Teen Eating Disorders - Thread 6

[myrtleWilson]

Hello everyone, and welcome to anyone looking at these threads for the first time..

Here is a link to thread 5 www.mumsnet.com/Talk/eating_disorders/4360801-Teen-Eating-Disorders-Thread-5

We've seen such an increase in young people facing eating disorders and these threads are testament to that.

With that in mind, we thought we'd try to include at the start of each thread 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

@BloodyHellKen hi and sorry you have had to fund us....
Your main advantage here is your DDs age. (My DD was 13 when she started restricting too). You shouldn't encounter issues with medical competence (when your DD can make all medical decisions herself) and so my advice is to hit this hard. My DD is now 15 and it would be v different now....
Some things i would add (and which you may be already doing from your post) are to ban your DD from all food prep and decisions on what to eat. Food is your domain and non negotiable.
I found a weekly meal plan v helpful. Dd was not involved in making it (given any choice the ED will default to as few cal as possible although my DDs ED was quite naive about what cals were in what!) but it was left for DD to read and the lack of surprise was helpful to her. ED makes spontaneity almost impossible. Include all snacks and drinks in the plan too. At the height of her illness my DD used the plan as a to do list and it helped her see the food almost as chores that she had no choice but to do. This helps them in their internal fight with the ED "I had no choice I had to wat mum made me" gives them an 'out'
Try not to go more than 4 hours without food (except overnight). Set meal/snack times also help. We did 7am, 10am, 1pm, 4pm, 6pm, 9pm
Distraction when eating helps stop the drawn out eating you mention. TV show (we found a series on Netflix and watched one a meal for instance), quiz shows are good too, chat about something else, games, puzzles, colouring. Whatever works.
If she is already drinking smoothies or you plan milky drinks then add double cream. My DD had a 700 cal smoothie every evening and now she is weight restored a 400 cal version and the only difference is double cream. add it after blending as it will make it v thick otherwise. Or use a high fat icecream can send you the recipe if you need.
The quicker she gets the weight on the more likely a full recovery is. Although full recovery looks different in my experience to 'life before ED' and leaves the sufferer at risk of relapse and with a very small and quiet voice which is still a whispering presence at times....sadly. currently your DDs ED is a loud shouting terrorising bully in your DDs head. Every time she gets upset remember the ED is making her upset not you. Hit it hard and it will eventually retreat. My DD says now that when she was at her worst she was so hungry she was in pain but 'wasn't allowed' to eat. She knew rationally she should but was totally unable to because of that ED voice/ bully. She was relieved when I took total control and stood up to it for her. She still hit me, broke stuff, got hysterical. The power of the ED is huge. But you have to be stronger than it.
And yes it is exhausting and some days will be better than others and some weeks weight will go on and some not recovery is not linear. Be kind to yourself as well.

@Lougle this sounds like a worrying situation for you. I dread DD getting ill. My DDs braces have been an issue but now wax has arrived it is settling... I hope your DD and you can get herself back

@Lougle Sorry to hear your DD has had a setback. Just a quick word on Olanzapine. It comes in different formats, so you could request the pill form (soluble on tongue, or the one you swallow with water) if it does come to that.

Hi all, I’m very glad to find this thread and hope you can help me. My dd12 seems to have suddenly become severely anorexic in the last 2 months. It has come out of nowhere, although she does have autism so it isn’t unusual for her to have sudden extreme obsessions. About two weeks ago she basically stopped eating anything at all and has been surviving on for eg an apple, a piece of lettuce and a carrot stick a day. If I try and persuade her to eat more she just repeats that she’s fine and she’s not hungry.
My immediate problem is that we are in Spain on holiday with friends at the moment, which is making the situation so much harder. As soon as we get home I will get her an urgent appointment but for now I don’t know what to do to get her through this holiday. I’m not coping very well and haven’t slept at all and feel sick and panicky. I’m trying to control that for her sake and not to get into battles over food as she doubles down but I feel completely helpless and lost. And also worried that she’ll collapse from hunger while we’re here.
Any advice to get us through the next week on holiday would be great - I need to pull myself together but it all feels too overwhelming at the moment.

Yes, the trouble is that DD1 needed 1mg and the Psych didn't want to prescribe liquid because it's expensive.

Iam hi and welcome to the thread.

If I was you I would ban all 'fun' things on holiday unless she eats, no swimming or beach etc. Basically put her on bed rest. Make sure you are making her food and giving it to her with the expectation she will eat it. If you're not getting any food into her (less than 500 cals a day) you may need to find a local health centre to take her to to get checked out.

Autism and EDs are a very common mix unfortunately,

I'm also abroad at the moment and it has been harder to manage than I expected tbh, I naively thought as dd was weight restored and eats generally okay at home it would be fine here. I think the hot weather, change in routine and different foods have all been a challenge.

@Iambitingmytongue What a nightmare for you. I do think collapsing is a real risk especially in the heat - my DD fainted after 48 hours with no food. Is she drinking? Can you get juices and/or smoothies into her? Do you have access to a doctor where you are?

@Iambitingmytongue sorry that you find yourself here. There is a lot of experience to draw on. In your shoes my primary concern would be DD fainting due to lack of food, low blood sugar and the heat. Is there anything that she will eat, apologies if I am stating the obvious but what about cold foods in the heat, smoothies, ice cream or milkshake?

There is also the flight home to consider when lower cabin pressure can cause disorientation.

I would certainly seek out details of local medical centres.

Food is her medicine and getting that food in her. Easier said than done.

@Girliefriendlikespuppies although we are holidaying in the UK we are experiencing the same issues. I wish DD was back at school with the set routine. Waking up, food and mealtimes are all over the place and the disorganisation is helping the ED. I’ve never been as anxious on a ‘holiday’.

Thank you all. I had been told to try and ignore it and not make a battle of it so I backed off but it sounds like that isn’t the best plan at this point. I’ve gone and told her that she shouldn’t go in the pool until she’s eaten something and she’s still digging her heels in. I will keep trying. It feels wrong to use threats but I did say we would find a local doctor if she doesn’t eat a bit more today. I don’t think she believes me but I am prepared to!

@Iambitingmytongue - Others have given great advice re eating today. But regarding seeking medical advice in Spain (hopefully you won't need it -you may speak Spanish already and the local medical centres will probably speak English too) but I speak a bit so if you need help with the language either written or oral do drop me a DM.

That’s so kind of you, thank you. We actually used to live here so speak Spanish and it’s all familiar and not as scary as it could be.

@Iambitingmytongue your DD may well be feeling 'fine' but most kids with ED are actually really scared underneath it all. Scared of what they're doing and scared of what will happen if they stop. I think, given that you're in Spain, I would initially look at her fluid intake because that's what would do her damage the fastest. If you can get her to drink well, great. Bear in mind that lots of water on its own can deplete electrolytes, though. Food is really important. Are there any foods that she will willingly eat? Would she eat a few nuts, for example? They look very innocent but have a lot of nutrients and a good fat content.

Iam yep backing off is often dished out as advice when actually you need to do the opposite and be really hard on her. It feels completely wrong to bully them into eating but ultimately they have to eat or they die.

Lougle I know you're quite good at working out calories can you give me a rough guesstimate at what two small pancakes with Nutella, two small pieces of toast with no butter and a small scraping of Nutella plus a portion of melon would be?! I'm thinking probably less than 500 cals ☹️

Dd really struggles with the buffet style breakfast and won't ever go back for more incase anyone thinks she greedy 🙄

It's the same at dinner time, it's all buffet style food and they only give you annoyingly small plates.

Oh well, dds currently in the pool and has found some other kids to play with so it's not all bad. This is the current view...

D1 yep I feel the same although dd starts college in sept which will come with its own set of challenges.

@Rollergirl11 @Girliefriendlikespuppies (sorry, tagging not fixed yet!)
If 2 small pieces of toast is the equivalent of 1 slice, that's 82 calorie. If it was just 2 quarters, 41 calories.

A heaped teaspoon of Nutella is 80 calories.

Pancake... Depends on the recipe.
www.bbcgoodfood.com/recipes/easy-pancakes this one is 61 per small pancake.

Melon isn't worth counting. 35-40 cals per 100g.

Ugh that's worse than I thought Lougle 😕* *

I can see her loosing weight this holiday and having to massively up the calories when we get home.

Sorry 😞 The good news is that if she'll eat pancakes on holiday, you could make fortified ones (duck egg, double cream) when you get home that will seem the same.

Yes Lougle I'm hoping she can eat enough to maintain if nothing else, she's just had a vegan wrap (large one) and ice cream for lunch which I'm hoping is 500-600 cals.

She's probably getting around 2000 cals a day compared to 3000 cals at home.

Hello, I hope it's ok for me to jump on this thread and ask some advice.

I'm concerned that my DD13 is starting to show some signs of disordered eating and I'm not sure at what point to jump in, or even what to do if I do need to intervene.

She's over the past month or so started to eat less at each meal, leaving food whereas before she would have eaten all of it. She says she's eating breakfast at school but I actually don't know if this is true or she's skipping (she ate at home until about 5 months ago). The amount being left at mealtimes has increased and I've noticed her going for healthier options for treats eg lolly instead of ice cream.

However she does still buy and eat sweets, and if I make a nice dessert she likes she will still eat it all.

Tonight she was really upset and told me she was fat and hated it. She's definitely not, is a size 8 and if anything I'm worried she's lost a bit of weight. Her body is developing though and I know she feels really self conscious about it.

I'm very sensitive to this as my niece (who she is close to, although doesn't see very often) has had quite serious anorexia involving being sectioned and a lengthy stay in a facility , so I have seen at close quarters how awful and insidious this illness can be. She's out now and is doing well, but obviously still a long road to full recovery. We're due to go on holiday with them in a few weeks and this also concerns me in terms of what they will say to eat other.

Would really appreciate some advice on what I do from here as I'm really worried

Hi little it sounds like you're right to be worried tbh, anorexia does have a genetic link but the major factor that kick starts it is weight loss.

I would insist she has breakfast at home and keep a close eye on other meals.

If she wants to eat sweets and puddings then fab, that should definitely be encouraged.

Thanks. How do I insist about breakfast? Do I be open that I'm worried about how much she's eating and I want to see her have it?

She does get quite upset/annoyed at any perceived criticism (which I know is a normal teenage trait)

Hi @LittlePickleHead - I am so sorry you are going through this. I would also say, and others may not agree with me, but I would be careful about using the term 'anorexia' around your DD too soon. Not because I don't think she is showing early signs of it (she could be - or at least disordered eating) but AN is a competitive illness and you don't want her to compare herself to her cousin's illness and feel that she isn't 'sick enough'.

I would start by insisting on breakfast at home - perhaps make it into something nice for the two of your together with her favourite food and time for you two to talk about something / plan something together. Try to re-establish it as something that is normal.

Role model a healthy relationship with food and your body yourself as well (e.g. no diet talk or mention of 'summer bodies' etc). Try and work on boosting her confidence - this website has some great mantras / cards etc zannakeithley.com/resources/

If things don't improve, I would reconsider going on her holiday with the cousin who has been unwell depending on where your cousin is in her recovery as that could prove very triggering to your DD.

We had the psychiatrist and LD nurse yesterday. They're worried and talked through the options. The fluoxetine is already above the normal dose. To change to something else would require weaning off the fluoxetine first so they don't want to do that while she's so low.

First step is to increase physical activity and keep a diary of it. See if that improves her mood.

How are you feeling today @Lougle - sorry that the psychiatrist and LD nurse were worried - its a double edged sword isn't it - you want someone to reassure its all fine and yet at the same time, there is often a relief when you know someone feels the same as you.

@Iambitingmytongue did you manage to avoid the medical centre? How are things going for you @Girliefriendlikespuppies and welcome @LittlePickleHead

DD got back from mini break in Cornwall with her boyfriend and had a bit of a body image wobble but she dealt with it very well - both a reminder of the long haul nature of this game but also a reflection on how far she's come.

She's started thinking about next steps in terms of jobs - she was interested in a CAMHS apprenticeship which surprised me initially but I think from the anecdata that is social media a fair amount of those who have recovered from ED end up working in medical/social care settings - a bit like how I vowed to retrain as a midwife after having DD (reader, I didn't retrain)

Hi @myrtleWilson , thanks for asking. We ended up cutting short our holiday and flew home today. She hadn’t eaten more than a piece of fruit for 2 days. Currently sitting in A&E waiting to be seen. I just can’t get over how rapidly it all escalated… hope they take it seriously and we can get her the help she needs. Poor thing is begging me to take her home and telling me she’ll eat but I know we need to stay.

Am so sorry iam but you're right - you're in the right place - if you need to refer to the MARSIPAN scale it is on the very first (or second) post of this thread. I hope you get seen and treated well