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

I’m just going to add one thing, OP.

My DD was ill for a long time, and ill enough to be in hospital. What became really important was that we did not collude with the ED, and that we were honest all the time. It told her stuff that she believed-she was overweight, life would be better if she was thin, we were lying to her (along with all the professionals), we just wanted her to be fat etc etc. When she was well and aware enough to challenge it, it was so important that she trusted us and she could only do that because we had shown ourselves to be trustworthy. That’s why I would not advocate adding things to food, hiding calories etc.

Also please liaise with the professional team for food, weigh ins, and so on.

One last thing: the ED is sneaky, hateful, dishonest. I really struggled with that, DD was deceitful, dishonest and I have always valued honesty. It isn’t your DD but if it feels like she has been taken over by an alien that you can’t trust, that’s pretty normal for the abnormal world you might experience. Don’t give up, but do be aware that this isn’t yours to change. You can be her biggest supporter, but she has to do this and you have to watch. That’s why support for you is important.

Just to echo everyone else, it is helpful to separate the ED from the child. My dd is lovely, helpful and compassionate. The ED was selfish, irrational and hated everyone!!!

I also added calories, it’s really important to set ground rules including that the kitchen is now off limits to your dd. She should not be wandering in when you’re preparing food.

I aimed to get around 3000 calories into dd a day for a 0.5-1kg weight gain per week. I made porridge with double cream with an added banana and nuts for breakfast (around 800 calories), high calorie snacks cakes/chocolate bars/crisps and dips etc.

I added butter and double cream to absolutely everything.

Does she exercise? If so that needs to stop.

Anorexia is really a brain based illness, similar to dementia or schizophrenia. The brain takes a massive hit when the body is in calorie deficit and can shrink by a considerable amount. This causes symptoms such as the anorexia voice (a voice in their head telling them not to eat/everyone else is trying to make them fat etc), severe anxiety, OCD, irrational beliefs (my dd thought brushing her teeth would make her fat at one point.)

The good news is with weight gain these behaviours will disappear. I don’t agree there is always an underlying psychological issue that causes anorexia, sometimes teenagers just don’t realise what’s happening until it’s too late.

Theres also an anorexia gene (it’s really similar to the schizophrenia gene which makes sense when you consider the ED voice they can hear) and the theory is this gene activates when there’s weight loss. Theres a million and one reasons why someone might lose weight but for some with the gene they will be much higher risk of developing ED.

We never got to the bottom of why. Dd can’t explain it either.

I found it weirdly comforting that it has been an issue throughout time. The Romans the Tudors they all had daughters with it.

Also agree it produces behaviours that are nothing like the actual person. We couldn’t believe this snappy sneaky lying girl was our lovely honest smart Dd.

Yes exercise has to stop. Everything went upside down. Pre ED I used to say Dd should walk to school and she would agitate for a lift. When she had the ED she was desperate to walk to burn calories 🙄 and it was me insisting on driving her.

If you’re in wales I’m sure there’s a service Beat runs that covers your region. Check here. It’s 1:1 support for you as a parent - https://helpfinder.beateatingdisorders.org.uk/?utm_source=beat&utm_medium=website&utm_campaign=helpfinder2023&utm_content=notification-bar

@mildlysweaty nothing comes up in our area on there but thank you. I have found a contact number for cahms for our area though so I can chase up the referral if necessary.

I've realised it's been a week since I weighed her so I'll weigh her this afternoon. She's still being very compliant, other than a bit of a moan about cheese yesterday. I feel like we're in the eye of the storm and the ED is regrouping to work out what to do next.

She doesn't do a lot of exercise, just riding twice a week which I'm very reluctant to stop as it's so good for her mentally. She likes the occasional walk which I'm not allowing now. She is more keen on school than she was which makes me suspicious that she's spending her morning break getting steps in.

We have a prom dress fitting today. She is worried about what will happen if she gains weight and can't get in her dress. We've obviously told her this would be a good thing as it would mean she's getting better and we'll just buy another one. I am debating asking the seamstress privately, away from DD, if there is scope to 'let it out' at all. It's a problem I'm praying we have to deal with but obviously it's bothering DD.

Thanks for updating us, everything crossed for weight gain.

Is she eating at school?

When is the prom? Does the fitting have to take place right now?

Thinking of you. I wish you had real life support xx

She doesn't eat at break time but we meet her at lunch and she eats then. Hopefully this is good enough but we'll see when we weigh her.

Prom not til summer but I feel like the fitting is best done now when she could only really have put on a small amount than delay and she may (hopefully!) have put on enough weight for it to feel tight or not fit and freak her out. My plan is to take the dress and keep it away from her after the fitting today in case she's tempted to keep trying it on

Fab idea about the dress. It’s good to do it now before she puts on the weight as you say.

Good luck with weighing her, I really hope she’s gaining and realises she needs to.

Pleaae Continue with the referral etc regardless. It’s easy to think all is ok and then wish you had help.

We are not trying to be the ones that know it all, we just know what our experiences are xx

I absolutely will be continuing with the referral, whatever the scales say today I've resolved to call cahms Monday if we haven't had a letter by then. I want to make sure the referral has been done and get an idea of waiting times.

I am hearing everything those of you who have been there are saying, don't worry. She needs more than just me giving her extra food.

I Hope I didn’t sound patronising, it’s easy to deny things ourselves as we don’t want this to be happening.

Good idea to call CHAMs yourself. I’m not sure how it works in Wales.

Enjoy the dress fit, next time you see her in it your life might be very different. You are doing a fab job xx

Not at all, please don't apologise for anything. Your advice - and that of everyone else who's replied to me - is so appreciated.

We’re on your shoulder, it’s shit right now, but I promise you will feel better when you have more support. You are in a life you don’t understand and never wanted to be in.

One hour at a time, everything crossed for the weigh in xx

I’m not trying to alarm you but please also be vigilant about potential SH. An ED is a coping mechanism, and once that was taken away from our daughter, she was physically better but was clearly still struggling with anxiety and emotions and unfortunately turned to SH. We found out and I believe it was only a brief period of time this was happening, just after she was discharged from CAMHS. We then got her private therapy which helped enormously.

My dd is a good horse rider. If your dd is relatively advanced in riding, doing a lot of trot and canter work, she will be exercising a great deal whilst on the horse. Riding at speed is not much different in energy expenditure to running, so I would be thinking carefully about this tbh.

Exercise increases metabolism and it’s important that she eats well for this, especially in the 24 hours beforehand. The gold standard for dealing with an ED is 3 meals and 3 snacks.

I would be using riding as a bargaining tool for her eating. She needs to be eating at least 3000 calories to not lose weight… but don’t talk to her about calories. We talk about energy intake, fuelling the body etc.

Can you tell your dd she needs to eat something mid morning to keep her blood sugars stable? And you want her to eat this because she’s riding and it’s important to keep her strength up, which it is for riding! Riding was the first sport I made my dd stop as it’s dangerous for anyone too emaciated.

Right now anything is a win, even if it’s something small. Packs of Belvita breakfast biscuits (the little 4 packs) are very popular with anorexics. Calorific drinks also count as snacks if you hit a massive obstacle on that front.

Well she's put on 0.3kg. Given that after we weighed her last week we naively didn't monitor her food and she was hiding it, I think that's ok. She's only been on 3 meals and 2 or 3 snacks since Monday. I'm going to weigh her again this coming Monday and see what a whole week of proper, supervised meals and snacks gives us. I'm hopeful it's 0.5kg.

Stopping the riding is something that I'm keeping in my back pocket. If we can't get her to consistently gain enough then it will have to stop, absolutely. I will get her to eat more on riding days though to compensate in the hope we don't get to that.

I'll also be vigilant about sh. I can see how that might happen without the ed as an outlet.

I personally advocate blind weighing, my dd completely freaked when she realised she had gained weight and it set her back months as well as causing a spike in other behaviours such as self harm and ocd. I wish I’d insisted on blind weighing from the start.

I also worried about dds prom dress although dd was more stable by then, I went a size up which was fine by prom time.

My dd is also a rider, I let her ride for a while but it had to stop as I could see it took too much out of her and I was also worried about injury if she came off.

That’s great news. Does she know? How did she take it?

Well done, that’s what the ED team will be looking for xx

I wasn't sure whether to blind weigh her, I offered her the choice and she claimed not to be bothered about seeing it. She didn't react really but I know that doesn't mean she isn't struggling on the inside.

Until you get help, it’s really hard to know if blind weighing is the best for you all. Hopefully you will get support soon xx

Well that was an awful lunch time. Cahms rang me as I was on my way to meet her. This is obviously great that they have the referral and we have a time for the first appointment in about 10 days. They gave me advice and confirmed I'm doing exactly the right thing with 3 meals and 3 snacks. They confirmed what some of you have said though, no horse riding. No activity at all and they don't want her using the stairs at school.

I stupidly told her this when I met her. She was devastated about the riding. I feel like I've made her worse. She only managed half her meal. The only silver lining was she actually started talking a bit about how she feels, she doesn't want to gain weight, she feels bloated and upset every time she goes to bed. She wants to eat but she can't eat. I'm hopeful it's like lancing a wound and it'll help to get the poison out.

I get why they want her to stop riding and I support it but I'm gutted that something that has helped lift her mood needs to be taken away.

Could it spur her on? The spectre of losing things she valued helped Dd eat again. I know it seems harsh at the time. Cruel to be kind.

I was really mean found myself saying how will you feel if all your friends go to Boardmasters and you can’t because you are still unwell etc. It did work.

Do you lose many calories riding? Can the compromise not be that she eats more on riding days rather than stopping it completely?

I hope she'll get to the headspace where it spurs her on. She wasn't capable of thinking like that today though. She did say she'd eat extra to compromise but I think it's more to do with her weight being so low that it's dangerous to exert herself rather than the calories burned.

I did say that she may have put on a bit more weight again by the appointment time and we can discuss it further. Perhaps they'll allow a short lesson once a week. Perhaps they can give her a weight to aim for too. She was too distraught to take any of that in though

There would be no good time to tell her that. I thought they would say no exercise. They often say purposeful movement only.

It is good she’s opening up, and I’m so pleased about the referral. I would do what you can over the next ten days, but be kind to yourself as this is hard for you all xx

The ED team will look at her weight to height and decide what they think about any form of exercise. It’s so tricky, on one hand she’s losing all joy for life, but on the other she is underweight and deliberately trying to be, so they will be worried it’s not sensible to exert her body.

I think I would just say let’s see what they say in the appointment. You don’t want her worrying about the appointment and not engaging when there. This is all so hard, we really do understand it’s so difficult for you xx