose to do 'day 1' when she's very ill but her body is compensating, or when she's at death's door. But 'day 1' will come. DD1 was 68% WFH by the time I kicked up a stink and told my Dr to document that she was safe with a HR of 144. But she'd been like that for weeks. Now, she's 100% WFH. There's no way on this earth I'd even let her get to 90% WFH without being seen now. EDT are talking about d/c her in a couple of months, once she's off olanzapine. My first question was 'and if all goes horribly wrong, what's the process for getting back to you? They said that they'd far rather see her before she was really poorly again.

I think we only managed to avoid hospital by a few days/weeks, if we hadn't had the 1st Camhs ED appointment when we did it scares me to think what could have happened. Dd was only 90% wfh then but her body and mind were massively struggling.

I think at any point if you can't get the food in at home you have to take them to hospital. At the very least a&e will do some obs, check what their bloods and heart are doing and insist they eat something. It also sends a clear message to the ED that you're not f*cking around and that not eating is not an option.

The clinic was good I guess. Really liked the psychiatrist and we have meds now. The reason I'm reluctant to take her is the psych said at this point she'd be sent home and that would reinforce her thoughts that she's not really ill. She can go to school only if she doesn't lose any more weight and clearly that will not happen as she's not capable. But you're right, hospital is now inevitable. However I do think she's beyond what they can offer and she point blank refused to go anyway. She's jealous of people in hospital apparently.

@DarkBlueEyes what do you mean by "However I do think she's beyond what they can offer and she point blank refused to go anyway."

I'm sorry to hear that your DD is 'jealous' of people in the hospital - did she say that?

Did she expand on why? It's not a good sign that you will get anywhere at home. I'd be telling A&E that when you ultimately decide to go, and i'd be making a big fuss about her behaviors so they take it seriously.