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?

[quote myrtleWilson]@DarkBlueEyes - with your detail about the nice surprise I think I'm now less surprised about the vomiting moment. ED's (in our experience) really try hard when under pressure - DD had a bad day last week when the ED was going crazy in her head but that was because the ED was mightily pissed off about how good DD's life is at the moment. My advice would be to keep talking and use tonight as an illustration of how the ED wants nothing more than to squish her down again and take away all the good things that are starting to open up for her.[/quote]
Yep I saw this yesterday actually, dd had had a lovely day and even managed some bday cake at her cousins bday party.

By the evening her mood was terrible, it's like a black cloud just appeared.

Thankfully these moments at getting more short lived and today she's fine again.

@DarkBlueEyes I have no advice re.purging itself, but my dentist clocked that DD had an eating disorder and gave me a discreet chat about it. Main points are don't clean teeth after purging for at least an hour. Encourage a glass of water because it rinses off the acid from the teeth.

@NanFlanders I'm glad your DD is safe. I agree that tube feeding can be the best thing in the short term. We almost went down the tube feeding line but DD1 was upset at the thought of being admitted to hospital again (we were planning a 3 day admission to stabilise her on a tube then home tube feeding) and the psychiatrist suggested a trial of olanzapine first. It was like magic and the tube wasn't needed.

My dd 14 had her first appointment at the ED clinic with camhs today. The lady there was lovely and said it sounds a lot like anorexia.
They've advised me to give her 3 full meals and 3 snacks a day no matter how much she resists, that will be a challenge in itself!
They told us to think of the ED as an invisible person that wants dd to starve herself and purge and to work against it by feeding her.
They also told her not to clean her teeth for an hour after being sick.
This is gonna be a long battle

That sounds good @peanut22
How are you both feeling?
My DD cried yesterday at her first appointment but I felt an enormous relief.

@Complexneeds I feel glad that she's realised she's not well even though it will take time to recover. DD said having 3 meals and 3 snacks is impossible for her but she made a real effort yesterday, she didn't have breakfast but she ate lunch and dinner and had 2 snacks

That’s a great start! My DD is having a good go at it too! Snacks are tricky but had pom bears for 2 of her snacks yesterday that are very light and only 60 cals but the clinic said to keep portions etc normal and build up gradually. When do you go back?

Complex if your dd eats Pom bears then what I'd do is decant them onto a plate and add half or a full other pack.

Complex and Peanut good luck, I remember the start of the journey well 😕

What I would say is don't be afraid to poke the ED beast, you have to see it to slay it. Don't offer lower calorie choices thinking that will cause less stress (it might for one meal but in the longer term will just prolong everything.) Get used to adding fats (cream, butter, oil etc) to everything.

Don't back down, if you want them to eat it they have to eat it. Use whatever leverage works and lots and lots of distractions- talk about anything and keep them talking (and hopefully eating!) Use phrases like 'this is exactly what you need' ' this is exactly the right amount' 'I know exactly what you need' 'trust me'

Ignore any bile spewed by the ED, if it's angry then good - you're fighting a war and you want it to feel under pressure!!

@Complexneeds

That’s a great start! My DD is having a good go at it too! Snacks are tricky but had pom bears for 2 of her snacks yesterday that are very light and only 60 cals but the clinic said to keep portions etc normal and build up gradually. When do you go back?

The ED clinic are going to call me by the end of the week to let me know what happens next. DD didn't manage breakfast this morning, I think she deliberately got up late although she'll deny it. School will make sure she has lunch and I'll make sure she eats tonight

@Girliefriendlikespuppies I really appreciate your posts, you are so good at reminding me to keep pushing forward rather than just making the least stressful choice. Thank you

[quote LizzieDarling]@Girliefriendlikespuppies I really appreciate your posts, you are so good at reminding me to keep pushing forward rather than just making the least stressful choice. Thank you [/quote]
Thank you 🥰

Fwiw I've definitely not always pushed when I should have so it definitely is a case of picking your battles. Some days you're just more battle ready and determined than others and that's okay.

I had a sharp reminder today that we still have a way to go, last week dd had to buy lunch at school for a couple of days as she was in an evening drama show. I checked the online account today and sure enough on one of the days no lunch was bought 🤨 she swears blind the payment machine was broken.

I'm so pissed off, just when I started to think I could relax a bit.

Peanut I wouldn't let her out the house if she's not eaten breakfast 🤷‍♀️

Thanks girlie decanting pom bears is simple yet genius!
peanuts so your DD is still going to school? Although my DD is upset there’s no school it would have been impossible to give her 3 proper meals and 3 snacks unless at home. She just wouldn’t eat them.
She’s sleeping with me at the moment as she’s so sad. She’s missing a high level competition that’s in 3 weeks, which she’s been training hard for. She’s so upset. She doesn’t know what to tell her friends who are asking where she is (school and training). She’s told a couple of friends that her weight is too low but they’ve said things like ‘just eat loads then’ and don’t see why she can’t train and continue in the team. She cried and cried herself to sleep last night.

Oh Complex that's so sad, your poor dd. That's one of the hardest things, seeing them so upset and not being able to 'fix' it for them. And the terrible fear of food, dd is doing well with her meal plan, but the look of absolute terror at the mention of changing it in any small way.

We are going to the cinema today, I'm hoping it will cheer her up. Dd is so weak she can't walk far, I've found a local cinema with a lift from the car park she should be able to manage. Going to a mid day show to try to fit in with the meal plan. For lunch she has soup one day, a sandwich the next. I have to pick a sandwich day to go out, so we can bring it with us. The logistics fry my brain at times. It seems another lifetime when we could be spontaneous with outings and meals and eat whatever and whenever we liked. EDs really suck the joy out of life.

Hello and welcome (wrong word) to newcomers. I'm so sorry that you've realised your child has an eating disorder. It sucks, it really does. The last year has been crap but we will get to the other end.

I've been a bit absent - I think I'm just sick of the whole business and work and other child's university applications has diverted me.

DD has just got her second period, 28 days after the first. She is convinced she's now the right weight. It's only 83 or 84% WFH but it's almost exactly where she's always been on her the growth charts (25th for weight, 75 for height) other than the weird rapid weight gain in first lockdown. Obviously I want her to gain more weight but it's a battle. I oscillate between fighting to carry on sticking to the meal plan to the letter and introducing some independence as we're all fearful of the next phase.

I feel very weary, it grinds you down.

@Valleyofthedollymix you ae absolutely right, it does grind you down, I am right there with you.

I thought I would share the meal I made last night which DD14 ate and loved - previously having gone nowhere near a curry.

www.recipetineats.com/poached-salmon-in-coconut-lime-sauce/

I added lots more fish sauce and it served three, so lots more sauce to spoon over. At four portions it's 500 cals approximately so a good dinner choice. It was yummy. I added mange tout, broccoli and cauliflower to the sauce and poached the salmon over the top.

I'm trying to find therapy for DD now. Has anyone used the Surrey Centre for Eating Disorders? The wait list at CAMHS is months long and trying to find a a private therapist is a nightmare as there are so few who will treat adolescents/EDs.

Much love to you all, keep going.

Apparently our clinic doesn’t give meal plans. Not sure how usual that is. Would any of you be willing to share yours please? She’s 78% wfh and only needs to gain a kilo to get to 80%

Goodness, in the early days I'd have felt very adrift without a meal plan - not because of the plan itself but because of its legitimacy because it came from the dietician not us so Dd could say to the anorexia she was eating because of clinical direction. Plus our calls with the dietician were helpful part of therapy.

I'll dig out an old copy of ours but this is from Dorset and gives you an idea.
www.dorsethealthcare.nhs.uk/application/files/6016/1968/9531/Restoring_towards_a_healthy_weight_7_day_meal_example_plan.pdf

Where that isn't helpful is if you're dealing with any particular fear foods and you have to work around these. When we were at 2000 calories a day we used to do roughly breakfast at 350 calories, lunch at 400 and dinner at 500 which left 250 for each snack. Does your DD have any fear foods that you need to work around?

lizzie hope the cinema trip goes well. What a great idea! Oh valley it’s so hard It’s only day 4 and I’m already bored, exhausted & fed up (esp of thinking of things to cook).
@DarkBlueEyes I’ve heard good things about the Schoen centre in Chelsea. Could be too far from Surrey. Roehampton Priory had no vacancies when I called; the next nearest priory in Chelmsford had nothing until May. Couldn’t find anywhere else. I’m a bit concerned that our nhs one aren’t going to offer anything at all.

@complexneeds we did have a consultation at the Schoen, I really liked the psychiatrist there. DD did not want to go however, but it might be an idea to revisit. We didn't get a meal plan from the clinic "you know how to feed your child". But we did get one from the hospital.

I have posted a number of recipes on the various threads if you can be bothered searching for them. Our meals look like this:

B: 2 weetabix with blueberries and FF milk enriched with Nestle Nido. or bircher muesli (recipe on the thread), blueberry wheats with milk as above, 2 crumpets with butter and honey, plus a juice with added maxijul
S: at school so somethig in a pack like an Alpen, Brunch Bar, KitKat etc, plus juicee
L: sandwich of some sort - toasted foccacia with cheese and sweetcorn (green pack from Waitrose), or a wrap (use two mission wraps sandwiched together with butter and mayo - heat up a little so the butter can't be scraped off) with home made tuna mayo and cucumber (use tuna in oil and only drain lightly), PLUS packet of crisps, biscuit of some sort and small amount of fruit, plus a juice as above
S: home made baking with juice Or hot chocolate, or nestle quik
D: pasta bake/sausages and loaded mash/thai curry/burgers and chips/tuna linguine/chicken kiev I use the mini dauphinois from Lidl, and the skin on chips from Lidl (add lard). Puddings either home made OR the melt in the middle puds from Lidl, or the salted caramel cheesecakes or sticky toffee puddiing (all with double cream or ice cream) or the little apple tarts in the cake section with ice cream (tart heated up), eton mess etc
S: pack of smarties, two or three chocolates with herbal tea with added maxijul or a hot chocolate.

Disclaimer: I have NO idea how many calories this is!

Dark that meal plan sounds similar to what we were given however I had to tweak dds as snacks were and are such a sticking point.

Our (unofficial) meal plan looks like this.

Porridge mixed with double cream and ff milk for breakfast, large portion approx 650 cals. Small glass of juice or small yogurt drink.

Tuna Mayo sandwich (thick bread from Aldi 130 cals per slice) bag of crisps, piece of cake or chocolate bar, small yogurt, juice or smoothie approx 700cals (or would be if she finished it all 🙄).

Cereal bar 200cals

Dinner is a large portion of whatever I have cooked usual meals here are pesto pasta with cheese and garlic bread, fish pie (with added double cream to the mash) veggie cheese burgers and chips, jacket potatoes and beans and cheese. I add butter and double cream anywhere I can 800 cals .

Pudding is a large portion of something yummy, current favourites are tiramisu, sponge pudding and cream, cheesecake or a portion of chocolate. 600-700cals.

Aiming for around 3000 cals a day. The meals have to pack a high calorie punch as snacks are missing morning and evening. Teens (girls) need to be on at least 2500-3000 cals a day for weight gain and for some it's much more than that.

I built this up over the last 18 months or so by gradually increasing portion sizes and exposing her to fear foods over and over again. That said all fear foods vanished around 98% wfh.

Valley I wondered how you were doing, I hear you re feeling weary, I still struggle to see a time when dd will just eat normally. Can you book yourself some you time? A day doing something for you?

Thank you for your plans @Girliefriendlikespuppies and @DarkBlueEyes
I spoke to the ED clinic earlier and they insisted no supplements, no special foods, no adding cream or butter if don’t already or any additives - just regular family food. But we are still being assessed so maybe that’s the reasoning. It’s also slightly reassuring that that meal plan has taken months, as there’s no way my DD could eat anywhere near that amount. I’ve two older teen DDs and they’d have no problem though!

So true that the ED sucks the joy out of everything. I'm glad to say it does get better and we are on an upward curve which is a good job as DD plans on going to uni in September. She's put on 37% of her bodyweight since being hospitalised yet still not 100% wfh apparently. Like pp, she's never been what they would say is 100% though so I'm just happy if she now maintains and continues to get better mentally.

The ED clinic doesn’t seem to think it’s an eating disorder as she’s not actually lost weight. She’s gained 2kg in the last 8 months which follows (just below) the 2nd centile. Hence the extended assessment over the next two weeks.

@ComplexNeeds

Thank you for your plans *@Girliefriendlikespuppies and @DarkBlueEyes* I spoke to the ED clinic earlier and they insisted no supplements, no special foods, no adding cream or butter if don’t already or any additives - just regular family food. But we are still being assessed so maybe that’s the reasoning. It’s also slightly reassuring that that meal plan has taken months, as there’s no way my DD could eat anywhere near that amount. I’ve two older teen DDs and they’d have no problem though!

Personally complex I'd ignore the clinic and go with what you think your dd needs. If she can't eat large portions literally every mouthful has to count. Plus normal family foods should include lots of fats and dairy anyway if you're feeding teens.

This thread is nearly full 😮 hoping Myrtle is happy to keep the tradition going of starting new threads!!

Done!
www.mumsnet.com/Talk/eating_disorders/4471980-Teen-Eating-Disorders-Thread-6?watched=1