@Lottsbiffandsmudge that is fab news about her being re-signed for football, she must be so talented!
@D1ANA22 here goes, this is probably very rambly and waffly so I apologise in advance (brevity not my strong point).
Initially things went well with FBT, diagnosed in May, at 80% WFH, had some days off school, but went back with no PE. Then massive relapse in the school holidays, and I couldn't get anyone to help her. Went back to CAMHS, begged for medication - as I could see her anxiety was off the scale. She used to lie on her bed and SCREAM for hours while I just held her. Throwing food on the floor, hiding it (socks and knickers) she was so fast we couldn't take our eyes off her for a second. CAMHS refused until I went to the GP a broken woman and showed him her weight loss (it helped he was a friend), and they agreed to take her back. But things kept spiralling. I took her to A and E in Epsom and the community mental health team got involved. I kept ringing the crisis line, but they wouldn't admit her. I then took her to St Peter's in Chertsey and they admitted her thank God at 78% WFH, so not as low as your DD but I still thought she was going to die. Just prior to that as CAMHS were so useless I took her to the Schoen Clinic to see a psychiatrist there (she was utterly lovely) who agreed she needed medication and put her on a non therapeutic dose to see how she tolerated it. By the time we were at the review date she was admitted so I just banged on and on at CAMHS to prescribe. Once the hospital team saw her screaming (they were tubing her and I had to leave the room - I could hear it from the other end of the paeds ward) they prescribed Olanzapine 2.5mg three times daily. It had quite an immediate impact as it's a sedative and initially made her quite sleepy but did alleviate the distress.
CAMHS kept saying that sertraline was not effective at such a low weight (massive chicken and egg scenario right there) but the private psych was ok to prescribe it and they then had to go with it. Remember she started it at 78% WFH and they basically said it would need to be over 85% to be effective so I think it would be ok for your DD. She had to be 90% to do any sport but we pushed it and introduced it VERY slowly so she could see she was being rewarded.
Then I basically just banged on and on and on and they upped the sertraline to 75mg and that did make a difference. Eventually in January when she was really distressed (vile) they upped it to 100mg and that was the magic dose - three weeks afterwards I could see a change in her and that's when things really started to shift.
Interestingly, I was in a really bad way and was prescribed sertraline myself so I experienced the difference it made to me. I was suicidal, crying all the time and my friends told me I just shook constantly. I was nauseous and lost 8kg (sadly all back on). DD described her anxiety around eating and it made her feel sick and I think that's why they caved in the end - and it DID make a difference, and allowed us to be calmer. I started off on 50mg, went to 75 am now on 100 and I am gradually going to reduce this as I feel truly me again.
You cannot let her calorie count. YOU are in charge of food "this is what you need", no discussions of calories or what's in food at all. Cut that sh*t dead. But in your head you obviously need to do it thought some days I had no idea - aiming for 200 calories minimum for each snack, and lunch was always a sandwich or wrap (two wraps sandwiched together with butter/mayo - the Mission ones are the highest) and whatever filling, plus a pack of crisps, a piece of fruit and a biscuit. The early days I had a cheese portion in there too.
If she likes milkshakes buy ensure and use that in a milkshake with cream and full fat milk and ice cream too. That's a great snack.
Specifically, she was banned from the kitchen while I was preparing food. I add fats to EVERYTHING. I bought Nestle Nido from Amazon and that gets added into her FF milk for ceral/hot chocolate etc. I bought maxijul from Chemist Direct and that got added into juices (hidden in the garage both of them). Cream into everything I could - stirred into yoghurt, hot chocolate, pasta bake, spag bol, you name it.
I buy the skin on fries from Lidl (actually best frozen chips EVER) and add a big chunk of lard to them (might explain my current size too [hmmm] god they are goooood!)
I bought a chisel tip thick sharpie and cross out all the calorie counts of anything packaged. Takes bloody ages mind you!
High calorie puddings: Lidl melt in the middle deluxe puddings (lush) with cream or ice cream added. Ditto sticky toffee pudding and the millionaires cheesecake.
We had lots of pastry/pies but lots of things she was scared of like croissants and eventually, lasagne so we didn't force this. Sausages oven baked with lard, stir olive oil into hummous etc etc. The lovely individual pies from Lidl are 500 calories each! Combine that with buttery and creamy mash, roast parsnips and a small amount of other veg and with pudding there's over 1000 calories right there.
Sometimes I'd give her a toddler's choice: do you want sausages or pasta bake?
If you search through my posts you'll see I've posted lots of recipes/food ideas - when I found something she liked, I shared it.
She always had to leave something, and still does to a great extent but occasionally she is now finishing things. So I just dished up a percentage more to account for it, and when she left, I'd say that wasn't enough, you need to have more - and I'd portion it up - she felt she was winning as she did leave things.
She knew that she had to eat to earn priveleges: if you eat your snack then you can do xxx.I started off by saying if you don't eat your snack you can'tdo xxx but found it was more effective the other way round.
I read and re-read Eva Musby's book but heaven knows not all of that is doable for mere mortals.
You sound extremely competent and sensible and I know you can do this. I was a wreck and somehow we are limping through.
