Support thread (8)for parents of young people with an eating disorder

[myrtleWilson]

Welcome to anyone who is a parent/carer of a young person who has (or suspects may have) an eating disorder.

We're experts by experience and will share our insight - but obviously we're not medically endorsed, we celebrate all our small wins and provide a space for relief from the intensity of supporting a young person whether pre teen, teen or young adult with any eating disorder

@Valleyofthedollymix and @Threeyearsalready I believe the weight target from the NHS is to put them in a safe place (health wise) and getting DC to that weight demonstrates that parents can do the job of an inpatient unit (someone on this thread once wrote that the NHS has effectively subcontracted the hard work of refeeding to the parents). I don’t know about weight goals for purging but it does seem unrealistic.

The sufferer has to want to get better, their reasons will be personal - I’m not sure if headwork is effective, but living their life (friends, school, family, activities, routine) in my opinion is a greater incentive than an hour a week chatting to a stranger. Of course everyone is different but DD’s school counsellor has poisoned my relationship with DD, painting me as the controlling baddie forever feeding her and of course having the odd argument.

I completely agree with your sentiment about the ED closing their worlds down and the need to push back @Valleyofthedollymix - its why I frequently repeat the advice given to us about filling the day into 30 minute intervals with lots of activity. I do think as well that part of the reason for the rise in ED's over the past few years was that we (society) inadvertently created the perfect environment for EDs once triggered to thrive with lockdown.

I do wonder where CAMHS are going wrong in terms of psych support though. I don't think anyone on this board has ever said the psych support was the breakthrough needed? Our experience was that it quite ineffectual - although DD's transition person from CAMHS to adults was much more interesting in just the first meeting - really getting to points in DD's psychological make up that hadn't been explored previously. Is it a culture of fear of going too 'deep' in case it fractures family relationships somehow? I assume you don't go into CAMHS to make your name in the field so does that create and recreate a culture...

For us, just as Hadley describes the moment she let the anorexia in (or perhaps out is more apt), there seemed to be a moment when DD decided she didn't trust the anorexia as much as she had previously and it felt like a door had been opened but this time DD (like all good vampire slayers) didn't let the anorexia come with her over the threshold - but every step away from the threshold takes effort and is painful and we have to hope that our DC look back less and less frequently as the anorexia vampire stays shouting and shouting - and we have to hope that despite the shouting, eventually the words don't reach our DC's ears as they continue to walk away, the words don't linger in the air but fall silent and unacknowledged to the ground.

Hi all, haven't posted for a while, some may remember I'm at the beginning of this with my son, 11, showing early signs of restrictive eating. Finally spoke to the GP today and have been referred. I've also completed the Triple P fear less course for supporting kids with anxiety, which I've found really helpful. We are enforcing meals, supervising eating etc and resistance is a bit less but he still showing considerable anxiety over it and talking about being fat etc.

Just looking for any tips on how to discuss seeking help with him, his automatic reaction is to dismiss/underplay and he's absolutely resisted talking to anyone at school about his school-related anxiety for example. I don't want to destroy his trust in me, I've essentially gone behind his back to the GP. Any advice for getting them on side, or do I just have to accept that I'll be the bad guy for a while?

I think it's really tricky as the road to recovery for anorexia has many different aspects.

Anorexia is ultimately a brain based disorder whereby the brain is damaged by loosing significant mass and fat stores. The brain scans of the brain of someone with anorexia vs a non anorexic are vastly different.

Therefore getting the food in and weight on will be an essential component of recovery, therapy wouldn't be useful at the point where the brain is severely effected in the same way that therapy wouldn't be useful for someone with dementia for example.

Getting the brain functioning and recovering has to be the priority, in some cases medication is also useful in dampening down some of the anxiety and the psychosis triggered by the weight loss.

I also do not agree that the sufferer has to want to recover, it's very much a part of the illness to deny being ill and deny wanting to get better. The desire to recover will kick in eventually but at some point much further down the line.

I think the only thing that is certain in the treatment of EDs is that it is incredibly complex and a one size fits all approach is not helpful.
Our experience truly was that weight gain and a prolonged period at a over restored weight was the only solution needed. There was nothing else except my learning strategies to deal with intense distress during her illness that i still use today for any more minor issues.
I pushed for psychological help for DD and was told it was pointless. Because of her brain state. She could have had cbt for her intense ocd but actually her ocd has now resolved. In fact I was told that most sufferers won't engage. And DD didn't engage with CAMHS which seems to be v common.

The more I read the more it seems that the age of the sufferer has a bearing. My DD was too young for intense body dysmorphia. That wasn't her driver. Although she liked her skeletal body and couldn't see it properly, weight gain and the changes to her body didn't terrify her. She was terrified of losing fitness.
I do agree tho that having something in their lives is important. My DD exercised throughout against normal advice.
Everyone's journey is different. But certainly for younger sufferers as fast a weight gain is what i would advise.

But this is what confuses me/worries me about everyone mentioning the need for weight gain. Dd had an eating disorder for 2 years with normal weight. In fact her ED started during a time her BMI increased, during lockdown.
It was what CAMHS frustrated me at the time by going on about 3snacjs 3 meals. She had this anyway.
Her purging became worse and worse and in the end she became scared of eating because it would set off her purging.

It also worries me she is putting too much hope on CBT. She is "desperate" to start.

@Threeyearsalready yes I am talking about out experience of AN. I have no experience of EDs where purging is the main issue and not weight loss (where obvs purging can play a part).

Oh, weight loss is now a major problem (currently at 80%).
But this was (initially) obtained more by purging rather than restricting .

Threeyears I suspect there is a detrimental effect on the brain caused by purging, it causes all sorts of issues with electrolytes and malabsorption especially at a low weight.

The CBT will hopefully be really useful at challenging your dds thoughts and beliefs that led her down this path as well as giving her some alternative coping strategies.

@curlykate99 - hello, you may remember me, by 11 year old DD is a few months ahead of your son's journey.

There are two people in your DS's head. There is your DS and there is the anxiety/ED monster. The monster does not want help. He does not want people interfering. He thrives on shame. Shame breeds in the dark - the more he hides what he feels, the worse he will feel. This is what the monster wants.

I would suggest asking him to draw the anxiety, personalise it a bit and explain that the anxiety doesn't want people to help and support your DS, but that the only way to get back to a happier life is to ignore the monster and reach out.

You will not be doing your son a favour by taking his word for it that he doesn't want support. I think everyone here would probably agree that behind the fear and negativity of the monster there is a child screaming out for help. Talk to that child.

Lots of VAR - validate, acknowledge and reassure - "I can see how scary this is for you. I know it's not easy but I can help. There are lots of people out there who know all about worries like these ands with their help, we can do this. No one is going to judge you or give you a hard time."

If I had done as the ED wanted and let it stay hidden DD would still be stuck in hell. I have made many mistakes over the last 4 months but getting the help she needed whether she wanted to or not, wasn't one of them.

Also FYI you might be interested - she has ended up eating 2,800-3,000 calories a day to get the gain and get ahead of growth.

Good luck x

@Threeyearsalready
I have a lot of experience with CBT and while it is very useful indeed it requires masses of practice - it's like playing an instrument, you only get good if you practice outside of lessons. I would definitely manage your DDs expectations; it is not a magic bullet, but rather a healthier way of being with your thoughts. If she's prepared to use the tools it WILL help but she has to use them x

Really interesting reading all your thoughts on weight gain VS (as well as?) therapeutic help. Having had 2 children with disordered eating I think it's complicated because there are different reasons for restricting cals. DD1 had body dysmorphia and scared herself so came to us to tell us she was restricting, we were in and out of the crisis in 2 months. She has been having counselling but only in the last year, 2 years after she got better, and finds it helpful. She wanted help from the beginning and this is key.

DD2 - who has been 1000x worse - I think has an OCD/addictive personality type and the features about the Hadley Freeman book sounds horribly similar. I have this dark feeling she will struggle with trying to control her feelings externally all her life. We are lucky enough to have a really lovely consultant psychologist at CAMHS and DD has engaged but this is after stonewalling 2 other people. Sadly this lady is so senior we only get 3 sessions with her but It has made me feel that the right intervention/person will help there too. But not yet.

@Lottsbiffandsmudge - you were the other super helpful person! Thank you so so much again. So silly because I wanted to ask - DD is getting bored of her porridge breakfast and I said I'd do a smoothie. I've copied and pasted your smoothie recipe but wondered - do you soak the oats or just whizz them up?

So, we have not reduced DD's intake. We are currently at 102% W4H. She is at a playdate with a very sympathetic mum who is comfortable overseeing her snack and lunch. It feels really good. Really... normal.

Aaaand on to the next. Older DD - the one who came to us - is on a knife edge. She has been performatively eating to get DD2 to eat and is the heaviest she's every been and very fragile emotionally.

Does anyone have any advice/thoughts on siblings who have disordered eating tendencies?

Thank you @WhatHo
Yes that makes perfect sense

@WhatHo I don't soak the oats just add them and whizz up. Its a bit bitty but DD likes the texture.

i agree with @Girliefriendlikespuppies we hold our DD at a safe weight and continue to monitor and supervise her eating. She is in recovery but not recovered. The hope is that one day she will choose recovery herself, in the meantime we are her safety net until she makes that choice.

This becomes more difficult as she gets older and craves the independence that older adolescents desire (college, driving, going out with friends) - she wears baggy clothes and I do worry about weight loss not being obvious, for those with older teens is it feasible to continue to blind weigh after discharge from EDYS?
Therapy I think is a case of horses for courses, I have suffered with depression before and talking therapy and medication didn’t work for me, getting busy living a life is what got me out of that hole and I hope it is the same for my DD as she starts to spread her wings.

I hadn't finished the Hadley Freeman podcast when I posted (the one on Stories of our Times) and at the end she said the single piece of advice as to keep stressing this parallel world without an ED and how good it could be. I'd read a much earlier piece by her where she'd said something similar and it was one of my guiding principles. A friend who had it for about four years as a teen also told me that one day she just woke up and thought, I'm bored of this.

We used to do endless drawings where we put all the good things about a life with normal eating on one side and the very few 'benefits' of anorexia on the other. I genuinely feel that, physical danger aside, the recommendations we had to do absolutely NOTHING bar sit at home following an eating plan were counter productive and I'm glad we ignored.

One thing I disagree with Hadley about it is that she says anorexia is always characterised by very very low weight. I'm completely convinced that you can be a high weight and have anorexia. For instance, I'd have to lose about three stone to become underweight. If I lost that weight rapidly, I think I'd be anorexic long before this magic time when I go from 7 and a half stone to 7 stone 6.

Conversely my daughter is recovered and is still at less than 90% WFH (I think, we no longer weigh her).

Different weights for different people.

Yeah I totally agree re the weight thing valley my dd only ever lost half a stone ish but was very much in the grips of the illness. Having gone through this journey it's really made me appreciate how everyone's 'healthy' weight can vary massively. I think myself and dds healthy weight is around 9.5-10.5 stone (although I'm heavier than that now!)

That's just our build, we are tall with broad shoulders. It explains why we were both really unwell at anything less than 9 stone.

I have friends who have never gone above 9 stone in their life and haven't got an ED and eat what they like 🤷‍♀️

I guess that's why the checking their weight/height centiles is useful as in theory that should be your guide.

Hi all,
Hope you don't mind me jumping in here; have spent the past week or so reading through all the threads right from the beginning and finally have caught up! I'm not a parent/carer, but I was in your DC's shoes a couple of years ago (I'm 18 now) and hope I can be of some use to you all by providing a bit of insight from the opposite perspective. I'd firstly want to say that my hat goes off to you all, you are doing one of the toughest jobs out there and the strength it takes to wake up everyday and continue fighting against such a cruel illness that is ruining your child's life is unbelievable, and I really hope you all remember how incredible you are.

I was diagnosed with anorexia at my first assessment with the CAMHS ED team when I was around 15 during the first lockdown. Like many of you all, my parents had definitely noticed that I had taken to doing excessive amounts of exercise, and was decreasing my portions drastically. I've also always been on the thinner side, so it was difficult for them to know whether the weight loss was intentional or if I was simply a very disproportionately growing teen. I lived with my mother so she was my primary carer, feeder, supervisor, all of that in one. I gave her absolute hell, not verbally (my mother is Asian and believe me, Asian parents are not the ones to mess with!), but just by tormenting her with my relentless mission to lose as much weight as possible. I engaged in almost all the behaviours your DDs have; the sit ups in the bathroom, spitting food into napkins and hiding them up my sleeves, doing silent ab workouts in my bedroom while on "bed rest". I was pulled out of school by CAMHS, but luckily avoided any hospital admissions at that point (I have had one since, but years later and only a short one for a relapse). I can't remember the exact figures, but my BMI was 13. something and my WFH I think was 67%. I'm going to share below the things that helped me to recover (I'm currently sat in bed eating chocolate purely because i feel like it), and I am well aware there is no one method that works for everybody, but I hope some of these might be of use.

1. Take your DDs phone, and look through the apps they have downloaded. Delete MyFitnessPal, any apps that include calorie counting/exercise monitoring. There is a way to remove the health app feature of tracking the steps - there will be tutorials on google which will tell you how. If they have FitBits, Apple watches, or anything like that, take them away. I am aware this is easier said than done, but it is SO important. Anorexia has many crossovers with OCD, and numbers are a huge thing for people with anorexia, whether that be a target number of steps they need to meet each day, the calories consumed, the calories burnt, weight, all of it. Put parental controls on their phones if you haven't already because this means when they download an app it must be approved by you first - so they won't be able to re-download any of them without you entering a passcode. You can also filter key words like "workout" "weight loss" and "anorexia" for example, so they can't search for tips on the internet.
2. I know this one will be a battle, but please, for the love of God, GET RID OF TIKTOK! That app is the absolute devil of social media. I would constantly lie to my parents, saying I only watched funny videos, animal videos, makeup videos, but I wasn't doing anything of the sort. Tiktok absolutely glamourises, normalises and promotes eating disorders; ESPECIALLY anorexia. So many people post "What I Eat in a Day" videos showing things like black coffee for breakfast, bell peppers and humous for lunch, and all kinds of ridiculous diet/protein supplements for dinner. People post frequent bodychecks whilst being extremely underweight; ribs, collarbones, knees sticking out - all of these things are warped by the algorithm so young people with EDs are far more likely to see these, and they are hard to look away from. There are also lots of videos people post while inpatient for anorexia, showing off their NG tubes, telling everyone how they hide food, how they refuse to complete their mealplans etc. As a parent it will seem as though most people with anorexia are terrified of all these things, but unfortunately you will find that a lot of people, especially those under 18, actually feel that being in hospital, being underweight and having a tube is a trophy of being 'sick enough', the validation is a huge component of anorexia yet so many will refuse to admit they struggle with this. Instagram also has an ED recovery community on it, where people post in detail about non-compliance with meal plans and similar things - it's so important to go through your DC's phones and make sure they aren't engaging in any of this activity. Some may have multiple accounts so don't be fooled if it seems like they're not; I had a second account on both platforms so I could look for as much pro-anorexia content as possible. I was devastated when my parents forced me to delete Tiktok, but I can't even begin to explain what a difference it made. Social media makes it seem as though everybody has an ED, that's its normal, and that you aren't 'ill enough' to recover unless you're completely emaciated and have a tube up your nose. With time and the abstraction of these sites, your DDs will begin to realise what a false view of the world this provides, and it really will enable them to fully heal.
3. For all your DDs struggling with self harm, please have a look into getting a DBT workbook online. Dialectical behavioural therapy targets behaviours such as self harming, impulsivity, anger, suicidal actions and thoughts, and emotional dysregulation. As you all have definitely heard multiple times from CAMHS, engaging in intensive therapy whilst still underweight is largely ineffective, as malnutrition will render your DCs cognitively impaired, however as someone who's really been through the system (I've spent months and months sectioned on CAMHS wards though not for my ED), they aren't really telling the whole truth. Teaching your DDs the distress tolerance skills from the modules in DBT can and absolutely will work, whether someone is underweight or not. These are easy to implement, though your DDs will need help from you at the start to practise them, but you would be amazed at how effective they are! As someone who began self harming at 9 years old, using DBT distress tolerance skills such as TIPP, STOP, Wise Mind and Pros and Cons (you can find these skills in the DBT workbook) have enabled me to become completely clean from all self harm. For in the moment de-escalation, having something like a knee pad (you know the ones you kneel on when you're gardening) and placing that in front of them on the wall while they are headbanging will at least decrease the physical harm they are causing themselves. Red food dye poured over a bowl of ice cubes and then letting the ice cubes drip down their arms is another way of both imitating the visual stimulation and the physical stimulation they may be searching for when they engage in cutting for example.
4. For those of your DDs struggling with ASD/suspected ASD or anxiety, making something called a self soothe pouch is a brilliant travel sized weapon you can bring out for them during meal/snack times. You can buy a small bag/pouch off of Amazon and fill it with small items which cover the 5 senses to help ground them when they are extremely distressed. Great items to put in there would be essential oils, sensory toys such as tangles or fidget cubes, toxic wastes (I'm aware this one could be tricky as technically it is food but they are TINY and the shcok factor from how sour they are really helps to ground into the present moment), little flashcards with quotes on like 'every mouthful is a step closer to freedom', crystals, and other little bits are great. I do have a pinned video on my page on Tiktok (I have almost 60,000 followers and share coping skills and advocate against the harmful content posted) with 1.7 million views where I show whats in mine, where to get the bits from and demonstrate how to use them so if you google @/sagesolitude or type it into Tiktok it will be the first video to come up if you want to see a visual demonstration.
5. I'd really recommend watching Ro Mitchell on YouTube with your DCs. She is such an incredible advocate for ED recovery, and she is one of the very few out there who didn't swap restriction for excessive gym use and becoming a "protein bar girly" - she is brilliant! Watching someone like Ro's videos while having a particularly tricky meal or snack is a great way to show that it is possible to fully recover, to ENJOY eating with no restrictions, and she's a gorgeous girl! I remember being mortified that I would end up really "fat" or "ugly" if I weight restored, but that simply isn't how it works. Being able to watch someone really get their life back and refusing to give into the ED is so inspiring, in fact I think all of you parents out there would cry of relief if you saw her videos... it's so easy to panic thinking full recovery doesn't exist, but it does, and everyone of your DDs can and will get there. I promise.
6. BE FIRM. I know you all already are, but I mean NEVER relent. NEVER negotiate. NEVER give into the conversations of "oh but it's just one little bit i'm leaving, i feel sick/i'm full/i'm tired etc". My mother probably took it a bit too far as she was emotionally abusive (I ended up in care and we have since repaired our relationship), but I very quickly got to the stage where I was finishing every meal, drinking every cup of juice, eating all the snacks without even trying to argue about it. If they know there is absolutely no point in trying to get you to decrease their portions or allow them to swap for healthier options, they will give up eventually. They will also probably be relieved; a huge part of the ED is having anorexia tell them that they "aren't trying hard enough" to fight against the food intake. If they can tell that voice "look, there is no way around this, mum is never going to let it slide" then that gives them permission to eat.
7. Lastly (and I have wayyyy more points but this message is stupidly long so I can do another list if it's any help to anyone), and this is harsh, is talking about something I call the 3 routes of possibility. When you have anorexia, your brain is telling you that the only way you can possibly have a happy life is by restricting forever, exercising forever, and trying to stay as skinny as possible until the day you die. Now, you and I both know that's ridiculous, but your DDs will be thoroughly convinced that it's possible. So, if you can, I would sit them down when tensions are low, and have this talk. Draw it on a piece of paper as you talk it through if that helps. Say: "You are here. (dot on paper). There are three pathways you can choose to follow for the rest of your life. The first one goes like this; (draw an arrow from the dot) You continue fighting against everybody, and restrict your intake as much as possible every single day for the rest of your life. You exercise whenever you can, until you're completely exhausted, your entire body hurts, and you feel like you're going to collapse. You get cold even in the Summer, you're constantly starving, completely miserable. You fail your exams and can't go to uni because you're too unwell. You never get a job, because your body wouldn't be able to handle the physical exertion, and you have no friends because you never go out as you can't eat in front of them and can't waste any time when you could be exercising. When your body finally gives up decades later, you've achieved nothing, you haven't smiled in decades, and anorexia stole your entire potential for a worthwhile, beautiful life, and made it utterly miserable. That's route number 1. The second route goes as follows: (draw a second arrow from the dot) You start eating. It's terrifying, and you don't want to, but you comply with the meal plan and you answer your body's hunger cues and you gain the weight that you never should have lost. Once your brain is no longer starved you realise you actually prefer the way your body looks now (believe me, I WAY preferred my body after I was recovered even though I was so terrified of gaining for so long) and you wonder why you ever put it through so much torture. You pass your exams and go to uni or get your dream job, waking up everyday excited to do what you've always longed to. You spend so much time with your friends and family, going on nights out, partying, spending holidays together. You feel warmer and stronger, you can eat the chocolate bar you're craving because it no longer scares you and calories are a thing of the past, and it tastes AMAZING. The world is bright and full of hope, you enjoy all your hobbies, and life is how you've always wanted it to be. Then there is the final route: (draw a third arrow from the dot). You continue restricting, you carry on exercising, and you continue chasing the number on the scales lower and lower. Every time you think you've lost enough the anorexia tells you "just one more kilogram, and then you can stop", except it's never just one more, it's another, and then another, and then another. One night you crawl into bed, joints pounding in pain, hair falling out, stomach so hollow you can practically hear it screaming for food. Your heart fails in the middle of the night and you never wake up again. Your parents find you, cold and limp, and your battle has finally ended. Anorexia has won.

Now I know this last one is harsh, and I wouldn't recommend it for anyone whose DCs have only just started the recovery journey, who are particularly young, or have learning disabilities, but if they are older, if this recovery process has been going on for years and nothing seems to be working, this is a shock factor. Nobody taught me this, I was sitting there one night miserable as always and decided to make a mindmap on the different outcomes of what would happen if i recovered vs if I didn't. This was what I realised, and it shocked and scared me so hard I cried for hours. I also woke up the next morning and ate my breakfast, and had my snack, and stayed in bed, and completed my meals and drank the stupid milk. I never looked back. The only lives that involve anorexia are either gut-wrenchingly miserable, or end in premature death. That's the truth, and it's the truth that so many people with EDs haven't even comprehended. I am sending so much strength and love to all of you. It's a horrid battle, but you will win the war. If there's anything you want to ask, any advice you need, from someone who has been through it but recently (so I'm more relatable to your DDs) please don't hesitate to reach out. I am more than happy to PM my email to anyone who has a child who might benefit to talking to someone a similar age as them who has come out the other side and recovered. Hope you've all had as good of a day as you can!

@sagesolitude Thank you so much for posting this. MFP was a huge trigger for my DD (currently very poorly in an IP unit) , who kept reducing and reduced the target calorie consumption. I'm a big fan of #RoRecovering too. It's very generous of you to share your story and tips. And it's great to hear from someone who had pushed on through and recovered. Wishing you all the very best for your future.

@sagesagesolitude thank you. Thank you. Thank you.

Sage that's a brilliant post, thank you! I really wish I'd read it three years ago as I feel like I made so many mistakes in the early days.

I got some things right, I went through her phone, never allowed social media although she has got tiktok now. I got rid of the scales and the fitness watch.

However I was not strict enough when it came to finishing food and that's something dd is still struggling with now.

The therapy you describe sounds really helpful but I'm assuming there would still need to be some willingness to engage. My dd won't discuss her ED at all and I find it's like we just skirt around talking about it.

I'm so pleased you've come out the other side and have taken the time to post, it really is helpful.

Thank you @sagesolitude and heartfelt best wishes for a brilliant future for you. My Dd discovered Ro when it felt like she (daughter) was playing out what recovery may look like. For any parents on here struggling with how to manage meal times I'd recommend watching Ro's videos on YT - I remember having an epiphany listening to her mom and dad and definitely modelled my behaviour on their approach.

sagesolitude

Thanks so much for your post. It helps a lot to hear the experience from a sufferers perspective.

You sound like an incredible, articulate and empathetic young lady and I'm so pleased the future is bright for you now.

@NanFlanders I'm sorry to hear about your DD in the IP unit. You may have already said but I'm assuming it's an EDU rather than a GAU but either way, although they are horrible and it's so tough being away from her, these places really can help to turn things around. I have many friends who had admissions to EDUs and it really was the kickstart needed to take the plunge into recovery - I hope the same for your DD. I don't know her status (whether she's informal or detained under section), but if she is sectioned I would really recommend getting her in touch with an IMHA (independent mental health advocate) who will be able to come and see her on the ward, address any worries or concerns she has and escalate them further on so that action is taken; I found mine very helpful so it could be worth a shot.

@Girliefriendlikespuppies Don't blame yourself for things you could have done differently in the early days, there is nobody on the planet who has ever managed to get it 100% "right" all the way from the beginning of starting recovery, and anyways by the sounds of it you did an absolute brilliant job with the apps and Fitbits! The DBT however has absolutely nothing to do with EDs which I think would actually be better for your DD. It's targeted at other mental health difficulties, which often there are many which are simply masked by the all consuming anorexia. Your DD may actually find it really helpful and feel more understood because one thing I know from CAMHS ED services and ED services in general is that they kind of refuse to acknowledge the underlying issues, like low mood, emerging personality disorders, self-harm etc - which can manifest in people with EDs trying to ramp up the ED behaviours in an effort of hoping someone might notice that the anorexia isn't the whole picture. There isn't a single piece about eating disorders in DBT, so perhaps if you presented it to her as something to help her cope with her mental health and stress that it's completely UNRELATED to the ED she may be more willing to give it a go.

@myrtleWilson Yes, Ro is fab! Such an amazing role model for everyone in recovery and the fact she did it without professional help makes it even more incredible - I knew her pre-recovery through one of my best friends and she was really really poorly, I remember how worried we all were about her; now we all look up to her in awe!

@BagpussSaggyOldClothCat Thank you so much. Sending good wishes your way. :)

@sagesolitude Thank you so much for your post, some fantastic tips.

I wonder if you might have an insight into my older DD. She had a brush with disordered eating 2 years ago, she scared herself and came to my and her form teacher to confess she had been limiting her calories. She was referred to CAMHS because of her rapid weight loss but never formally diagnosed with an ED. She was in and out of the experience in 2 months and all I really had to do was put 3 meals and 3 snacks in front of her. Looking at what we have had to do (and are still doing) for DD2 - the full monty of refeeding and self harm management including medication - I realise how extraordinary she was. She basically did all the work herself. I sometimes feel quite frightened about how stupid and naive DH and I were and how lucky we got.

DD2 has been very controlling of DD1 which has caused her to eat performatively and she has put on quite a bit of weight. I couldn't give a monkeys - she is growing like a weed - but she hates her body and the last 4 months have taken a serious toll on her emotionally. I am absolutely terrified that we will pull DD2 out and like a seesaw DD1 will go down next. She is seeing a counsellor and I will direct her to Ro Mitchell (I know she follows some recovery people and she does not have TikTok, we have parental locks on her phone) so she may have Ro already, but if you had any wise advice I would be very interested.

I know a few other mums have discussed the heavy toll ED takes on siblings and I don't know how unique my situation is with DD1 having dabbled already but I'm open to any and all advice.