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

Clearer snack options sound good. We sometimes had success with almost a time table for the day and the meal plan so then it stopped the conversations around food at other times and allowed to see when other fun things would happen in the day that could be moved on to.

A loss is so frustrating but we have also been told that anything below 500g either way is a maintenance/ normal bodily fluctuation. So a 200g upward number wouldn’t be a gain either. The scales where my daughter is inpatient are calibrated to 500g, so any fluctuation below this isn’t known up or down. Hopefully you find that positive.

Thanks @Pearl97

I didn't have the chance @Girliefriendlikespuppies but I have asked to have some time alone with the nurse on Monday so I'll ask then. I didn't want to ask and they refuse and DD latches on to that as another reason to hate CAMHs! It wouldn't surprise me if my DD swore at them either. She's just been mute so far. And then complains they don't listen to her. Listen to what exactly I don't know...The nurse is also going to ask about one to one time for us parents with the family therapist. I think that would really help us

Thanks @Tops16 we do have her meals on a strict timetable. Her weight has fluctuated the whole time which they say they're very worried about although it's rarely in big increments. But ultimately in 9 or 10 weeks we are only a kg up which is nowhere near recovery really.

My dd’s weight gain has also only ever been this sort of pace. Then easily lost with a relapse. It’s just so frustrating! I hope you get somewhere with meds, if your dd will take them.

It’s just so soul destroying when they are so stuck. Have they offered any distress coping sessions or similar for skills for her? Olanzapine can be helpful, my daughter flatly refuses to take this though so I don’t have direct experience. Fingers crossed for a better day.

I think what worries me more than the very slow weight gain is her thoughts processes are becoming more anorexic - she is even more focused on calories and more rigid about what she'll eat.

We haven't had any help from CAMHs with managing her distress although I have books and am doing a beat course that touches on it. She very much withdraws when she's distressed so it can feel very hard to reach her with the techniques I've read about. I am going to ask about meds on Monday when I see the nurse alone.

She actually came round last night and spent some time with us - ultimately I think that was because of the scales going down at her appointment. It's really hard, the relief at having her happy and being ok with us but knowing the only reason she's like that is because she's lost weight.

It’s terrifying the stronger the grip it gets the longer it goes on.

Just shower her with love. Any way you can to connect with her. Watching TV etc. and hopefully meeting up with her friends will be a boost. It’s normal to be more rigid when restricting further. You’ve been reading the main thread. Look at the ups and downs with my dd for starters. She has been better nourished for the best part of 2 weeks now. And suddenly the flexibility has returned. She eats out with friends or at their houses a fair bit. I’m so attuned to it all that I can tell if she didn’t eat enough for the evening meal / evening snack the day before.

I’d keep asking about blind weighing her as well, it sounds like she’s fixed on the numbers.

Totally agree about blind weighing. The only issue we had with that was the nurse said if they were happy, so they sort of know! You need it to be in another room, done not spoken about and then move on

They have been really clear that they won't blind weigh her unless she agrees to it - which she won't unfortunately.

To be fair, it is in another room and then they don't speak about it. To the point where I often have to ask because I don't know! I can usually tell by my dd's face though whether it's up or down.

And thank you @Mummyoflittledragon She's like a little hedgehog who rolls herself into a spiky ball and won't let anyone close when she's upset. She finally let me in last night though and I was able to do some showering of love and spending time with her.

@weightlossworriedI just want to offer a handhold, here if you want someone to talk to. Dd just turned 16 and was discharged from CAMHS a couple of weeks ago (far too soon imo but hey ho). We spent a large part of last summer in hospital Dd was at 64%, gp didn’t act, referred too late and we had to wait too long etc. I had to fight for home discharge rather than inpatient because her mental health would never have coped and she simply wouldn’t be here, outpatient twice weekly then once weekly etc. Like your Dd she wasn’t given therapy initially as her brain was too starved and then her therapist was not very helpful in her attitude so Dd shut down with her, by the time she could engage we both detested her. She did engage with the dietitian and other team members though and luckily enough she engaged with me. Large parts of our day and night are spent on impromptu improvised therapy sessions at home still because she is now opening up. Unfortunately in a way and luckily in another though she is very rigid so she follows the meal plan to the letter still but that means she can’t eat out or go for a full day out and she won’t eat in front of of anyone but me and kind of DH (her Dad) she eats breakfast and dinner with her sister but not lunch or snacks. However life is so much better since she reached 90+ because I can talk to and see Dd again rather than just the anorexia. She is able to go outside again and be with her cow and sheep and walk her dog etc and starting to think about her future again and how best to achieve it. She’s definitely not the same person she was before in many ways she’s stronger and more mature but in some ways I don’t know when we will get to the end of the journey. She acknowledges now that she was ill which is a massive step forward and that she doesn’t want to go back but she’s terrified how easy it would be.

Thank you so much for sharing that with me @Theresalittlebitofwitchinyou You've both been (and are still going) through a lot. How awful that you weren't listened to and she got so ill. I'm genuinely inspired by how hard you've fought for your daughter. I hope she continues to do well in her recovery xx

@Weightlossworried I’d keep talking to the professionals about blind weighing, you could say you don’t feel that your dd has the mental capacity to agree to knowing her weight. For her to have the mental capacity she’d have to be able to fully weigh up the risks vs benefits and be able to reach a reasonable conclusion. The illness means she can’t do this.

Id also be saying to your dd ‘I really think knowing your weight is unhelpful and keeping you unwell for longer, you need to ask to be blind weighed.’

I hate that the services work against children like this, it’s infuriating.

I agree. It's never made sense to me that she is too unwell to process any therapy but apparently well enough to process the figures on the scale. I will keep on banging the drum.

Had a terrible breakfast again. Food thrown, deliberately trying to make the food inedible by crumbling into the milk from her cereal. I'm scared that by letting too much go for the last 8 weeks it's too late to change anything now

It’s definitely not to late, my dd did all of those things as well, she also pouched food in her mouth, hid food in her underwear, smeared food on her clothes or the table..

The behaviours all reduced with weight gain so all you can do is keep pushing the food in. This bit - the bit you’re in right now - is the hardest bit and it absolutely will get better.

I completely agree with your point about therapy, I’d say that to them. The people that come up with these policies around knowing their weight will have had no first hand experience of caring for a child with anorexia.

I guess the problem is we haven't succeeded at pushing more food in at all. We are being firmer with no results yet other than her losing her mind over it.

Is that normal? Will she eventually give in and eat more or have other parents got immediate results from being firm? I would find the tantrums easier to deal with if ultimately she ate more but that's not happening yet.

@Weightlossworried if you read back threads you will find that very few accept the increase without major tantrums! Some do, but it’s very rare and they often aren’t as poorly as most of our children are/were xx

Oh yes I absolutely expected the tantrums. I guess what I mean is, I expected tantrums followed by eating more. All we have is the tantrums so far. It's been a week of us being firmer and as yet we have nothing to show for it other than shredded nerves! She hasn't increased her food intake at all.

@Weightlossworried it’s my fault, I mean tantrums and not eating more, often eating less when asked to eat more! Xx

@Weightlossworried it is normal however I think your dd probably needs some meds to help her, we managed without but only by the skin of our teeth.

What happens now when she refuses food? What leverage have you got? Eva Musby gives some examples of how to deal with refusal. Ultimately you can threaten to put her in the car and drive to a&e if all else fails. A planned admission for refeeding and to start her eating the full 3 meals and 3 snacks might also be needed.

It helped me to know the push back is normal, my dd also developed OCD behaviours the more I pushed her and self harmed. The self harm was more to frighten me and get me to back off than anything else. A few meal times she also started head banging the wall 😢

It’s not a quick illness to recover from but once we got to the point of gaining rather than losing things slowly improved. My dd is now travelling in Australia and doing all the normal things a young, free and single girl should be doing so there’s hope.

Thanks again both.

I've just rewatched the Eva musby video about being stuck. Lots to think about.

Currently we prompt her to eat more, she refuses. She asks to leave the table, we say no, she needs to finish her meal. She refuses, rants about how awful we are, how awful CAMHs are. We acknowledge how hard it is for her and encourage her again to eat. She refuses. This continues until about the 30 minute mark when it's clear she's not even close to eating any more so we end the meal.

Until this week I'd have said we have very little leverage. She's not had many good friends or a social life. This seems to have changed this week though with friends making plans with her. She was refusing lunch today but I told her I couldn't let her see a friend this afternoon if she didn't eat it so she did with some grumbling.

I'm hoping this social stuff will continue so I can use it as leverage and it will improve her general mood.

Yes definitely, I used leverage like that all the time, I’d also be prepared to sit it out. I know Camhs don’t recommend it but there were times where I wouldn’t let dd leave the table until the food was eaten even when it took 2 hours. I can be bloody minded so once I’d decided she was going to eat it I would not back down.

I also would follow her round the house with the food and again not give her a mins peace until it was eaten.

In my mind it’s the same as if she needed chemo but was refusing because she was scared of needles, I would keep on at her until she decided it was easier to just do it!

You only tend to need to take the hardline a few times before they concede ime.

I did see that making them sit until they're done was one of the options Eva Musby went through.

I'm going to have to give that one a lot of thought. DD has always been very stubborn and the eating disorder has given her super human powers of stubbornness. I'm not convinced it'll work although ultimately I may have to try it.

We had a calmer breakfast today. She didn't eat more but she wasn't kicking off. I feel like I want to continue with this for now in the hope that she will become more amenable to the coaching and prompts once she's calmer.

Is she able to try and explain what’s going on in her head? Or just she shut down in this respect? I’ve been trying to work on the food ‘noise’ that’s happening it can be helpful if they try and tell you about it. If they are able to ‘notice’ it then they can start to separate themselves from it slowly. It can create a distance between them and the ED. It’s something I’ve been trying and I think it’s helped a bit.

She does tell us a bit, that it feels awful when she thinks she's eaten too much. But not specifics. That's a good idea though, we'll keep trying to get her to open up to us about it.