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...

Wise words about trying to 'let go anxiety wise' when they're eating out of home - Dd once rightly berated her Dad and I saying that our anxiety/fear was reinforcing her having an ED, not liberating her from it- she correctly called us out on seeing her as 'anorexic Dd' rather than Dd

Pressed send too soon!

of course that didn't stop us being anxious we just had to adjust how we showed it - so we too were faking it till we were making it

DD has started refusing breakfasts this week. (Started refusing milk and juice drinks last week and saying she was happier at her lowest weight so I knew which way it was going). I said she couldn't go into town today to do volunteering job and then see friends as she hadn't had breakfast so shouldn't be expending energy. (Heart rate at 54 bpm at last week's obs). She said we couldn't stop her - she's 16 - and just walked out. Don't know what to do now - I'm thinking confiscating phone for the rest of the day and stopping next week's pocket money if she won't hand it over. It's difficult because I suspect she'll 'retaliate' by not eating tea. WWYD?

@NanFlanders I’m sorry your D is kicking back, I am probably going against the grain her but confiscating or punishing never works with my D, when she is somewhat rational I try and talk to her and try and instal motivation in her if that makes sense. Sometimes we make mood boards or we have a travel book which we look through and talk about all the places she could go. I try and empathise not the physical ability to do things she would like to do but more the mental side so would you want to go on holiday with Bert ( the Ed) and have him take away every happy memory. Rightly or wrongly I have booked something like a theatre trip on the condition she ate well up to that. Also stress long term health impacts infertility and osteoporosis sometimes that works. I would try and send the message to her that she wasn’t really happiest at her lowest, I sometimes use pictures and we talk about the day that photo was taken and how happy she was and then make her realise not once in the day did she worry about weight, food or exercise so it is possible

Hi everyone - I came across these self-help resources that you may find useful. They are on a variety of topics so could help you, your DC or other family members. There are information sheets and work books you can work through...

www.cci.health.wa.gov.au/Resources/Looking-After-Yourself

@Aranan when you first enter the world of ED, the statistic that always seems to get thrown is the awful one about anorexia having the highest mortality rate of any mental illness. However, actually the recovery rates aren't as awful as other conditions. For example my friend's son has a level of ADHD and OCD that makes normal life near impossible and I do wonder if he'll have that for life. The prognosis for anorexics is much better. About half make a full recovery, 30% recover but with some issues and the remaining 20% don't.

I don't know what constitutes a partial recovery given that lots of people/women have issues around food and body image.

One in 5 not recovering sounds pretty awful but those are very bald statistics and if you drill down, the odds are better for your DD. The younger the sufferer (ie in their teens) and the more support they receive, the better the odds for recovery. It's much, much harder for adults to recover. We have a 20something relative who expresses envy that DD has us to monitor her eating as she finds it hard to do alone.

Our experience with DD has flushed out a lot of ex anorexics that I had no idea about. They all seem to have come through with their fertility intact and now lead normal, mainly happy lives. A couple of them are weird about food - brilliant and generous cooks yet still very thin themselves, but the rest seem fine.

@Valleyofthedollymix that is a very helpful way of framing it. I’ll admit I’m very much a pessimist generally so it’s not really in my nature to look for positives in any bad situation! My son’s long medical condition for put a bit of hope in my mind for my daughter - as she has hope - but then that reminds me that he doesn’t! Right now he at least is coping well though.

In my dds case I'm sure hormones are playing a big part in her illness but when I've bought it up at camhs appointments it gets brushed aside. Her periods haven't stopped and are really heavy and painful. She gets really bad ovulation pain and from then until her period is due her mood drops very low and self loathing and parental loathing is at it's worst. Meal times during that time becomes more difficult as she wants to be in her room eating alone. College and seeing friends is almost impossible. A day or two after her period starts her mood lifts rapidly. I'm not sure if going on the pill might help her. I've discussed it with her but she says no. I'm not saying her ED is a hormonal thing but I often wonder if hormones did somehow trigger her body image issues and if we can get that under control we might stand a chance of moving her recovery forward as we seem a bit stuck at the moment.
Sorry - as usual I'm over thinking, trying to make sense of it all and hoping we can find a way forward.

I think hormones play a part for sure. My daughter had not started her periods when she got ill, and then the ED clearly delayed them. They have since started, then stopped, then started, then aroppwd, then started again. It’s like she’s going through puberty over and over.

Apologies for typos

DD's second appointment with the ED therapist.

Resulted in her completely disengaging during the session and refusing to respond other than shrugs.

And then when we came out declaring we need to cancel all the plans she's made as she's not going to eat.

This is in response to the fact the fortisip has run out and she needs to start eating the full plan.

I know this is probably the ED raging against losing control, and I'm hoping the reality of cancelling stuff she's looking forward to will counteract this, but I'm not sure. Will have to see how dinner goes now.

She had actually been doing quite well increasing her mouthfuls each day until this point, but I guess there will always be a tipping off the bandaid point.

It's just relentless isn't it.

Argh ok so we're on food and fortisip refusal now. I'm so hacked off I'm struggling to remain compassionate.

Words of wisdom on what to do?!

LittlePickleHead So sorry to hear this. My dd is difficult after appointments. It's the ED fighting back but it feels very counterproductive when she's been doing well. Many times I tell myself we're not going again but I don't know how else to get help. She's usually a bit better and more compliant the next day. I do lots of love bombing and empathy, telling her I know the appointment made her feel bad and I'm sorry about that, but everyone just wants to help her have a good life. It's hard to keep that up when it feels like they're sabotaging their progress but I go into robot mode and keep repeating. Your dd has proved she can eat and make progress so take strength from that, remind her of it often, and keep going 💪

She did eventually have a few mouthfuls and the final fortisip we have, but I was clear we're back on track tomorrow. I'm going to carry on with the gradual increase as I think the jump to full meals has raised her anxiety to unmanageable levels

The plan is to make homemade smoothies instead of fortisip if she doesn't finish (I'm adding cream, oil, ground almonds) and hopefully keep increasing mouthfuls.

She's very constipated at the moment, I think a combination of lack of fibre/food bulk and the fortisip

I definitely think hormones play a part, dds mood and eating are awful in the days before her period and then it's like a light goes on and she's much better afterwards. She has been given the contraceptive patch to try but hasn't been brave enough to stick it on yet!!

My friend who was severely anorexic in her teens thinks her illness was linked to going on the pill 🤷‍♀️

Keep going gradually LittlePickleHead if that works better for your dd. You know her best. Our camhs team pushed 2000 calorie meal plan from day one. Maybe that approach works for some, but my dd was extremely anxious and tbh I didn't have the mental strength myself to get her to eat that much straight away. Taking it slowly and making small changes while getting fats in wherever possible is proving successful for my dd. Her progress is slow but any progress is good.

Girliefriendlikespuppies dd used to take borage oil which took the edge off her premenstrual symptoms nicely, but as it's an oil she started refusing it. It's definitely helps my peri symptoms. Maybe I should try and get it into dds food somehow.

Thanks @Whyisthishappeningtous it's frustratingly slow going and DD is pushing back a lot anyway. It's so hard to know if I'm enabling this?

She had plans at the weekend and I said if she did everything I asked in increasing daily she could go. She did do it. However she just maintained this week.

There are plans at the weekend (ice skating in particular) and i don't know if I should be pushing harder for her to progress more quickly if she wants to go. Last night though she pushed back so hard and if I cancel them then I have no leverage. But maybe she needs a hard consequence?

Is anyone on the Facebook group linked to f.e.a.s.t? They are properly hardcore - breaking tech, removing cushions from beds and blaring out horrible music, just going all in. It makes me wonder if I'm just being far too soft here?

LittlePickleHead that makes me sad. I'm my dds protector and I couldn't remove all her comforts. Life is shit enough for them. I haven't threatened to remove her phone as it's her connection to friends and family. She's nearly 17 though. Maybe phone removal is easier for younger ones.

We have cancelled plans. We cancelled a holiday, a couple of concerts and days out at theme parks. I made it clear it wasn't a punishment. It was because she didn't have the energy and she had low blood pressure so it was dangerous. I also said the holiday was due to insurance issues and concerns about treatment abroad and the possible of being unable to fly, which left her with no doubt that ED is a serious illness.

I think you need risk assess each activity with her. Ice skating is very physical and she could be hurt if she feels faint and can't get to the side quickly. Make it clear that not going isn't a punishment, it's because she's not well enough.

Try putting the ball in her court. Instead of saying:

If you don't eat enough you can't go ice skating.

Try:

Let's make a plan to ensure you're well enough for ice skating.

If she did everything you asked, to go to the weekend activities, I would let her go. you need to show her that she will get the reward you promised, I don't think changing the goalposts after that is a good idea. you can make a plan of how she can get there safely (drive?), what she can eat when there, just limit time out but I would let her go. It's not just about the consequences of complying, she is actually a person who needs to see her friends and have time out from being the daughter with the eating disorder IMO.

@LittlePickleHead I agree with @Buteverythingsfine - she has done everything you asked so it isn't fair to move the goalposts just before. However, if she knows her weight/that she maintained, it is a good time to explain that it is enough for her body to repair and for her to be strong enough to do activities on a regular basis. Then start looking to the future with the premise of in order to x she needs to eat y...

There's a film on Channel 4 at 9pm tonight called I am Ruth. It's about a mother and daughter's relationship as the daughter gets mentally ill and it's focused on the effects of social media. It's stars Kate Winslet and her real daughter. Just seeing the trailer set me off as it feels a bit too close to what we're going through. I dont thinks there's an ED element but I just thought I'd mention it in case anyone wants to actively avoid it.

Thanks - I'll give that a miss. Another appointment today with no weight gain. Been nothing since we joined the system 2 months ago. And yet every increase to the meal plan sends her into a spin that lasts for days. Big sigh.

@SwattyPie if it's any consolation at the start of recovery DD had no gains for weeks as her increased food intake was used for body repair and she had a hyper metabolism at that early stage. The point is that she didn't continue to lose and then a point came when physically things settled down and the increased food intake lead to weekly gains.

Thanks @D1ANA22 That does help. Managed an increase of 2 maltesers today. Whoopy Doo....