DD14 not eating. What now?

[sammyspoon]

We've only just started picking up on the signs. She's always been such a great eater. Started with noticing her lunch wasn't being eaten. Then she stopped eating breakfast. Then said she couldn't eat lunch at school because of the canteen atmosphere. She was still snacking after school and eating dinner but that's all changed over the last 6 weeks. She’s struggling to eat anything at all. I realise now there are plenty of other signs. She looks terrible.
It came to a head last night and she admitted she needs help. I already have a GP appointment for her on Monday but should I do something sooner? I feel so guilty and out of my depth.

If she recognises she has a problem would she be willing to have high calorie milk based shakes?
200ml milk with a sachet of Ensure (Amazon or other places) is a huge 370 calories. If you add a spoon of peanut or almond butter it’s 450 for one large glass.
This is the most calorific easy to consume food we have found.

Mummame222
I think everyone would agree that professional help is needed but in some places it can take a long time. Camhs took over 4 months to accept DD had a problem. I had to repeatedly contact them for help.
Not long after that they sent us to A&E.
I have had a lot of good advice from oher parents here.

@sammyspoon if you’ve not heard on Monday I’d give your local ED clinic a call to see if they’ve received your referral (don’t bother with camhs go straight to ED services) and ask them what to do whilst waiting. BEAT are open 3pm today so you could call them now for advice.
Not meaning to be picky but crackers with cream cheese and beansprouts will be extremely low calorie. The first thing I did was remove anything that was low fat or diet (other than my diet tonic for my G&Ts). We have full fat Fage 5% yoghurt, full fat blue top milk, proper butter that I cook with and there’s always a 600ml tub of double cream in the fridge. Plus lots of chocolate. Absolutely nothing diet or low fat.

@Mummame222 I’m a MH nurse with ED experience. As I said earlier in the thread, anyone who eats less than 500 calories a day for more than a few days needs to go to A&E as very low calorie intake can lead to electrolyte imbalance which can cause heart failure. Discouraging people from taking individuals with EDs who are food refusing to A&E is extremely dangerous.

@sammyspoon The meal plan I posted was an example of the kind of thing that ED services will want to build towards in the next few weeks. It’s so much food as teenagers need more food than adults and need a lot more food to gain weight (many teenage girls need 2500-3000 calories a day just to maintain).
I wouldn’t try to force that much food yet as, after a period of under nutrition, trying to eat too much too soon could lead to “re feeding syndrome” (potassium imbalance) which is very dangerous, and it may also cause your daughter to deteriorate mentally. What I would suggest is that you contact ED services yourself if they haven’t contacted you by Monday and that you insist your daughter eats something three times a day every day, even if it’s fairly low calorie. All nutrition is good nutrition at this stage. I would supervise her for 30 minutes after every meal-eating disorders can be devious so she may try to throw the food away or exercise it off.

im sorry, I’m sure you’re great at your job but I’ve seen so many MH nurses that have given me the shittest advice regarding my addiction and eating disorder issues. Wouldn’t trust another one with my life, literally.

@Mummame222 I’m sorry you’ve had bad advice in the past. Not everything is going to help everyone and clearly some things didn’t work for you. The fact remains, however, that eating less than 500 calories a day is incredibly dangerous. A&E was entirely appropriate in this case. I would also appreciate it if you didn’t put the OP off seeking help from ED CAMHS. You can dislike me and others in my profession but anorexia is one of the most life threatening illnesses and receiving professional help is vital. I do agree with you though on contacting BEAT. They’re a good charity and a good source of support on top of CAMHS.

What are you talking about???? Where did I put OP off that, I told her to go and get help at her GP. If you’re going to come for me read my comments properly. Yet another incompetent MH nurse not looking at the facts accurately.

And actually I didn’t see the part where she had eaten under 500 calories a day for several days.

I advised OP not to put in loads of restrictions without the guidance of professionals, I didn’t tell her not to seek that guidance. Read properly.

@Mummame222 when you said “I wouldn’t trust another mh health professional with my life, literally”, what message exactly were you hoping the OP would take away from that then? It’s clearly intended to discourage not encourage seeking treatment or help from qualified mh professionals. Please consider carefully before posting so negatively when the OP is clearly vulnerable.

The doctor who saw us at A&E said we had absolutely done the right thing in coming in. They were very concerned about her and at one point discussed whether she needed to go on a drip.

I will follow up tomorrow afternoon if I haven't heard anything. I was slightly nervous that the doc wasn't sure which ED clinic area we would fall under.
In the meantime I'll get her to regularly eat food she is comfortable with. The balls, nuts, veg and fruit. But I still doubt she's getting 500 calories a day.
I really appreciate the advice I'm getting here as I'm feeling very alone.

Could you try making ‘health’ bars?
like the high protein ones my DH gets while training. They are usually high in calories. But could make with peanut butter and nuts etc so she might like it?

I've just sat down with her and made a list of things she's willing to eat for now, so that it's not too much of a battle.
It's mainly low cal... veg and fruit. But she's ok with snacking on nuts, and has agreed to try some plain chicken.

You are doing a great job OP. If she will eat fruit, did you ask about smoothies? They are a great way to get extra cals in.
If she will est veg, would she eat a veg and tomato sauce?
Basically anything that has a bit of liquid you can get protein powder in (vegan protein powder if she's non dairy) for some added cals and nutrition

For some reason she won't accept smoothies. Even home made. I'm was thinking to try to add some cream into the protein balls but I'm worried she'll notice and I'll lose trust and they're the densest thing she's eating at the moment.

My 14 year old daughter had anorexia 2 years ago. She spent 8 days in hospital for 'refeeding' and was then discharged. We had no help- CAMHS had to make the anorexia diagnosis and even though the doctors agreed she was anorexic, she just lied to the CAMHS psychiatrist. Her heart rate was 35 mom, she looked dreadful, she was 5'7'' and weighed just over 6 stone.

I read everything I could and took advice from the eating disorders board on here too. We instituted a 3 meals, 3 snacks regime and I took total control of her food. This is the Maudsely Family Therapy approach, developed by specialist at the Maudsley hospital in London. The brain shrinks with anorexia and the child cannot make informed choices for themselves. You cannot let them dictate what they are eating. You need to reinstate foods they previously ate. Go slowly but insist they eat what you prepare. She needs high energy foods and 'good fats' are especially important for the brain: plenty of olive oil, whole milk, full fat yoghurt and cream. Your daughter will cry, she will shout, she might swear at you. That's the ED. You need to be stronger than the ED and take it all. It's very hard. You need to sit with her whilst she eats and insists she clears her plate. You need to be calm and provide distractions e.g. playing cards, watching TV as she eats,

After about 3 months it was like a switch had flipped. She had put on sufficient weight and it was honestly as if her brain changed. It's not been easy but this approach works. I believe it saved her. She has not had a relapse, which we are very fortunate with but she has been having sessions with a clinical pyschologist from once she was weight restored. Therapy is no good until the child has started to put weight on.

Good luck. It is so very difficult. Do not underestimate how sneaky children with an eating disorder can be. It took me a while to realise what was happening. The sleights of hand- hiding food in her pockets, up her sleeve etc was unbelievable. She will lie to you. It is heartbreaking. But remember it is the ED not your daughter. The earlier you catch it the better the outcomes, so get going now. I'd also recommend Eva Musby.

You have to insist she drinks the smoothies. I made one each night for my daughter and you can get loads into a smoothie. My son used to have one with her.

Two years on- neither of us can bear the sound of the blender! But smoothies are such a greta way to get good calories in. You have to be strong and you have to insist.

https://anorexiafamily.com/

You also need to stop avoiding the idea of a battle. It will be a battle. You have to show her that you are stronger than the eating disorder voice in her head. You need to garner all your strength and the strength of the rest of the family. To beat this is without a doubt, a battle.

Probably sensible. If she's eating those at least you know it's something and keeping her trust is the best thing you can do.

Good luck OP

@sammyspoon Am sorry to read about your DD and see you've had great advice on this thread. I also wanted to let you know you'd be very welcome to join the other parents/care givers on this thread https://www.mumsnet.com/talk/eating_disorders/4983816-support-thread-11-for-parents-of-young-people-with-an-eating-disorder?reply=133776770. There's a group of us on there all at different stages of helping our DC battle their ED - from people just discovering their child has an ED through to people like me whose DC is now in recovery. You'll get lots of peer advice both about sticking to meal plans, dealing with distress, managing self harm, navigating services and support from others who really know what you're going through and the toll it takes on you as a person, mother, partner etc. I started the first of the support threads in lockdown and the fact that we're on thread 11 is both a disgrace that so many people need it and also a testament to support people are seeking and sharing.

@sammyspoon on the smoothie - adding cream etc front.. There are differing perspectives. Some parents have done it extremely succesfully - they have stuck to their guns that the more succesful you are at getting calories into their child, the more able the child is to get to a place of weigh restoration and recovery. I took the view that at that point the breaking of trust would set us back further - we did have however an extremely limited set of foods DD would eat and lots of fear foods so in hindsight I don't know if we took the right path - I guess no-one knows either way.

I'm prepared for a battle if needed. I think I should wait for clinic advice first. In the meantime I've ordered the Eva Musby book and I'm planning to call BEAT tomorrow. I'll keep feeding her tiny amounts regularly. I'm worried that today it took 40 minutes to eat the protein ball she ate in 5 minutes yesterday.

You ARE doing a great job!! Do you have a partner? Are they on board? As it really does need to be the whole family.
It’s hard so do look after yourself too. And use the boards, FB group etc to vent as well ask for help. Sending hugs!

Eating foods will sometimes take a long time. It really will. So don't worry about that. Keep calm, keep talking but do not give in on not finishing the food.
Arm yourself with as much information as you can from people who having been there. The Mumsnet thread here was a lifesaver for me and really opened my eyes. There is also a Facebook group 'Eating Disorders parents/Carers UK' I found to be very informative and supportive.

It will take you a while to get your head round things. It did me. I couldn't believe it was happening to my daughter or my family (or me, I suppose). I was in denial about the reality of the situation for a while. For my daughter, the medical support was woeful. We were basically left with nothing. Atrocious. But other people have much better experiences.

My husband is struggling with this as his older sister had anorexia at a similar age. Im trying to persuade him that he might need counselling himself to equip himself to be able to support me.