Teen Eating Disorders - Thread 5

[myrtleWilson]

Welcome everyone,
Our last thread can be found here
www.mumsnet.com/Talk/eating_disorders/4279530-Teen-Eating-Disorders-Thread-4?watched=1&msgid=111172926#111172926

That we're on thread 5 in about a year is a reflection of the incredible increase in mental health issues, including eating disorders amongst young people over the last couple of years.

With that in mind, we thought we'd try to include some resources that have helped us along the way to date. No one resource will be a panacea but hopefully this list will be a useful starting off point for any newcomers and a reflection for others. It is our first go at sharing a list of resources on a thread so it won't be perfect!

www.beateatingdisorders.org.uk

anorexiafamily.com/?v=79cba1185463

www.youtube.com/evamusby

www.youtube.com/channel/UCa7G1P5WQopVMc9qTSP_lgA

www.orri-uk.com

www.nhs.uk/mental-health/feelings-symptoms-behaviours/behaviours/eating-disorders/overview/

www.stgeorges.nhs.uk/wp-content/uploads/2019/01/Junior-MARSIPAN-Risk-Assessment-Framework.pdf

People to look up on social media
Hope Virgo
Ro-Recovering
James Downs
Cara Lisette
Adam Fare
BarefootRebel
Ilona Burton

Girlie hope Covid is not too bad for your DD

Betty - great news on a gain!

dark how are you doing?

Also thinking about you and your DD Dark. Hope your hospital stint isn’t too traumatic and that your DD is starting to resist the process less day by day.

Just reading about those who have been on admitted onto paediatric wards. DD was the only one on there. If there were more, does that not encourage 'competition' between them to not eat?

@DarkBlueEyes I've just read your update on the old thread. Take the chance to have some time to yourself x

@Rollergirl11 thank you 😊
I’m not sure what to think but dd described the scales rising and then falling and she watches ours like a hawk.
Anyway but if an update. After a miserable teams call with the nurse again yesterday I finally took the bull by the horns and made contact with the ED team. I spoke to a really helpful lady who has asked the clinical lead of the Ed nurse to contact me over the next day or so to discuss a return to school. Also after an email to the nurse the dietitian is also calling us on Monday. The meal plan we’ve been given isn’t at all tailored to DDs natural eating. Maybe we’ll start to see some progress with her recovery now.
One of the other things that occurred to me was DD insists that the ED feelings began in the January lockdown, she said she had time on her hands and her thoughts got carried away. She was also looking at social media that she probably shouldn’t have been. But DD is now almost in another lockdown, only worse because she’s the only one it.

NCTDN there were around 4 girls on the paed ward for ED’s at the same time as DD. Some of them we only saw on trips to the toilets/bathrooms but one Mum and DD who were in a bed opposite us we got to know quite well. We have all stayed in touch, DD with the girl and me with the Mum. I did worry that the girls might be in competition with each other and it might impede on recovery but DD tells me that the girl is actually really supportive as she completely understands. They never discuss weight or numbers with each other but more the mental side of things.

Betty that is exactly when DD’s started, around the end of Jan in the 2nd lockdown. Ended up looking at lots of pro-ana TikTok accounts and the seed took route. She has always had poor body image and (I suspect) body dysmorphia and lockdown gave her time to reflect. However DD has said to me since that she thinks lockdown was the catalyst but not the cause. Unfortunately it is now clear to us that DD exhibits all the building blocks to develop an ED. A high achiever with an anxious personality and a serious case of perfectionism. Throw in slight OCD and poor body image and there you have it! 😔

@Bettybarkalot123 @Rollergirl11 dd is the same. The winter lockdown was the worst point for her, trapped inside with bad weather. I'm worried that if there are any more lockdowns she will deteriorate again. She definitely suffers from seasonal affective disorder as well.

@Rollergirl11 you’ve just described my daughter as well. In hindsight I should perhaps have kept a better look out for the signs. We also have a family history, my cousin had anorexia when she was DDs age. A long time ago and she made a full recovery. My auntie got in touch with me actually to offer support. She told me that even back then they were given a meal plan, but they basically fed their daughter whatever she wanted to eat… if she wanted chicken they cooked it. She says after about six months she regained her weight and just started eating normally again. She was a compulsive exerciser too.

@NCTDN DD was the same and now she feels she’s locked down again and she’s struggling to cope.
Her teachers have been great and they call her into some of her lessons via teams, no one but the teacher and her friends know she’s there but she is able to listen. She heard her friends voice in the lesson today and she says it made her feel sad. I said sad enough to eat a big bowl of rice pudding??!!

I’m expecting a call from them this evening so I will ask about school then. Dd said her symptoms started when she had to isolate before Christmas so maybe that’s why they haven’t pulled her out yet. Also I don’t know if they take into account her previous weight? As she has always been very light even when she used to eat well. I’m clutching at straws as you can probably tell!

@Valleyofthedollymix dd already eats lunch in a lunch club which is run by one of the pastoral staff at school for kids who are struggling. The staff member is happy to monitor what she eats and to get her to eat more so that’s really reassuring for me. Her snack may well not get eaten though and I’m not sure how I can control that while she’s in school.

@Rollergirl11 she’s currently on a reintroduction to foods starter plan which is quite small portions but just to get her eating and drinking regularly again. Then they’ve said after a week or two max she’ll go onto a weight gain plan which is bigger portions and high calorie. She’ll be on that until she is weight restored and can then go onto a more normal eating plan to maintain weight. Does that sound similar to how others have had to do it?

@Moomarre dd started on half portions of food then built them up in a similar way. She too is tiny anyway but I have no idea what her weight was before all of this as I never had any need to know. She was still going to college the day before she was hospitalised at 70%wfh because we didn't realise how low it had got. She never had any physical symptoms to make us concerned apart from the obvious weight loss.

My dd is also similar in that she is also a perfectionist, suffers with poor body image and lockdown gave her the perfect opportunity to invest in restricting and over exercise. Plus all the Joe wicks and my mum (unintentionally) pushing healthy eating and exercise did not help.

Dd is feeling a bit better today, temp is down but appetite not improved 😕 I had a bit of a meltdown this morning and called the ED a lying, manipulative bitch 😶 not my finest moment but I think seeing her leave all her breakfast was massively triggering for me.

She's managed some of her lunch but still not great tbh - ugh. So frustrating as had just got to 100% wfh and this feels like a big step backwards.

@Moomarre DD was admitted to hospital and spent a week refeeding there. They started off smaller (I think around 1200 calories) but introduced something new each day. So a dessert after dinner one day, then dessert after lunch the next day, then a mid-morning snack next, then mid-afternoon snack the next. After a week (which coincided with when she got home) she was on 3 meals + 3 snacks and 1 pint of milk per day. All food controlled by the parents. This is the basis of FBT (family based treatment) that all ED clinics follow.

Cor a pint of milk? We've never had that (thankfully as we've never been a milk-drinking family so DD would have struggled).

@Reallyimeanreally2022 I know that nausea can be a side effect of Sertraline but I've never heard that it reduces appetite. We've not noticed either so far - in fact we've had probably our best week since starting it (though I suspect this is coincidental). Psychiatrist said that he's had good results with it and is the one best tolerated with risperidone.

As long she never has Olanzapine again, I'm willing to give it a go!

Valley maybe that was because DD’s periods had stopped actually. They said the milk was because of the risk of brittle bones with the lack of estrogen so the milk is to combat that.

@Rollergirl11 my dd was sent to hospital for blood tests and an ecg but they released her after a couple of hours and she was just sent home with no real advice other than to keep offering her food and to keep a food diary until we had our appointment with the ED nurse 5 days later. Then the ED clinic gave us the attached meal plan and said if she doesn’t eat it go to a&e

That seems like a v cautious meal plan tbh moom, I'd recommend trying to add calories where possible. I consider myself somewhat of a pro at maximising every mouthful so if you want ideas for high calorie meals or ways to add double cream and butter to everything let me know!!

For decent weight gain your dd is going to need at least 2500 calories a day, ideally closer to 3000 calories and for some teens it needs to be a lot higher.

What was the verdict re school?

@Moomarre the WFH sounds about right. I've just put your DD's stats in to my instant weight for height app and if she's exactly 15, it's 73.6% WFH and if she's very almost 16, it's 71.87% WFH.

DD1 has had a tricky few days. A week off last week for her cold, then she's vomited 2 nights in a row because she's constipated.

@Valleyofthedollymix

Firstly nausea reduces appetite automatically

Secondly, my GP was very hesitant re putting me on it as I’m very underweight

I have not noticed a reduction in appetite but certainly my sister has

[quote Moomarre]@Rollergirl11 my dd was sent to hospital for blood tests and an ecg but they released her after a couple of hours and she was just sent home with no real advice other than to keep offering her food and to keep a food diary until we had our appointment with the ED nurse 5 days later. Then the ED clinic gave us the attached meal plan and said if she doesn’t eat it go to a&e[/quote]
Cautious yes
But I think really good
Your daughter will like the use of “small” “half”
I think it’s a good starting point
But certainly won’t lead to any substantial weight gain

Can I join please. A few days ago my 14 year old son admitted to having an eating disorder. He said he doesn't eat for days and then when he does he will binge and then purge. As a result of the binging, he then self harms as a form of punishment. He's already under CAHMS for anxiety, I've let them know and he has an appointment in 2 weeks. Seeing the GP tomorrow. What sort of support is available for the next steps. I'm so worried about him. He ate his dinner today but then purged it. He's had nothing else to eat

I've been reading through the threads and keep seeing wfh. Could someone calculate that for me please? He's 5ft 11 and weighs 8stone 12lbs and birthday 30th December.

Hi @Mamazita I'm sorry you're joining us too. He's 87.5% WFH, but you should bear in mind that it isn't just his weight itself that you need to think about, but the rate at which he's losing. If he's missing food for days, then he could well become biochemically unstable (i.e. his electrolytes can have the wrong values) and his heart, etc., can struggle.

Has he given you any indication of how long he's been struggling? Do you know how much weight he's lost and over what time period?

I think I'd be tempted to take him to A&E if he's not eating (and keeping) over 500 calories per day.

@Lougle

Hi *@Mamazita* I'm sorry you're joining us too. He's 87.5% WFH, but you should bear in mind that it isn't just his weight itself that you need to think about, but the rate at which he's losing. If he's missing food for days, then he could well become biochemically unstable (i.e. his electrolytes can have the wrong values) and his heart, etc., can struggle.

Has he given you any indication of how long he's been struggling? Do you know how much weight he's lost and over what time period?

I think I'd be tempted to take him to A&E if he's not eating (and keeping) over 500 calories per day.

Thank you! I don't know exactly how much weight he has lost, but he's gone really skinny. He's also an obsessive exerciser and says he's walking on the spot in his room until 3am to hit 25K steps. He said he wants to get down to 8 stone to be happy with his image. I'm so worried, that this has spiralled out of control. I hope cahms and the GP can do something. Will they take it seriously given his wfh? It doesn't seem as low as others on here. The self harming really worries me too and I'm so scared

@Valleyofthedollymix

Sorry to bother
Could you calculate my Neice’s please
5’7 7 stone 2 pounds 17 years old

Despite being in this space for longer than I care to remember - I don’t know how to calculate WFH

@Reallyimeanreally2022 74-75% WFH, depending on which end of 17 she is.

@Mamazita they shouldn't be judging on his WFH alone. The link in the first post to the MARSIPAN checklist shows all the factors they should be taking into account.

@Reallyimeanreally2022 @Girliefriendlikespuppies from what they said she won’t be on this plan long, it’s just to get her used to eating regularly again and then she’ll go on the weight gain one after a week or so. She feels like she’s eating loads and is really uncomfortable but is doing well at eating without too much fuss.

Regarding school they’ve basically left it up to us to decide for now. Mixed feelings about this but dd is happy. I’ve told her if she doesn’t eat I’ll be pulling her out though.