DD's friend has a serious eating disorder - what can I do to help?

[Balletschmallet]

The child in question is almost 14, very severely anorexic. It's been obvious for a while and her mum officially told me today. They have very little in terms of a support network. The school have been really unsupportive and the GP seems to have been as well - she's on a waiting list to see a nutritionist but that seems to be it. The poor mum is having an absolutely awful time. Her DD doesn't have friends apart from my DC (they know each other from outside school), she's too unwell to be in school and is very unhappy there anyway so it's just her and her parents, who are really struggling to keep an eye on her / make her eat / stop her over-exercising and also hold down jobs.

The thing is, I got the impression, that her mum is maybe struggling to take on board the seriousness of it, which I totally understand - it's spiralled downwards really fast and I think she just can't believe it's happening. I don't mean she's in denial, she knows what's going on but I think she's hoping that a gentle approach will do the trick. They're trying to get her to stick to a high calorie diet but that's clearly not happening. I think she is just about maintaining her (very low) weight for now. But she looks really seriously ill to me (i.e. I would expect her to be in hospital at the weight she is at), and I can't see her getting better this way. I'm really worried for her and her parents. Other than being a listening ear, is there anything I can do to help? I think they are at their wits' end.

BEAT have some good resources and advice https://www.beateatingdisorders.org.uk/

A nutritionist isn't going to help with anorexia. Can they afford private counselling as a starting point

could you gently suggest some specialist eating disorder therapy to the parents? a nutritionist is all well and good but the deeper causes for the eating disorder could probably benefit from some therapy that's especially tailored. Maybe you could find a local recommendation and give it to them or something.

How have school been "unsupportive" if she's not actually there? What would you have them do?

Sorry that wasn't clear, I meant before she stopped attending. They essentially seem to have said that there isn't any support available at school. They also had a really unhelpful / confrontational interaction with the child before speaking to her parents, which seems to have exacerbated things. There are also bullying issues that haven't been addressed as I understand it. Anyway, probably not really relevant because I'm not sure she will go back there.

Be careful not to undermine the mother which in turn could cause tension between her and her daughter.

Don't get involved with the daughter directly but do pass on contact details for organisations that you think might be able to help. Ask first if the mother wants the information otherwise she'll think you're treading on her toes.

That's a good idea. I did say that I thought therapy would be a good thing rather than just looking at nutrition. But actually getting a recommendation sounds v sensible.

Thanks @Jewelspun that's v good advice. Def wouldn't undermine the mum. I think she's brilliant, I just think maybe it's proving hard to face the reality of it. I imagine I'd feel the same.

@cocksstrideintheevening Sorry I somehow missed your post to begin with. Thanks for the link. I've actually just been looking at the Beat website and reading their support guides.

Have to head off for a bit but thanks everyone for the responses so far.

She needs a formal referral on to an earring disorder clinic, not a nutritionist. There are certain things which trigger an automatic referral

look at the BEAT website for support and information

As someone who had a close friend with anorexia, support your daughter too. I was sometimes put in a tricky position of being asked to say friend had dinner at mine, for example. I'd ask friend's mum to confirm anything like that with you, so your DD isnt put in the position of being asked. Let her just be her friend, not her keeper.

Be careful with language and don't be pushy with food - my mum was a bit of a nightmare with trying to repeatedly offer different snacks/meal options rather than accepting a "no thank you".

I sadly lost my friend in our early 20s but she is fondly remembered.

sounds like she needs an urgent paediatric psych referral by GP! I don't know if they can directly refer to the specialist eating disorder unit or have to refer to psych first, but either way she needs proper care. how awful for her. hope she gets better soon.

the school or parents will need to over see her eating at lunchtime, be it in the canteen, a side room or off site

Be there to listen - this is going ti be a long haul problem. She will never be fully rid of this horrendous condition.
Safeguard your own daughter. She can be a loving friend to this girl but must not be taking on any responsibility for her friend’s serious problem that only a trained adult can deal with. Teenage friendships are so intense, but she is a child too.
I feel for everyone in the situation. I know a similar case - it destroyed the parents marriage and all relationships with other siblings.

What an awful situation. I wouldn't underestimate what the mother's going through. She may appear calm but actually be falling apart. I don't know what you can do apart from the good suggestions made by others.

This was recommended to me by a few people when my DD was displaying early signs. She is known as being one of the most knowledgeable figures in the field.

anorexiafamily.com/contents-anorexia-book/

Perhaps you could send her a message / email with the link with a nice message saying that you have heard that this is a really good resource for parents.. you may have already seen it but in case not here it is. Please let me know if there is anything I can do. I'd like to support X in any way I can. It must be really hard. Etc

@AwkwardPaws27 I'm so sorry about your friend.

Really helpful suggestions here, thanks so much. And I'll def be looking out for my DD too

I think she needs an urgent mental health referral. Also - unfort not your place - but there is a strong link between neurodiversity and eating disorders.

Have a look at Orri's website and type in Orri vimeo channel - some useful resources and webinars (for free) on there. They are a private service as well if that is something your friend wants to look into. If you follow them on social media, they also run workshops and lives.

There are a set of targets for the NHS that it may be helpful for the mother to know about:

https://www.england.nhs.uk/mental-health/cyp/eating-disorders/

That page says it relates to CCGs but the new ICBs which have replaced them should be working towards the same things.

If you find your local mental health trust you should be able to look up their results against these targets.

https://www.england.nhs.uk/statistics/statistical-work-areas/cyped-waiting-times/

If you look that up that should give you insight as to whether the daughter hasn't been correctly referred (which the nutritionist thing makes sound quite plausible) or if locally they are just terrible at meeting their targets.

If she's not been correctly referred then pushing for referral at the GP becomes the primary requirement.

If she has been referred but isn't being seen in a timely fashion then it might instead be looking at whether she's been classed as an urgent or non urgent referral and whether or not that seems right.

Obviously all of the above has to be caveated with the need to support the mother with things she wants, but the NHS can be pretty confusing to navigate so having had someone who has found out the above for the local area might well make life easier.

Thanks so much for your posts. I know a little bit more now. It seems the nutrition referral (which was meant to be urgent but was going to be 3 weeks min) was to see whether she clarified for very urgent care. My understanding is that because her bloods came back ok, that was the suggested route (her GP had expected the bloods to be worse apparently).

I'm really grateful for the helpful resources everyone has pointed me to - Mumsnet really is an amazing community at times like this. I feel I'm treading quite a fine line between offering as much support as poss and not being intrusive - I'm sure the last thing they need is lots of unsolicited advice. But I also know that they're a long way from family and that it can be hard to think straight when you're right in the thick of something awful like this and sometimes input from someone who is a little bit removed can be helpful. Anyway, I feel I've offered everything I can for now.

The YP in question spent some time with us last week to give her parents a break and she's eating very little (and in a very controlled way) and trying to burn calories wherever possible through moving about. It's really upsetting even just as a friend so can't imagine what her parents are going through.

I would recommend this book for mum here.

If your friend has any kind of private healthcare that covers the family then they may be able to access help that way.

Thanks @FanSpamTastic Unfortunately no family healthcare policy. I think they're now going to pay for a few sessions with someone who has been recommended to them but prob not sustainable longer term. That link just seemed to take me through to the home page of Routledge - what's the title of the book?

Book is by Janet Treasure - title "Skills based caring for a loved one with an eating disorder".

DD was 17 when she was diagnosed with Anorexia Nervosa. This occurred during the Covid period and she had very little face to face care. Most was over Zoom. Her treatment plan started with a nutritionist - who set daily menu plan and I had to keep notes of what had and had not been eaten and send these to the nutritionist. DD also had weekly sessions with a psychologist. I would say it took about 6 months before we started to see chinks of light - but very much down to DD desire to get better.

This video was helpful to me to understand a bit of what was going on . Hope this link works! It's a long video! Dr Leanne Baron EndED.