Purging and refusing food

[cheerup]

About a month ago, close to her twelth birthday dd told her dad (we're divorced) that she has been purging. She had been having problems at school for a little while, having started secondary during covid and not liking the new schools rules or making friends. Up until Christmas she seemed her normal self but since then seems to have generally been a downward spiral. Dad took her to the GP who checked her bmi - normal - and did bloods - at that point ok. Did a referral to CAMHS which was turned down. Since then she has pretty much stopped eating altogether and the very small amount she does eat she brings back up. We went to a&e on tues where they checked bp (ok) and got her to eat half a sandwich but didn't do bloods. Referred back to GP who has given appt on 13/8 to consider re-referral. She is now refusing pretty much all food, is purging the little she does eat and can't have eaten the volume of a single normal meal since Tues (at which point she hadn't eaten for a week). I'm beside myself. What do I do except as calmly as I can keep presenting food and asking her to eat it? Should I just go back to A&E tonight? It feels like an emergency but I have no comparators except for earlier this week which the gp seemed to think could wait given when the appt is.

I am so sorty to hear this. Hopefully, someone knowledgeable will come along soon, but meanwhile you may find this forum and website helpful:
www.aroundthedinnertable.org/h2around-the-dinner-table-online-forum-for-parents-and-carersh2-136439

Could it be Dr doesn't realise how little she is eating? Receptionist may not realise and just booked it in as a routine appointment? Could you get a telephone appointment with Dr or email/ ring and explain to receptionist in detail that she's now eating even less - almost nothing, and you're really worried.

Failing that, ask to speak to Practice nurse or school nurse for advice.

Unfortunately getting support for an ED can require a forceful approach, because the services that can provide support lack funding. Just because your daughter's BMI is normal doesn't mean she isn't unwell. You shouldn't have to wait until her BMI drops to get support. In the NICE guidelines it clearly states that BMI should not be used as a single indicator, so if you need to bring that up then do.

I think you should try and push for an appointment much sooner and get her bloods done again. Purging regularly will make her dehydrated and that can cause electrolyte imbalances.

Keep putting food in front of her and as far as is possible, make eating it non - negotiable. Get her to drink as much as you smoothie / milkshake type drinks. Tell her the bathroom is out of bounds for an hour after meal times.

I hope you get her the support she needs soon.

Thank you @Rustnot @Scarby9 @Atinytrolley. The GP knows how severe it is after the a&e letter and because I've spoken to them a couple of times since the initial appt.

@Rustnot how do I make it non-negotiable? I'd love her to have a smoothie or a milkshake but she won't drink anything except zero calorie diet drinks or water.

What area are you in? In most areas you can self refer to Camhs or the GP can also do an urgent referral. I would speak to GP reception again and request an urgent call back. If you are really concerned and she’s dehydrated then I guess it’s A&E. usually A&E would be able to refer to Camhs if needed.

What was the reason the initial Camhs referral was rejected?

I think that is the really difficult part, I realise I probably made it sound quite straight forward when the reality is I think you will have some very difficult weeks ahead of you. I suffer from an ED so have that perspective, rather than that of a parent supporting a sufferer.

You will get some good advice and support on this thread:
www.mumsnet.com/Talk/eating_disorders/4279530-Teen-Eating-Disorders-Thread-4

Getting the support of professionals will no doubt be helpful, as the message will then not just be coming from you. Again, easier said than done.