Worried about teen DD. Will Beat help?

[Weightlossworried]

I'm becoming worried about my 15 yo. She's always been slim with a small appetite but lately she seems to have lost weight and is eating even less.
She denies any issues around food/body image when I've gently raised it. She hates school and for a long time has refused breakfast or to eat much or anything while there saying she feels too sick and anxious. She used to make up for it at home but doesn't really any more. She does always eat dinner and enjoys helping make it too.
I have no idea how much she weighs as we don't have scales and I don't think it would be helpful to weigh her but she is visibly thinner I believe, although she denies it.
I am pretty scared of saying or doing the wrong thing and making it worse. Can Beat offer help with this to parents? Thanks

They did tell her. At the initial appointment the nurse discussed it with her and said she could choose not to see it. DD claimed not to care. The doctor we saw today said she felt it was important patients see their weight as they need to confront it. I know there's a lot of mixed feelings on this one. If DD makes it known she strongly wants to avoid seeing it then I'll definitely push for that for her.

The doctor said we go back next week and they will be trying to help her deal with some of the difficult feelings around food in the sessions. Nothing more concrete than that at the moment.

You can only take their advice and see how she goes. I’m glad you’re going back next week. It’s nice to have the break from going, but also going makes you feel supported. It’s just all a head f@ck really but we’re all here to help xx

That’s massive what you’ve got your dd to achieve. The exorcism is exactly how it feels. I’ve had such hatred at times towards the ED.

Congratulations on the weight gain! I’m going through exactly the same process with my daughter but a bit further in the process (we’re 3 months in post diagnosis). I’m also trying to WFH whilst dealing with the relentlessness of the treatment so you have my thoughts & solidarity. In my experience the first couple of months are the harder but it starts to feel less raw and unbearable. We’ve had a fair few weeks of no weight gain, my daughter needs close to 3000 calories to gain but little by little we’re getting there. Shes gone 78wfh to 84wfh and she’s in a much better place physically and mentally so hopefully that helps. Also to add my daughter is also often worst post a visit to CAMS (reluctant to eat) but that’s also improved as I think she finds the process less stressful now she’s more used to the team / process x

Thanks @ArtfulBird , it's good to know that the cahms effect might lessen with time.

Yesterday was bad. I thought I'd mentally prepared myself for it but I found it really upsetting. She wouldn't eat lunch at all. Had a very small bit of her afternoon snack and dinner. No evening snack. Worst of all though was how upset she was. She wouldn't speak at all. She just lay in her room and wouldn't engage with us.

I'm dreading waking her up for her breakfast. I'm trying not to panic. I know this process is probably going to be one step forward 2 steps back at times. I'm thinking I'll ring CAHMs for advice if she is like this the whole weekend. That hard won 700 grams is going to be gone in days at this rate.

@Weightlossworried when we went through this a couple of years ago, getting through the meal plan wasn’t optional. We had to sit with her and talk her through every meal and snack. The ED nurses helped us with understanding how to do this, what to say, what not to say. It’s incredibly difficult to start with and it can take a long time. How are you approaching getting her to eat?

We tell her it's meal/snack time. The meal/snack is already prepared. We sit with her, chat and try and distract. We have a jigsaw puzzle on the dining room table as a distraction which has worked in the past. We encourage using the phrases mentioned on here and in the Eva musby book. We set out the whole meal/snack as advised by CAHMs.

Yesterday she refused to even speak or look at the food. She had a small amount of dinner before storming out and up to her room. I don't know if I should have chased after her with the dinner but I know that continuing to force her to engage with us when she's like that makes her more and more distressed so I couldn't see it would achieve anything.

I don't really find any of the stock phrases work when she's decided she's not eating. Nothing seems to work. Cahms say to give the meal 30 minutes and then leave it so that's what we do - unless she's stormed off. But generally when she's stopped eating, we've had zero success getting her to eat more. It's like she shuts down.

It sounds like you’re doing all the right things. I found having some meal replacement shakes in were helpful in the early days, Holland & Barrett sell pre-made bottles called ‘this is food’ so I faced food/snack refusal I’d give her a glass of that with a straw and sit with her till she drank it. Ironically the hatred of CAMS has helped us at times, I’ve realised bargaining to get my daughter to eat doesn’t work (she has told me she doesn’t care what I take away, doesn’t want to get better etc) but when I’ve explained food refusal will mean more frequent CAMS visits, more them telling her exactly what to eat then that’s helped!

I think they should all be blind weighed, it really annoys me this concept that they need to know their weight. Dd absolutely could not cope with knowing her weight and when they did tell her she’d gained a small amount of weight her behaviours massively escalated.

I insisted she was blind weighed after that, dd protested a bit but I think it was actually a relief for her as well. I think if she hadn’t been blind weighed she’d have ended up in hospital or sectioned or both.

As it was it caused a massive relapse and put her recovery back by at least 6 months to a year.

Even now she is recovered and 20 years old she still doesn’t want to know her weight.

I think I'm going to have to do the same. She's in an awful state. No breakfast and won't get out of bed. She'll barely speak to me. I have no idea what to do with her.

We’re here for you @Weightlossworried this is a very normal reaction for them after people celebrating their weight gain. Xx

We really didn't celebrate though. We didn't comment on it at all. I told DH privately not in front of her and we've not said anything. Well, other than trying to get her to talk about how she's feeling.

We're taking it in turns just to sit with her. I don't want her to feel alone even though she won't engage with us.

She's devastated to have gained weight. It's the one thing she fears @Weightlossworried and she can't bear it. Her reaction is to be expected and I agree with everyone who believes that blind weighing makes a great deal more sense.

This is a setback for your family and we're here for you in the background. I hope your daughter starts to engage with you and that she starts eating again. If she doesn't, she may end up being hospitalised.

Our ED team strongly advised blind weighing. Our daughter was unaware of her weight for a very long time and we still don’t have scales in the house. The days when she was at CAMHS were always the worst and we prepared ourselves for her to be distressed for a day afterwards. It’s a long, horrible, exhausting process but you will get through it. Take all the support that is offered to you and we are all here for you with advice but of course every child is different.

@Weightlossworried
I am so sorry to hear its tough.
I remember it all so well.
I had to fix my eyes forward on a spot on the wall at mealtimes and repeat ad nauseum ' come on darling put your hand on the fork, just pick up the fork'
and:
'you deserve to eat, everyone deserves to eat'
'pick up the fork' ( in my head i was screaming pick up the f**ing fork FFS) ,
' take one bite, the first is going to be the hardest'
'i know it is hard for you and you are scared but pick up the fork'

and never ever say 'well done' if she eats or gains weight etc.
The best thing to say is:

' i know that was hard for you

it goes against all our natural instincts not to praise them doing what you asked but you have to .

my dd found it hard to pick up fork and sometimes would take so long just to get it to her mouth and put it down again and we'd start over. So i used to put my hand under the fork - i never forced it into her i just had it hovering as a steadying sort of barrier to putting it down.
The relentless cheerfulness needed at mealtimes was so exhausting.

I have friends who spoon fed their children when they couldn't even hold cutlery but my dd would not accept this.

Try hard not to be scared by the storming off and the missed meals - every thing you get her to eat is a small victory and one bad day or bad meal is not the end of the world. I panicked all the time if we missed something but I learnt that sometimes we would then have a good day and you had to go with it sometimes.

the other thing about sitting with her ..my dd was never alone , ever, firstly because at times she was actively suicidal and self harmed and she also had an exercise addiction and purged.
But now she says while the anorexia hated it, she was so scared and distressed that having me there with her ( I slept in her room for months ) made her feel less alone.
She also says now it was very gradual but she learnt to trust me , that i was not going to let her down, give up on her, abandon her to the illness...anorexia makes them untrusting and paranoid of parents intentions, you have to show up over and over and over to prove to the bit of your dd inside who is still wanting help etc that you are fighting this with her/for her

CAHMS should have given you a plan of what to do if she doent eat her meal.
She should have replacement in form of ensure or similar.
Ensure compak has 330 calories in 200 mls so was easiest to get down.
the rule in all in patient facilities we have experienced is :
30 mins for food. If eaten 3/4s thats ok
If eaten 1/2 then its half an ensure
eaten less than half then its all the ensure as well

then give them 15 mins to drink ensure

It was back to 'pick up the cup darling' 'try one sip' 'pick up the cup ' etc

It did kind of help as sometimes my dd would get half way through a meal and stop but could be talked into eating more to avoid the ensure.

The risks for them knowing their weight far outweigh the risks of not knowing imo.

It’s a bit like if someone was scared of spiders and the professionals shoved a massive spider in their face and said there you go deal with that.

It doesn’t have to be so brutal.

Agreed. Obviously at some point they will have to know and be able to deal with it, but it’s easier once they’re in established recovery.

Thank you everyone, I was absolutely losing it for a while there. She's got up and had some lunch and a snack. We went out for a drive and bought some more puzzles. She's still not herself but that's a big improvement. We're both exhausted now

Its an emotional rollercoaster. You’re doing so well @Weightlossworried. It will soon be bedtime xx

Our CAMHS case worker, who was amazing, used to constantly remind us ‘progress is not linear’ . And it was so true.

You just have to hold your nerve. We all know exactly what you’re feeling. It drives you insane. Your dd just needs you to be her rock and to be emotionally unbothered whether she eats or not. I get that goes against every instinct. With my dd she used to tell me what she’d eaten. She no longer does as she’s managing it ha ha. And a good phrase for that is ‘that’s good to know’.

A drive is always good. You can say thing in the car it’s not easy to say face to face. I would, however, be cautious about talking about food. I know how to speak to my dd about it without her bolting now… not that I’m saying your dd will. But we’ve had some very hairy situations in the past, where she takes her seatbelt off and tries to jump out of the car while I’m going along.

Thanks again. I meant to say, I'm going to ask cahms for more support with what to do when she's like this. The supplement sounds good, I'll ask about that

She really wasn't up for talking in the car but I was so relieved she was up and speaking at least a little bit. Last night and this morning she was just lying in bed refusing to even speak.

I think ask for all the support they can give. Have they told you how they will support you going forward?

I’m really hopefully tomorrow will be a better day for you xx