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...

@Girliefriendlikespuppies I'm getting approx 2000 cals in (mostly liquid form, smoothies and fortisip) so it's not terrible

But it's just her inability to even put a fork in her mouth - two weeks ago she was eating three full meals a day. I just don't understand it. Every meal I'm trying and I'm trying all the leverage I have but I haven't gone 'all in" at the advice of the ED clinic to wait until her assessment when I'll hopefully get support (21st Nov)

It's just the disconnect between her apparently deciding to never eat solid food again, and then thinking she can have a normal Christmas/go out for the day on her own?!

Swatty I got a good 3000-3500 cals into my dd without her being on board with recovery but you have to shove a lot of double cream into everything!! For example it is possible to make an 800 calorie plus bowl of porridge (add double cream, honey, ground almonds and a banana) ideally they'd have that with a smoothie to drink which could also have cream added to it so over 1000 calories done with just breakfast.

I know Lougle used to be amazing for high calorie pancakes!!

Little that sounds like a decent amount of calories to keep her functioning at least, definitely keep offering and encouraging normal food as well though.

@lovewinter are you absolutely sure she is not purging?
Vomiting, laxatives, exercise in secret?
And is she def eating it all. Not hiding food. Throwing it down the loo, out of the window. Hiding it in her clothes and disposing later?
If not and you are 100% sure its all going in and staying in then likely hyper metabolism.
My usually compliant DD took every opportunity to throw food away and exercise in secret. I could turn my back for a second and she'd have food in the bin or smoothie down the sink. And if I left her alone she would spend the time exercising as quietly as a mouse.
.

@Lottsbiffandsmudge I think she is eating everything as I feel as if we have caught every trick she had had and now taken steps to prevent it ! We now check pockets and sleeves etc and dog can’t go now her while she eats and if she needs the loo she has to be supervised etc

in regards to exercise we are trying our best to stamp it out but she has had very high level of supervision so she would have limited opportunities to despite her pacing etc but surely that can’t burn that many

definitely not being sick

@Girliefriendlikespuppies thank you she is waking up incredibly hot and drenched in sweat several times in the night if that is connected

Love yes that's definitely related and a symptom of hyper metabolism.

Love it would be worth mentioning to the Drs as they might want to check her bloods again, afaik the only treatment is massive calorie consumption and lots of fats in particular.

https://www.taliacecchele.com/amp/what-is-hypermetabolism-in-eating-disorder-recovery

This link explains it quite well.

@Girliefriendlikespuppies thank you that is really useful link, will be meeting her team today so she will get bloods done anyway but I will mention it, bless her she is having to change PJs 3 times a night and I have swapped bedding daily !

Not an awful weekend but one of those anxiety filled ones. Dd was out with friends on Saturday and they went to Burger King. She had a cheeseburger and diet coke. She wouldn't have much breakfast because of the mcdonald's and then picked at her dinner because of the mcdonald's. I calculated she probably only had half the cals she normally has.
It's so hard because she had fun and needs that but she's using energy while doing it (3 hours walking around the shops) plus not eating enough to replace.

It all feels very delicate at the moment. I'm filled with panic about what to do. Do I step in and tell her she can't go out with friends to eat as it messes up her food plan? Or do I just be happy she's being social and just try and replace the lost cals on other days?

Bearing in mind she's got severe dysmorphia and going 'out' is a massive thing for her confidence. If she can start recovering from the dysmorphia maybe she'll find it easier to eat normally again. She did look absolutely beautiful when she left the house which I told her and she said 'Thanks' which is huge as I usually get told she's thinks she looks disgusting.

So much going around in my head.

Sorry for burger King & mcdonald's. I try hard not to be too specific on here. It was one of those anyway!

@Whyisthishappeningtous I have always erred on the side of encouraging my dd to go out and 'take part in the world' (so friends, college) perhaps at the expense of stricter calorie retention as she was depressed for a long time (I mean diagnosed, under psychiatrist). There can come a short time, which it did eventually for us, that she couldn't go out, but knowing there was a whole world of friends, events, college, and future out there is proving a good motivator for recovery.

Try not to see any day or meal or choice as right or wrong or make or break. This is a long-haul illness, and even after they are 'recovered', they will have to go and live in the world as adults perhaps still with these vulnerabilities and worries. Her going out was hugely important in terms of confidence and breaking the ED voice, the cost was fewer cals on that day. All these days pan out differently and I wouldn't worry about any individual one, just get back with the program the best you can on days she's not going out. We also compromise, my dd is driven round/taxis everywhere to minimise cal output at present, no buses or walking really, but that's due to her being hospitalized in past month, and not everyone can do that. you sound like you and her are doing better than you think.

Buteverythingsfine

Thanks so much. I think I'm still so traumatised by the events of the last few months that I'm terrified of going back there and not being in control again.

Dd has come a long way from barely eating and absolutely hating herself a few months ago. So it's lovely to see the small mental improvement and have her eat a meal without being visibly upset (although I can see it's still difficult).

Her weight gains are small or just maintained so that's not ideal but I'm holding onto hope that more mental improvement will lead to more physical improvement.

I just need to try and take my mind off it a but more. Being on edge all the time isn't good for me or for dd.

@Whyisthishappeningtous I totally get that on edge feeling. It nearly tipped me over the edge at the start. Now I feel much better due to anti-ds and I also meditate/do relaxation every day, not for my dd but for myself as I was living in such a high state of stress. It helps having a plan for if things go wrong, I think- I feel better, weirdly, since she was hospitalized (temporarily), as we now know what can happen if we can't make things work at home (my dd sounds similar to yours in terms of maintaining/struggling to put on weight, but eating quite a bit). Having other people be responsible for her, and her being responsible for her has helped me- I think often refeeding at home ends up being positioned as the mum's responsibility completely and the fact that the ED teen has to want to change, and want to recover, is missed over. This creates incredible stress for the parents.

Why I completely agree with but I would take that as a win that your dd went to a fast food place with friends and ate something. I know exactly what you mean about it resulting in less calories overall but mentally it will have done her some good. It's also encouraging normal teen behaviour which I always try to do.

I think this illness results in a form of ptsd for the carers and it doesn't take much to push our anxiety up or to trigger a full blown panic attack sadly. My thoughts are still consumed by worrying about dd and whether or not she's eating enough 😕 it's very tiring.

@Whyisthishappeningtous I identify with the living on the edge that you mention - I have been like this for twelve months now, it seems it is all I think about to the detriment of DH, DS and my friendships. My anxiety around food and mealtimes is still high. DD is doing OK with her recovery, weight restored since June '22 and currently wfh 104% and appears to be getting on with her life. , the behaviours are always there - fear of liquid calories, trying to choose a kids happy meal in McDonalds ...

School have been a massive help, they supervise morning snack and lunchtimes and the same teacher emails me everyday to let me know. I had hoped that DD was going to stay at this school for A'levels (currently year 11) - but she is insistent that she attend a sixth form college - I have looked at the catering facilities at the college and there is a canteen and a Starbucks on site (college is quite rural so no food outlets close by) - I know we are not going to receive the same level of supervision and feedback (if any) and it will be a different dynamic to the school dining room which is very regimented. What do your DC do in sixth form college for eating?

@D1ANA22 my dd doesn't do very well eating at college, tbh. She will eat out, with me, quite a lot, and eats a wide variety of restaurant meals within limited parameters (calorie related), but it doesn't translate to independent eating when out. She often gets in then and eats two dinners at home to keep to the meal plan. She will have Costas and snacks though. This is an ongoing issue which predates her full eating disorder though. I certainly don't have all the answer on that one, but I do also know that as they get older, policing/moderating behaviour has to shift anyway as they are older, it's not necessarily appropriate to remove a 17 year old's phone, or stop them from attending college, or if you tried to, you may find they simply up and stay with a friend or leave home legally, it's not quite the same as even at 15. I'm looking towards her being 18 with some horror and trying to keep us all on the same page for now. I am probably not the best person to ask, as my dd is not weight restored yet.

But I completely relate to everything you've said, my dd is at college now (she will be 17yo in Feb) and it wouldn't feel appropriate to remove her phone or limit her movement. Like you said she could just decide to leave and go and stay at a friends house.

I try and do what I can but accept I can't police her like I used to. I make her a pack lunch to take to college as I wouldn't trust her to buy a lunch in the canteen plus that would get expensive. I strongly suspect that her sandwiches are going in the bin though 😕 that means she is getting through a long day at college on a bag of crisps and a couple of snacks.

She eats well at breakfast and dinner so I go with that. If she started to lose weight I suppose I'd have to rethink.

I live in hope that she will one day see the light and think fuck this I don't want an ED anymore and take the next steps towards recovery but it hasn't happened yet sadly.

My dd is on a reduced timetable so she can eat lunch at home. It works out that she doesn't miss too much as her actual timetable gives her two afternoons off anyway. She'll just about manage a cereal bar at break but actual lunch is a definite no. It's something I hoped would ease up by now but she's stubborn and won't even talk about going to the quiet room that's been offered.

I seem to spend half my life driving her there and back. 30 miles a day. There's absolutely nowhere to park so I'm always hovering on double yellows and getting beeped at. I also seem to have started to hate driving (thanks perimenopause) so a lot of my day is filled with anxiety. Dd never says thanks and is usually in a hideous hangry mood until we get home. She won't eat in the car.

I dream of the day she's well enough to get the bus.

Seems like lots of us are driving older teens around, and eating at college remains a sticking point for many. Argh, this disorder is so frustrating!

Thank you all - so frustrating that school meals are working well now, monitored not only by the teacher but also the serving staff to ensure DD doesn't make the wrong choice of meal. @Girliefriendlikespuppies do many students take packed lunches, there are some quite trendy lunch boxes available now - although it's not ideal as you say DD could just throw the food away or leave the lunch boxes at college.

A bit disheartened as I hoped DD would stay at school for sixth form and lunches continue as they are now but with a lighter touch of supervision as DD gets older - there are just so many places to hide and more interesting things to do a lunchtime in a large college.

D1ANA22

Could you explain to dd that staying in the familiar environment would be better for her health long term as she's well supported there? I know how hard it is though. At this age they're more likely to just want to be with friends and that often trumps the option thats better for them personally.

Is she able to apply for both and make the decision after her GCSE's so she doesn't miss out if she does change her mind?

Thank you @Whyisthishappeningtous - I had the conversation about food and school, she said that her Eating Disorder is all behind her (I truly believe she wants it to be but sadly that’s not my understanding of how eating disorders work). Her friends are mostly staying in school for A-levels, she has been at the same school for twelve years and I suspect she wants a change and also colleges offer more of the less traditional A-levels, she wants the choice.

The school will take her if she changes her mind. I’m thinking of food management and weight checking at college as she is possibly going to be discharged from the Eating Disorder service in the next three months. I’m terrified of going back to where we were a year ago.

D1ANA22 It's really difficult. Making their own choices is obviously what we all want for our teens, but at the same time we can't help but worry about their ED and how it might affected. I think we just have to gently nudge towards choices that might support them better, but ultimately they have to make their own decisions otherwise they might resent us further down the line. We just have to be there to support and advocate for them and keep everything crossed that it works out well.

Argh I just want to shout and scream! I'm doing so badly at this and it's come to negotiating over 3 fucking spoonfuls of soup

I met DD for lunch and the first thing she said was her legs were so fat so I knew it wasn't going to be great. She's fixating on her legs and how other girls have skinnier legs than her so she can't be skinny enough.

She wants to go for a dog walk with her friend after school and at the moment I'm torn between wanting her to stay connected and telling her she can't do these things without proper food.

I'm so worn down and out. Monday is the ED assessment and I'm desperately hoping we'll come away from that with a clear plan of action as I feel like I'm in limbo and fighting to even get her to have a single mouthful of normal food each meal

I also caught her googling 'how many meals is one fortisip' so I'm anticipating her starting to push back on that as well

Can anyone offer insight as what help to expect following Mondays assessment? I just feel like a failure and I don't know how to carry on. I don't even feel like a real person right now

LittlePickleHead After assessment, when dd was diagnosed, we were offered an appointment at the ED clinic 2 weeks later. I was emailed some links and pdfs about FBT. Then we started weekly appointments.

Appointments are obs and talking about what dd eats, her goals and how she can eat more to achieve her goals. We have dietician appointments as well but tbh it is more of the same and feels a bit like box ticking. I keep asking for psychiatric help but I'm told she needs to gain more weight first.

So sorry you're going through this. It is totally shit but recovery is possible. My dd was down to 500 cals a day, extremely underwight, zero energy and totally hated her body. I never thought I'd have the skills to get her to eat more, but by gently pushing, learning not to be afraid of meltdowns and talking sense into her in her more lucid moments we started to turn a corner.

It's very difficult to deal with situations like the dog walk. In the beginning I made it clear to dd that she was extremely ill and at risk of fainting (or worse) and physical activity had to stop. I had to risk assess everything. She was allowed to do a few things but on the whole she was in bed or on the sofa and very much treated like an ill person. Friends were allowed to come over but tbh she wasn't in the right frame of mind. It's only really since she's been eating 3+3 without too much resistance that she's been able to live life a bit more normally again.