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

D1AN22 my dd is 2 years on now from when she first started restricting food during the first kick down, she was 14 then.

She went down to 90% wfh but has always been around the 75th per centile so was actually really ill at this weight (periods stopped, cold all the time, hair falling out and heart rate of 40.)

I saw Camhs in the late summer and started FBT the next day. It was hideous to start with, dd banged her head against the walls when faced with food, screamed, shouted abuse etc but we did start to see small leaps of progress.

What worked for us was:

blind weighing - this was absolutely crucial in being able to get weight back on and lessened dds anxiety around food in general a lot.

Keeping dd out of the kitchen and giving her no choice over how food is prepped.

Adding cream and butter to absolutely everything. There is a lot of evidence that the brain needs animal fats to recover and I have seen first hand that this is true.

Dd refused snacks but I insisted on the afternoon one and increased portion sizes to compensate for the others. I would not recommend doing this but I suppose I'm using this as an example of how you can tweak certain things to work for you.

I have always pushed how much I've given dd and slowly increased portion sizes.

We are now in a place where dd is over 100% wfh and hopefully back on her centile line. I don't actually know her weight as she's been discharged from Camhs and I will never have scales in the house again!!

She is generally in a good place, going out with friends, enjoying school and looking to the future. We are much closer again as well and I feel like I have my dd back.

That said she's still not eating freely, I still make and give her her food. She still has a few ED behaviours including leaving small pieces of food on her plate. And there are still difficult days like last wend when she felt guilty for eating too much and then self harmed 😥 but I have hope now that she will recover.

Lots what a wonderful update, lovely to hear that things are still going well 😊

Dark my dds got bigger boobs than me now!!

I echo blind weighing.

Thank you @Lottsbiffandsmudge @DarkBlueEyes and @NCTDN - reading your journeys I am taking advice from all of your experiences. Frustrating day, I’m up at 7 am with DD for breakfast where we have strong words with regards to how much milk to have with cereal - I do the hard work, then later in the day DH permits her to go meet her friends on the condition that she take her snacks and buys herself lunch!?! 89% wfh (and the strong anorexic thoughts at this weight) is too low in my mind for independence but now a precedent has been set for going out which I will have to undo. I’m interested about the meds as CAMHs have offered some CBT (about six weeks of) before going down the road of medication - is it sertraline for anxiety - what is the difference between that and Olanzapine?

Also thank you to @girlfriendlikespuppies, sorry for the omission - typing on phone whilst cooking (all I seem to do).

Hi everyone,
Been little while since I posted - welcome @D1ANA22 - I hope you find the thread really supportive & helpful both in terms of treating the ED but as a place for your MH too - it really does make such a difference, I feel, talking with people who "get it"

All going well here, DD turned 19 this week - we went out for a meal and she had some anxiety which later turned into restrictive thoughts in the night - the first time she's had those in a while. However, she resisted and recognised that a "big event" like her birthday meal would likely be a trigger opportunity. She went away with her boyfriend for a weekend last weekend and whilst it was odd to have her not in the house at all, I was so proud of her for going away.
Finally, in a week of many successes, her school report was really positive. As many of you know, DD's anorexia really messed up her cognitive functions way past weight restoration - its only been in the last couple of months (coinciding with her working with a PT) that we've started to see her intellectual capacity get back to where it was. So am feeling more confident that this second go at Lower 6th will be positive and university is possible in 2023 (whilst keeping everything crossed!)

Lovely to read positive updates from others - onwards!

Hmm @D1ANA22 I was told therapies such as CBT don't really work whilst they are in the grip of AN. CBT takes a lot of mental and emotional effort and there is a lot of home work to do which if most of tour day is taken up with food battles is just going ro be one more thing to add to the burdens for you and her. I was lucky that our CAMHS saw the merit of short term meds (olanzapine is a short term solution that acts fast). My DD did do some therapy once WR but tbh she was reluctant and I am not sure it helped much but every child is different. She has revisited it now she is much better and adopted some of the strategies (around perfectionism) but I got more out of it learning how to deal with her issues without making them worse.
I am not an expert on sertraline but understand it is more of a long term solution and takes more time to act and to get the dose right. I know others on here have experience of it.

@myrtleWilson so great to hear such positive news from your end too!

Thank you @Lottsbiffandsmudge - the CBT mentioned was for anxiety (rather than CBT-E), like you I am not sure that this would be successful at such low weight and DD does not engage with CAMH in the meetings (it would be another therapist with her though rather than the eating disorder nurse) - I still doubt that she would engage. When DD was first diagnosed I read a lot and everything pointed to weight restoration and then therapy - I’m now thinking that therapy may not be the magic wand and possibly not that effective, it seems that WR and normalising eating behaviours is the key. For the short term I would like to reduce her anxiety with medication to alleviate some of her stress. Hi @myrtleWilson, sounds positive for your DD and yes to sharing with you all to help my MH so I can help my DD.

Hello... I am so sorry for jumping in to your threads without reading but I am struggling to take other situations in right now.

I have just discovered that my 19 DD has been restricting food, obsessively weighing, feeling incredibly guilty about eating and making herself sick for 3 months. The change is very noticeable in her appearance and personality.

She told her boyfriend who she recently broke up with and he told me. She came home from uni tonight and talked a lot. She said she is depressed, battling in her head and wants to stop this. I have asked her if she has thought about harming herself.

We are together on a family trip for the rest of this week which I know she is finding very difficult. I've managed to get her to have some Huel drink tonight as she wouldn't eat anything but I need some help. I am fully prepared to be firm and to do whatever it takes to support her. And whilst she seems distraught she also seems like she wants help

Sorry for the long post but please any guidance or reassurance is so appreciated x

Hi jelly welcome but sorry you've had to find us.

The first port of call would be taking your dd to a Dr, she will need some physical obs including bloods, ecg and bp check. In some areas you can self refer to ED services do check if that's the case for your dd otherwise the GP needs to refer. They can also weight check her, do you think she's lost a lot of weight?

It's difficult if your dd lives away and you may need for her to come home for a while to get started on FBT (family based treatment.) This basically means you take over all food related decisions for your dd and you give her 3 meals and 3 snacks a day. She has to eat what you give her and it needs to be at least 2500-3500 calories a day (the more the better.)

She will feel guilty, be very distressed but that is completely normal and part of the process sadly.

Tabitha Farrah has written a few books that I think are good at explaining what's going on in her head for older teens.

@jelly79 it's so difficult and won't be helped by the fact she's an adult so the nhs will need her acknowledgment in order to do anything.
Is she living away?

Thank you both!!

She does live away but only 30 minutes away. She is here now and we are on a family trip till Friday.
She is open to talking and action but is very distressed. She is great this morning but not entertaining food. We have a 3 hour drive soon so I will make sure she eats something along the way.

We would absolutely do FBT and I have said she needs to come home or at least be home more for the time being and if I think she needs to move home so be it.

She is training for a professional career in healthcare so she knows she has a lot of reasons to get well and take control of this.

I have a level head but feel overwhelmed by this x

She has lost over 2 stone in 3 months but she is out late and drinking alcohol too (all be it at this stage not to excess or as an issue) I have told her whilst she is unwell that has to stop

My sister will be with us this week who is a nurse and knows what's going on so that will help. But my mum is also who is weight obsessed and no tact so I have to navigate that situation carefully.

Do you have any vitamins you could recommend too?

Sorry for the long posts x

Over 2 stone in that time is frightening. You'll see lots of posts on here about wfh (weight for height) but for adults they still use bmi calculations. Do you know what hers is?
My dd is 18 so just starting to manage the adult support but @myrtleWilson dd is 19 I think so may have suggestions for support?

Hi @jelly79 - sorry to hear about your daughter's struggles. I'd suggest she speaks to her student welfare/health services - most Uni's have a policy on ED so you could have a look around their website to find it. Is she still registered with home GP or transferred over to Uni? If she's willing to speak about what she's dealing with in terms of eating then a conversation with her personal tutor may be a good route given its a healthcare related degree...

Local provision for adults for MH and for ED is incredibly patchy so I do think utilising university provision may be a good starting point alongside GP.

There are a couple of posters who have DD's at university so I'll tag them to see if they can offer practical advice about supporting over a distance @Boulshired @bluebuddha10

Thank you so much!

She is about 5'10 and under 9st now. She put on weight over 18 months and has dropped 2 stone since Xmas but not at her previous weight.

She has reluctantly had half a slice of toast and I am getting her an iced latte and some nuts

I am worried about engaging uni services as it may effect her placements but I think I need to get over this

It's come so out of the blue that I desperately hope it's early days and something we can manage really quickly

Hi - I understand reluctance re Uni but I do think they are (sadly) well used to supporting people with ED's and in terms of any impact on her work - if they see she's taken steps to let people know, the dept can perhaps be more proactively supportive. There are few people on social media/twitter who are HCP's with a lived experience of an ED - if you're not on twitter/don't follow them I'll dig out their twitter names for you.

Sorry, just to follow up. In my experience, the ED likes to find opportunities to cut off relationships, to make the world smaller for the one with the ED and part of that is not speaking about it. I know my DD struggled for a long while before being able to tell her friends what was really happening and I was conflicted about whether I was breaking her confidence if I spoke to my colleagues or more widely. In hindsight, both were strengthening the ED's hand..

@jelly79 I'm sorry you've found yourself here. Unfortunately I can't offer any advice as my DD is younger, but I'd suggest thinking about her health as the top priority - education can wait.

@D1ANA22 olanzapine is actually an anti-psychotic and a sedative, initially it can make them very sleepy but they quickly adjust as far as I understand. It helps to quieten the distress.

Sertraline is an SSIR anti depressant/anti anxiety medication which is not always tolerated by everyone. It can make things worse for a few weeks. DD was started at 25mg to see if she could tolerate it (me at 50mg) but 25mg is not a therapeutic dose. After a few months and much nagging from me she was upped to 50, then 75mg but the real breakthrough was the move to 100mg.

CBT will not be effective at 88% WFH as far as I understand and I'm amazed they've offered it. I can't get it for love nor money for DD who as of yesterday is 101% WFH!!!

They probably should address the anxiety with meds, get her mentally calmer so you can go in all guns blazing with FBT, then look at CBT if needed when she's closer to being weight restored. I've seen the need for therapy reduce as the weight goes up, but I think my DD will still need it.

Jelly** a 2 stone loss is huge and her internal organs could be really struggling. She needs to see a dr asap and personally I'd be telling her she needs to stay home until the eating is much better and the weights going back on.

If she is eating less than 500 cals a day she may need hospital admission....

Is she doing nursing or similar? She absolutely will need to tell the university and get their support, she shouldn't face any discrimination due to this.

Jesus as much as I am worried I may be naive in thinking that this is so early days we can break the cycle quickly!!

WTF she scratches when she 'eats'

I'm so sorry I feel like consuming and intruding your thread. I am out of my mind, this is so drastic

I don't know if I'm paranoid but I actually think someone is encouraging her on her phone

Jelly there is sadly a lot of pro anorexic crap on line so you may not be paranoid. The scratching will be anxiety, when she eats the ED will be shouting and screaming at her ☹️ my dd used to bang her head against a wall.

It sounds like your dd is very much in the grips of anorexia and sadly there isn't a quick fix, my dd is 2 years in and completely weight restored plus some but still has ED behaviours and thoughts that haven't buggered off yet.

You may find the fb group useful, lots of resources on FBT etc. it's the EDSUK one.

Please don't feel bad for posting that's what we're here for.

Thank you thank you.

You are keeping me sane.

We are sat round the table ordering a take away. She is anxious but she knows she needs to eat some, I'm sharing with her.

She became veggie a few weeks ago!!

Thanks @DarkBlueEyes, that’s really helpful lived experience for me to draw upon. @jelly79 going vegetarian / vegan is a means of those with eating disorders to restrict their food intake, in hospital the mantra is ‘all foods are good’ and unless the patient has been vegetarian for a long time then all foods are presented. This will be hard but from my experience we are now challenged as my DD restricts dairy and we need to tackle this, the longer this has allowed to go on the harder we find it to challenge feared food groups.