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've said weekly appointments at clinic but not what that will entail other than weighing and physical checks like blood pressure

They are possibly going to concentrate on the physical health checks for the time being, until her weight increases. It’s good you’re going weekly xx

How are you doing @Weightlossworried I hope Easter was as calm as it can be for you.

Times that revolve around eating can be very stressful. Easter, Christmas etc. I hope this week goes well for you and you get the real life support you need xx

Thanks @Pearl97

Easter went as well as it could. She seemed to have recovered a bit from the upset of the weigh in. She wanted to eat Easter chocolate but was really stressed by it and wanted to eat it for every meal and snack to get rid of it. We mostly went with it with one normal meal a day.

She's very up and down. I'm already nervous for Friday's appointment. She feels all CAHMs care about is food intake and she needs help with the mental side of things. I'm inclined to agree but scared to go against the advice of no therapy yet. It's so hard to know what to do for the best!

Hi @Weightlossworried glad to hear an update. Well done for getting her to eat some chocolate. We’ve not managed that so far, but we have finally go got our camhs appointment through for two weeks time. Interesting that they recommend no therapy - did they not offer any ? I’m interested to know what will happen. We’ve been sent some questionnaires to fill in and send. One is all about food behaviours and thoughts and the other is more emotional well being. Do camhs do their own blood tests?

Yes her attitude to the chocolate wasn't entirely healthy but at least she ate some. Me and DH spent Easter Saturday strategizing as we knew she'd propose having it instead of meals and wanted to make sure she had the equivalent amount in calories. There's less calories in a cream egg than you'd think!

I'm glad you have an appointment. Do they give you any contact details in case you have any problems you want to discuss before the appointment? Cahms did do their own blood tests despite the GP having referred us for tests already. I believe they were testing for other things. They also referred us for an ECG. They did blood pressure and standing and sitting heart rate. They asked a lot of questions of us all around food of course but family life, her childhood, school etc.

I don't know if this approach is universal but they said they don't recommend therapy until she's restored some weight. They don't believe she can meaningfully engage while she's so underweight.

Thanks. Did they have a target for weight gain each week? Yes our gp has taken some blood tests and also ordered another one which wasn’t done before. No idea what that one’s for but all the blood test appointments are really hard to make here as they seem to be in the middle of the day when we’re all at school. My DD just ate an egg and avocado for breakfast so I’m feeling relaxed so far today. But as you know things change very fast!

The aim for weight gain is 500 grams to 1kg a week.

They wrote 'refeeding' on the blood test form for DD so I guess they were looking for markers that she may have refeeding syndrome.

I'm bracing myself for our usual breakfast tussle. She'll eat a big bowl of cereal and some juice but won't entertain the toast (or equivalent) she also needs. We keep trying regardless.

Here's hoping for success in the rest of your dad's meals today.

@Raspberrysins did you work out the weight to height? They will use this as a marker for how much weight gain etc they are looking for. The first appointment usually takes a couple of hours and there is a physical health check. Not always bloods there and then, but weight, height sitting and standing blood pressure. It’s a long appointment and there are a lot of questions.

@Weightlossworried I will be thinking of you this week. I do see where your daughter is coming from. I always used to think they know they need to eat! They need help to do so! Xx

Just on the therapy / mental health support. We were told the same, that there would be nothing other than general family check in sessions until DD restored her weight. She started one to one therapy with a specialist last week, and we now see the EBT family therapist once a month (instead of once a week), with weigh ins, unless WFH starts to drop again. Whilst I was dismayed at first that there would be no therapy straight away I can now see she's in a much better place to be receptive as her general health is better and getting meals in is not so all consuming as it was

I agree. She said yesterday she was happier when she was restricting. I get that. It was her unhealthy coping mechanism. We've taken that away from her - and rightly so. But we've not replaced it with a healthy coping mechanism. She's still got the same problems that led to her restricting and she needs help with those. We're trying our best as her parents but we don't have all the answers

@Pearl97 no I don’t know about weight to height. I only know her measurements for each and BMI. She’s 5 ft 9 and 47 kg at the moment. Thanks for the info regarding first appointment. @Weightlossworried fingers crossed for you today. Every day is a battle. Yesterday I got told to F off when I enquired what was in her porridge. But today seems better. UPS and downs!

@Raspberrysins do you know if she’s lost weight recently?

That's useful to know. I do understand their logic but I feel conflicted about it.

@Pearl97 she has been around the same since January. Lost a kg in Feb (went on a school ski trip ) but has put one back on. But I don’t know if our scales are the same as the gps.

It is good you have an appointment. Having some support really helps. It varies depending on where you live, but I would think they will accept you into their service for at least weekly weigh ins to start with.

@Weightlossworriedour daughter started under the care of CAMHS about 2 years ago aged 14. Similarly they were focused on her being 100% wfh and getting her periods back. They said she could not engage with therapy until those physical health markers were achieved. She worked hard to recover over the summer but absolutely hated the CAMHS sessions and she was discharged in October which is when she started to SH. At that point we found a private therapist who has been a huge help to her and she is a completely different person now, happy, sociable and doing well in all aspects. So we will feel confident sending her off to university.

Sometimes medication rather than therapy in the early days is more helpful to help manage the anxiety and noise in their heads. Olanzipine can be helpful.

Lots of teens once weight restored go back to being a healthy teen with no need for therapy but that does depend a bit on what led to the food restriction initially I guess.

I stepped back because I found these threads so frightening but we have our first CAMHS appointment today and I wanted to just ask what we should be expecting - just a health check from what the very lovely lady on the phone said yesterday. Then an initial assessment on 1st May. Since we had the conversation with DD (15) nearly three weeks ago she has been having 3 solid meals a day and snacks and has stopped all exercise. She occassionally helps herself to food in the kitchen (dates, peanuts, chocolate) on top of the food we give her, which I'm taking as a good sign. She is marginally embarassed but not resistant.

She is struggling mentally a bit with the eating as she feels she is eating too much, but is doing it none the less - she has sat and watched a lot of telly. She has asked a couple of times when she can start running again but has not asked obsessively. She is spending a lot of time around us and not spending time in her room, which feels positive but almost like she needs a constant reassuring presence.

CAMHS told me yesterday that we have done the right thing but I still doubt myself every step of the way. I feel sure they will say today no D of E, which would be right, but will cause a real reaction in DD, as more than anything else she doesn't want to let her friend down and doesn't know how to have that conversation with her.

@Libre2we did let our daughter do DOE against CAMHS advice. She was doing so well, eating well etc just had not hit their physical targets yet. They are pretty black and white and we felt justified in our decision to let her do it, as at that stage, bonding with newly made friends what exactly what she needed. It was a very difficult decision and I’m sure some would say we were wrong to let her. But no regrets.

@sammyspoon - thank you for sharing that, that's really useful. I just feel we are still so early day that I will have to be led by them at the moment. She is possibly very underweight I think and although she has been engaging brilliantly, it still will only have been 4 weeks and a bit of eating reasonably well. I think if we were a bit further on in the process I might feel a bit more confident with making that decision. How is your daughter doing now?

It is her practice expedition so I feel like we can hope for the actual one which will be in a few months' time.

@Libre2 I have a post further up the page detailing what happened at our CAMHs appointment. Hopefully that'll help with expectations.

It's great that she's choosing to eat more - probably teaching you to suck eggs but make sure you're supervising all her food to check she's actually eating it all.

You say in your later post she's possibly very underweight. Don't underestimate how much this will have impacted her health. My daughter's heart rate went up significantly just when she stood up. I can't imagine how hard her heart would have to work to do any significant activity.

Our daughter is also spending lots of time with us. We're like the 3 amigos at the moment! Me and DH haven't had any real time alone together in a month.

I hope the appointment goes well

@Weightlossworried i hope your appointment goes well! Xx

Thank you. I'm dreading it. It's going to be hard either way, either she won't have gained weight or she will have and we'll have to deal with the fall out.

The only positive is that we know from last week that she does bounce back.