Teen Eating Disorders Thread 7

[Lottsbiffandsmudge]

We have managed to fill the previous Thread here https://www.mumsnet.com/talk/eating_disorders/4471980-Teen-Eating-Disorders-Thread-6?page=40

So I thought I would start a new one.

Everyone supporting a young person with and ED is welcome here for advice (non professional but lived experience) and support.

Hoping everyone can find us...

So sorry to hear that @NanFlanders best wishes to you and your DD
@lovewinter the food situation in hospital is ridiculous. Its good she is eating your food and plan tho. Hope that helps...

@NanFlanders I echo what others have said - sorry to hear that your DD is in hospital.

Hope that you are coping OK, or at least the best you can.

I'm finding it hard to know what say when dd says she just wants to stay the weight she is now because she doesn't want to be fat and ugly. The conversations go around in circles and she gets more and more wound up and upset. I talk about being healthy to enjoy her future and mention all her hopes and dreams, but she says she won't do anything if she is back to being ugly.

Does anyone have any magic phrases to nip these conversations in the bud?

@Whyisthishappeningtous not sure if this any help but we came from this as energy rather than weight - having the energy to do the things that DD wants - but she quickly equates energy = calories = weight so we couldn’t use this motivation for long.

D1ANA22 Thanks. I try to say anything other than weight, but when she's in that downward spiral of hating herself nothing really helps. I think I just need to try and find ways to defuse the situation rather than try to make it better because it's obvious thar after months of this - nothing I say can make it better. I just need to get as much food in as possible and hope and pray she doesn't hate herself when she puts weight on 😞

Oh Nan I'm sorry to hear that, this illness is so unbelievably shit. I really hope this admission is the one your dd needs to stay on track.

Why I wouldn't engage in those conversations at all, just don't discuss it. Your dd isn't able to have a rational conversation about it so it's a futile conversation. Blanket statements such as 'I'm sorry this is hard for you right now' I'm sorry this is scary for you' 'I will do everything in my power to get you well, you can trust me' and 'I can't discuss that with you right now but I can hear how scared you are, trust me, you are safe' generally work as well as moving the conversation on and distracting. Eva Musby is great for those difficult conversations.

If it helps my dd is at least 10kgs heavier now than she was at the start of FBT when she told me she'd kill herself if she gained even another gram 🤷‍♀️ She is currently at work and is living a (mostly) normal teen life. For us blind weighing was crucial though and even dd now recognises how important not knowing is for her.

@Whyisthishappeningtous I symapthise with you, one thing that has helped when I get sucked into those conversations is remind her that she has not always hated her self or felt the need to restrict and compensate and once when younger she was happier therefore it is possible so we focus on talking about how she is eating to get a healthy brain capacity again and be happier and we stress this doesn't correlate to weight restoration we are aiming together for old D brain's back and also we have and continue to promise therapy for how ever long she needs once she has weight restored to let her know we together are committed to a healthy brain. We also try and not talk about when you are healthy weight you can do X such as running or baking etc but more "think about when you can bake for the pure enjoyment you used to have" or alternatively we say "do you want to be able to ski again but not just physically be able but without Robert (the ED!) there tainting every experience so without any thoughts or urges."

do you think any of this may work ?

I just wanted to share as only you guys will understand but D despite having to be sedated earlier this morning due to such severe distress of the hospital setting she ate her old favourite pack of crisps today !

@lovewinter no one who doesn’t have a DC suffering from an ED will understand how massive that eating her crisps is. These victories combine towards your DD’s recovery.

yay to crisps! Small wins all the way!

Love the crisp win! Well done! I'm making a bucket list of things I'm looking forward to... One is her nicking the crisps I bought for packed lunches. And to think, a couple of years ago, I was hiding them in my car so they were still around when I needed them... If only that were needed now!

Yay to the crisps. It just shows they are always still in there somewhere trying to get free.
These are the small glimmers to cling to.

Thanks so much everyone. I've found the chapter in Eva Musby's book about how to answer the 'I'm fat' questions and show empathy and keep calm (this is the hard bit!). We had a situation last night and I just said I understand it's hard, I'm here for you and I love you but no and went for my shower. By the time I finished she had calmed down.

I meant to say I said I love you but will have no more conversations about how you feel about yourself that upset us both.

Afternoon ladies -

DD14's initial CAMHS assessment was supposed to be tomorrow morning (urgent referral within 3 weeks of GP appointment which I suppose is not too bad! these days!)

But this morning, they rang and said that due to staff sickness / shortage, the face to face appointment would have to be postponed, they weren't sure when but at least another 2-3 weeks. Or they said she could have an urgent online assessment meeting on Sat afternoon.

In the end, I went for the online appointment as I thought we need to start somewhere. But now I am worried that I've made the wrong decision - she really really doesn't want to to go the CAMHS and an online meeting will be even weirder and more impersonal for her...... Have I done the right thing?

Another question is - do you have to have body dysmorphia to be anorexic?? DD has never ever said she thinks she's fat or wants to lose weight, in fact she hates her thin body and says all she wants in the world is boobs and periods and to be 'normal'. Is this a good sign in any way? Or am I clutching at straws?

Basilbrush Our initial assessment was online and it was fine. Dd was worried but soon settled into it. We spoke together and separately. I think it was about 2 hours all in.
I don't think weight or looks always triggers ED. Anxiety and/or a need to control can trigger it. In dds case the dysmorphia was the trigger, mild at the beginning but worsened with brain starvation. I'm not sure whether not having the dysmorphia element means it's easier to treat but I do know that dds dysmorphia makes her scared to get better/back to normal weight. It’s all so complex and they're all so very different x

@basilbrush my experience is that your DD (or her ED) will not want to engage with CAMH anyway whether online or in person, so the quicker you are in the system the quicker your DD will receive support. Also ED’s are manipulative, what she says and what she feels are usually quite different - my DD wrote a long letter about how she was going to beat the ED on her own and that she was feeling OK - she would eat more and deal with it herself. Our ED nurse dismissed this and 12 months later we still deal with some of the issues she suffered from.

Prepare yourself for the appointment - when an ED is outed the fight back is hard.

@basilbrush I think you have done the right thing. Speed is more important than F2F we never saw DD's ED keyworker F2F (lock down) and only saw her psychiatrist in person twice. Either way my DD hated it. So that's normal.
No body dismorphia here either. There was worry about loss of six pack and fitness but no worry otherwise so there doesnt have to be body dismorphia. She was still formally diagnosed with AN (with exercise compulsion).
My DD got ill by losing weight by accident trying to keep fit and eating healthily during lockdown. The weight loss was the only trigger for her illness . AN is triggered by weight loss (as long as the genetic disposition is there). Why the weight loss occurs can vary.
Once she was severely underweight she had all the classic AN symptoms. But her lack of body dismorphia did make weight gain easier. As long as she thought her fitness had been maintained. She still was blind weighed tho.

Basil** I think lack of body dysmorphia is known as atypical anorexia, I think that is a good thing as it's one less thing to worry about! I'd of done the same thing re the appointment at least that gets your dd on their radar 🤷‍♀️

Thank you all for sharing my joy of the crisps !

@Girliefriendlikespuppies I am no expert but I believe atypical anorexia is when an individual has all/ most symptoms of anorexia but is not medically underweight. Regardless I agree with others that it is one’s less thing to have to fight.

did anyone see the segment on bbc breakfast today about giving schools eating disorder toolkits ? I was really happy to see Hope Virgo try and emphasis the myth that you have to look thin to have an eating disorder and that the severity of the illness doesn’t correlate with weight loss.

@lovewinter I missed the BBC segment, that’s good news. Teachers and dining room staff are key - DD was eating her evening meal but binning her school lunches, and lying about what she was eating at school, the best place for the ED to hide.

I am not aware of any ED talks at DD’s school - or any other local schools either - such a dangerous (and seemingly increasing) mental illness amongst our teenage girls. She did have a visit at school by a group advocating that girls can be born in the wrong bodies - for my DD suffering from body dysmorphia such a message has not been helpful.

Thank you - this is very useful info. I've got relatives saying she can't possibly have anorexia if you didn't lose weight 'on purpose' and doesn't think she's fat, that it must be that she is 'just' depressed/ stressed / anxious and that the weight loss is a side effect of that

I would shut down extensive discussion with relatives, just say 'well none of us are experts are we, let's see what they have to say'. Don't report everything back to them, it's hard enough to do everything needed to do without opening it all up for discussion (in the immediate family, do obviously!)

Sudden weight loss, whatever causes it, is highly concerning on both a physical and mental level. Also, unsurprisingly, depression and MH issues go hand in hand with anorexia. There is not one cause of anorexia, and not even one presentation of it, so your relative isn't very knowledgable anyway.

Good luck with it all.

The other thing is, weight loss/eating disorders are habitual as well, so things become entrenched habits, almost like addictions, whatever is underlying them. An entrenched habit of not eating, or purging, is highly destructive and needs intervention.

I agree. People/ relatives with no actual knowledge can be v damaging. The stereotype of the body conscious teen girl driven by a need for control and fitting in made worse by social media does not even begin to cover it! It's dangerous to make assumptions.
There's a reason why many elite athletes have issues with EDs and it's because they sail v close to being underweight and put high cal demands on their bodies. The closer one sails to being underweight the easier it is to stray into ED thoughts (as long as the genetics are there). That's why with weight gain profs ask patients to overshoot.
The lack of calories leads to depression, anxiety etc not necc the other way round although those with a genetic disposition to EDs I guess may also have the same predisposition to other MH issues. My DD was certainly anxious before her ED. It didn't lead to it tho. Her weight loss did.
In fact looking back on her childhood I think she was slightly underweight for a while which may have contributed to her anxiety. She is certainly in the best place mentally that she has ever been since early childhood (from around year 5 she had ocd and mh issues esp around anxiety and perfectionism) and she is also the heaviest wfh she has ever been.
Maybe my DD was not ever meant to be as lean as she was ?

I'm struggling today. She can't stop looking ahead and rejecting what she sees as a future that she doesn't want (concerning shape etc). I don't know how to get her to stop looking so far ahead. She thinks as she's done what she's been told for a couple of weeks now, and she feels fine, we should all forget about it and let her get back to normal (eg leave her alone). Any advice? :-(