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

She knows she has anorexia and that she's been very ill, has been hospitalised etc. we've never had really in depth conversations with her but as it's been going on for so long she's obviously been aware that things weren't normal for a long time (previously they were very close). My niece has just been diagnosed with ASD which means she has additional needs (and probably why traditional FBT treatments didn't work for her).

We don't see them often at all hand holiday was the first time in about 5 months.

As far as we tried to shield her, on holiday the restrictive and controlled eating was obvious, as was the codependent relationship with my SIL (my DD commented that they seem to be closer/she gets a lot more attention than with me and my DS).

After the holiday she showed me a photo from behind her and niece jumping into the water in their wetsuits and got upset saying how much fatter she looked.

Obviously have no idea if we handled the whole situation with my niece correctly, but she was only 9 when it started so we've gradually been a bit more open the older she has got.

We won't be getting the two of them together for the foreseeable future as I assume detrimental to both of them now.

Sorry I meant DD commented SIL and DN seemed to have a closer relationship than me and DD (not DS)

Little you are definitely doing the right thing by taking control, NICE guidelines state two weeks to be seen by an ED team so it definitely should not take months.

I think weighing her would be useful for you but I wouldn't let your dd see the weight as this can become another obstacle to refeeding.

I wouldn't talk too much about your niece, anorexia is a genetic condition so it's not unusual for two close relatives to have it sadly.

Are you on the FB group? There's lots more guidance on there about implementing FBT.

Personally I'd say no dancing until she's much better and a much higher weight. They just can't afford the extra calories at this point.

@LittlePickleHead don't feel too guilty though, you cannot isolate your child from others with ED as it's really prevalent sadly, my dd has a friend who is treated by the same ED team and posts constant updates from the ward (!), and where I work in HE you can see visibly thin girls walking about campus, so the idea you could isolate your child from all examples of this is false. Plus we sit in a ED clinic with other young people with ED every week! Which I've always thought is a bit odd. Often they are crying/having issues with their parents, the whole thing is very public, and it models all kinds of things to the other patients, as does going onto the wards if you do that.

DD understandably nervous about going back and how it will look to her friends that she's leaving for lunch each day. They obviously knew that she was throwing her lunch away each day but I don't think aware of the extent of the issue.

I don't know how to advise her other that to say it will all be fine, but I know how girls can talk and I'm worried about her getting comments or teased.

Any advice on how I can make her feel better? In the same situations were your daughters open and honest? Feeling trepidation about next week and doubting myself wondering if I can trust her to eat in order to not make things awkward at school (I know this isn't a good idea)

The way I did it little was that as that as long as the weight went back on I didn't enforce lunchtimes at school. Dd was mortified at the thought of either a teacher or me coming into the school to watch her eat so I agreed that as long as I was happy with the scales (she was blind weighed) I'd 'trust' her.

I don't believe she ate everything from her lunch but she did consistently gain weight so for me that was enough.

Hi @LittlePickleHead do her friends know about her illness? My DD felt able to tell 3 close friends and allowed me to talk to their mums so they all understood the going home for lunch thing and were able to deflect anyone else who asked! If she hasn't or isn't willing to tell friends then she is going to have to brazen it out.
Tbh there's not a lot you can do to reassure her. She has to sit with the anxiety. Over reassuring won't help her feel better.
And no you can't trust her to eat. She has told you she will not eat without you. Eating is her priority to recover. Allowing her to stay at school allows the ED to win. So yup it has to be the hard way. Depending on her weight for height when you finally see an ED team they might insist she stays home. The more weight she puts on before then the less likely that is.
Well.done for taking control.you are doing exactly the right thing.

Sorry I meant they may insist she doesn't attend school of her wfh is v low...

Also @LittlePickleHead my dd did a lot of dance. That was the thing that spurred her to eat because it was a non negotiable with us. Once the weight improved she was allowed to return to dance. She had a couple of months where she was banned from doing it by the professionals.

@Lottsbiffandsmudge no, her friends don't know yet. We've only realised over the course of the holidays so haven't had to have the conversation with any of them yet.

Just spoke to DD and sounds like lunch at school is actually quite triggering anyway in terms of the conversations taking place (lots of comments on what people are eating, what's healthy, what isn't, comments if people get cookies etc) so I think it would be incredibly difficult for DD to be left to her own devices and eat faced with that. It does worry me as to how she faces it with her friends though given that with at least a couple the food discussion seems to be quite obsessive. She's very much the kind of person to keep stuff to herself and not over share, so the thought of disclosing is very uncomfortable for her and I hate the thought of her becoming the topic of gossip

@LittlePickleHead lunchtimes can be really triggering and, if those conversations are going on, it might not be best to be completely honest with your DD's friends. Do they seem like a compassionate bunch or are they type to make comments that could trigger / unsettle your DD if they knew about her illness? If so, I would just saying something like your DD is taking part in a volunteering programme every lunchtime for the next few weeks or pick an out of school hobby and say it is something to do with that ahead of an exam. Don't over-explain, just make it sound like it is a done deal and going ahead so that is that sort of thing and move the topic on.

They seem like a nice group of girls, but they are 13 with the associated drama, occasional bitching, silly fall outs etc. so I think probably thinking of another excuse is for the best at this stage

I agree with using dance as leverage. She really shouldn't dance until she has been assessed by the ED team. If you want her to carry on then eating everything you give her without question is a non negotiable, then gradually up the calories.
How old is she again? My DD is a footballer and was 13 to 14 when ill. She needed 3500 a day to gain weight. It meant that in a day she needed 3 good meals, 3 snacks, a pudding and drinking milk to get to that level.
Continuing her sport was a massive incentive for her. She was losing performance as she was not eating enough and so she could see the logic to gaining weight. She still didnt want to but her desire to play football just about overcame her desire to not eat. Dancing is well known for eating issues and so I know its different but I do think you need to use it as leverage.
We didn't start off at 3500. I started at about 1500 (what she was roughly eating at meals no where near enough to fuel her activity). We quiclly added snacks back in aiming for 200 a snack for morning and afternoon and evening. Then I added a glass of milk with 2 snacks. then i added a pudding to lunch. Then she tried a smoothie her CAMHS keyworker suggested in the evening and liked it (400 cals).
Then over time I upped the calories on everything by adding double cream and butter as much as possible without her knowing. Eventually her smoothie was 700 cals.
I did a meal plan for each week for everything she had to eat. In the early days she used it as a to do list. . She didn't pick the meals. She tried to. Because she found some meals worse than others. And some lunch/ dinner combos unacceptable. But allowing her to negotiate is to enter a discussion with the ED. Which should be avoided.
And try to get her to finish her food or they end up leaving more and more. Or serve her more to compensate. The leaving stuff is again an ED thing
Wow sorry that ended up very long.

Sorry x posted. At 13 you can and have to be very much in control remove her from.all food discussions and prep and shopping. It feels wrong but is actually a kindness. She can tell her ED that she has no choice but to est. It gives her an 'out' with the ED.

Can anyone recommend fats that can be added to pasta sauces, curry sauces, stir fry etc that hide well? Dd only eats chicken, fish or plant based protein so there's not a lot of fat in those. I add olive oil but any more than than about a tbsp per person and it starts looking like it's swimming in grease. Dd eats these things well so I need tips to make them as calorific as possible very welcome. I made a curry last night that was around 900cals and she ate the lot but I was holding my breath the whole time as I could see the oil. Thanks.

Hi All,
Can you share with me what the highest calorie snacks are that you've found? I'm in need to switching things up a bit here.
thx

Why** I cook everything with a white sauce, my white sauce is butter mixed with flour, stir in ff milk to get the right consistency and then add double cream and cheese. In the early days I added mascarpone as well and I put a stock cube in to taste.

We have this with pasta, fish etc it's tasty and about a million calories 😉

One of dds favourite dinners is salmon pasta bake, I cook the salmon in the oven, make the above sauce and boil pasta with some veg. Once it's all cooked I put it all together with more grated cheese on top and crushed cheese Doritos. I dread to think how many calories it is but it tastes delicious and dd likes it so win win.

Sotired the best snacks are the home made ones things like flapjacks or granola bars which are easy to make and will be calorie dense. Otherwise cake, chocolate bars, hummus and crisps, ice cream, smoothies, milk shakes.

I made some Mary Berry chocolate brownies Ystd, they are easy to make and take a whole packet of butter 😳 dd loved it and only left crumbs. The good thing with making your own is that you can cut the pieces as big as you like. The recipe suggested 24 pieces and I cut it into 12!!

Meant to say with the pasta bake recipe that once it's all put together you stick it back in the oven until the cheese is all melted. The cheese and Doritos on top make it really crunchy and yummy.

My dd likes a chickpea curry that has ff coconut milk in and I add more double cream as well. That's v easy to make, fry an onion and garlic with curry powder, add a tin of chickpeas and a tin of coconut milk and cook together for 20 mins or so. You can add lentils as well and I normally add a stock cube to taste. I would serve that with rice and a naan bread.

@Whyisthishappeningtous mascarpone is a good one - tomato and mascarpone pasta sauce with cheese on top too.

Also - you can boil rice in coconut milk to increase the calories.

If anyone is interested I worked out calories on a few Mary Berry tray bakes that's I make for the kids snacks at school. They were a life saver for DD I can post if it helps.
Other snack ideas are nuts which are v calorie dense.

thank you all! I'll be checking out Mary Berry's recipes.
We too love the curries with coconut milk. Practically live on them to help DD

Good morning all - quick update from me. Went to GP surgery in person (rather than phone when DD14 might overhear me) and we have been given a nurse's appointment on 4th October 🙄

Meanwhile, first day of term here - this morning she became hysterical when I tried to take the annual Back to School photo with her siblings because of her legs. And then she cried all the way to school.

Basilbrush

It was the same at my gp, even with an email from camhs they didn't seem to take it seriously. I called and asked to speak with the practice manager who got the ball rolling quickly. Obs and blood tests booked within days.

Have you tried calling camhs? Even though you say you can't self refer they may still be able to advise on how to get help quickly and speed the process up. The longer this is left the worse it gets. Gp receptionists should really know this.

Wishing you well. Sorry your dd was upset this morning 😔