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

Riding is dangerous with low weight. You’re in charge of a horse, which in some ways is more dangerous than driving car. I advised op to get her dd to eat extra in the 24 hours beforehand as she didn’t want her dd to stop even though stopping is the right thing to do.@Girliefriendlikespuppies said she made her dd stop too. CAMHS have told her to not let her dd ride and it’s important she heeds that advice. An hours ride could easily see her shredding 500 calories. And that’s not shedding fat at a low weight, it’s eating muscle, reducing bone. And the heart is a muscle.

Now your dd needs to want to ride more than she wants to restrict her eating op. We have all been there. I’m still there now with my dd. She restarted dancing 6 weeks ago after a year off and I’ve handed 3 months notice at the gym - she was doing more gentle exercise there initially 2, then sometimes a 3 times week. But next week she wants to dance the 3 hours, go to the gym once and play a netball match. She’s not into riding anymore atm. I’m just about to tackle everything she wants to do as it’s too much energy expenditure unless she agrees to increase her eating.

For reference, dd was so weak for a while that she went on bed rest. This kept her out of hospital. She’s come a long way since then. You can do this op.

Thank you @Mummyoflittledragon I hope you and the other poster know I wasn't disregarding what you posted about riding. I just felt scared that I was going to take something away that helps her mental health at a time she really needed it. I've told the stables she won't be back for a while but she does want to go and watch her friend ride. I'll go with her and make sure she's just sat watching.

It's weight for height the cahms nurse quoted to us as being too low. 73% I think.

It's been a tough couple of days. She really went backwards Friday. She was a little better yesterday but didn't manage all her dinner. She likes jigsaws and colouring in so we bought some bits for her and she sat and did a puzzle with us in the evening which was lovely and calm.

I've been looking through the long running thread on here but taking it a page or 2 at a time. It's helpful but also scary and I find myself spiralling sometimes thinking about how bad this might get.

I hope everyone is managing a peaceful mother's day.

Stopping their exercise is so tough, I get that. DDs face crumpling when cahms told her she needed complete bed rest until the hospital had checked her physically will stay with me for a long time. But that was what was needed to make her take it seriously, and to tell her friends, which was a big step. One of her wise friends gave her a card reminding her this may feel like forever now but it will be a small part of life overall, which we needed. 73% is low, reducing movement is important right now
Jigsaws and word puzzles are featuring a lot with us, so its worth trying those at meals as well to calm things if DD enjoys them. We do a couple online together every morning to get breakfast going
Mothers Day is different this year, so sending hugs

That's a really good point about the puzzles and distraction at meal times. I gave her a snack while we did the puzzle and she just ate it with minimal issues. I'll try that again. Thanks.

I hope your daughter is doing ok now.

She's back to healthy wfh and slowly reintroducing exercise, but mentally still fragile. Currently making me brunch, late because her breakfast had to come first and that takes a while! Much more positive than a couple of months ago when we were where you are now, but still a long way to "normal".
Thanks x

sending love on Mother’s Day.

the ED team will use distraction technique if they ever have meals with your daughter.

I agree about reading things at pace, it gets very overwhelming.

take it one day at a time. Your appointment is quite soon now xx

We used to watch reels at meal times or plan trips. The rules about no phones at table was suspended. Distraction worked well

I’m not at all offended @Weightlossworried. I absolutely get where you’re coming from. You are exactly where I was 2 years ago, being told on here to stop dd’s activities, and struggling to make that happen.

We also watch tv with dd when we eat together. She will only eat with us twice a week, the rest of the time she is alone or with friends. She’d never go for board games. Eating alone is against standard recommendation and we need to have a great level of trust with dd. But we have had to modify things for dd as under the guidance of an ED coach. I’ve suggested we watch the Netflix manosphere documentary next. Dd is 17.

Also sending love on Mother’s Day.

Despite my username, my DD14 was diagnosed with anorexia just over a year ago and is well on the road to recovery. She is also a keen rider and was devastated when she had to give it up.

As I think someone said upthread, it was more for safety than the exercise element, as you don’t want to risk falling off a horse due to being dizzy from low blood pressure. Like you, I also wanted to keep the riding for mental health reasons. We used it as a major incentive to start eating properly. Our DD also was about 73% wfh when we stopped the riding. Once she was eating 3 meals/3 snacks a day and blood pressure reading was ok, the doctor said it was fine to ride again - but the instructor kept lessons gentle so that she wasn’t burning many calories. DD only ended up missing about 3 weeks of riding. This really helped her mental health and helped her to eat more. It was at least 3months later that she was allowed to do any school sport again.

Anyway, hope that helps in some way - it doesn’t have to be a long break from riding if you can use this an incentive. Good luck and best wishes for her recovery.

To echo what @EDjustdiagnosed said, if your dd wants to do the activity that badly, she will need to overcome the demons to do it. Doing this serves as a tool to nudge the sufferer along the recovery process.

We managed to get dd to eat enough to do a horse riding day camp in France within a very short time of her starting to regain weight. It was a tough gig. She was absolutely exhausted in the evening. It was a full on day, 2 or 3 hours of riding, albeit not at a terribly high level, plus looking after the horses. But it was the right thing to do for her. She even put on weight that week because she didn’t stop eating. We took a friend with us as well to give her the confidence to eat. We had to put the entire trip on the line 2 days before we left as she still wasn’t eating until lunchtime at that stage and that was a total no go for getting on a horse. Doing this was the only way to get her onto 3 meals and 3 snacks.

I should add that this was a one off in terms of energy expenditure and she had to earn the right to do any sport once we returned home as she was then in her own so to speak, rather than with her friend, who helped her so much.

73% wfh is very very low. Has she had all the physical checks? She needs bloods, ECG, Bp, pulse.

She needs to be on bed/sofa rest.

Have they considered refeeding syndrome?

It’s good she is upset about the riding, and should be upset, anorexia is a joy thief and it will be something to motivate recovery.

Life stops until they eat 🤷‍♀️

If she is eating less than 500 calories a day or has any symptoms of breathlessness, feeling faint or anything that doesn’t seem right take her straight to A&E.

Anorexia is a deadly disease with a high mortality rate, I don’t want to scare you but it’s important to know the risks.

@LurkyLurkyLou I'm glad things are moving in the right direction, even if there's still a way to go.

I'm grateful for the hopeful messages about riding too. I have said to DD this only needs to be a temporary setback if she engages with all the help.

She did have a full check at the GP. The cahms nurse also told us to take her to a&e if we have any concerns which we absolutely will. He told us she was ok for school as long as she'd eaten breakfast and avoided the stairs. She's actually been excused from pe for long while anyway.

Today has been ok. We had a mother's day meal with my mum and she ate well. I expect trouble ahead for her evening meal and snack though. We'll see.

Even though she's been less cooperative the last couple of days she's definitely eating more than 500 calories. I'm not convinced she's eaten enough to put on weight but pretty sure it's enough to stop her losing unless she's doing anything daft in secret. Which she could be of course. I'm weighing her again tomorrow..I want to keep a close eye until we've seen cahms.

Thinking of you @Weightlossworried. We know this is a horrible time and you probably feel very alone.

You arent alone. We’re here for you xx

I used to spend so much time on these boards as DD had a pretty bad ED from the end 2020-22 - developed in Covid lockdown and took about two years of work, therapy, fights, misery etc but since then she's been pretty much fine with no relapses. The preexisting personality that made her susceptible (very awkward, sensitive, anxious) is still there but remarkably she never falls back on ED to cope. It feels as if puberty was both the trigger and the cure.

I don't know what made me look at these threads after such a long time but this particular OP is so reminiscent of us at the beginning. Even down to the weight and height. The 'eating healthy' bit is very typical - I saw a nutritionist in an article say 'if my daughter said she wanted to get healthy, I'd be as alarmed as if she said she wanted to take up smoking'. Ditto dairy intolerance and a hitherto unexplored concern for animal welfare. DD still has oat milk but she's no longer a vegetarian.

Various things. No parent has ever wished they hadn't intervened. Every single one of them wishes they'd done so earlier. Like the previous poster with the American friend, it was obvious that something was wrong but I was desperate to delude myself rather than confront. Calling it out will not make the ED worse. It will make her behaviour and your lives worse, but it's something you have to do.

It's very easy to think that they're eating enough because they're eating dinner with you. I had some sort of an idea of what an anorexic's eating looked like and it didn't involve eating at all. In fact, adolescents need a vast amount of calories and so even if they eat a similar amount to us, they're undereating. DD was eating dinner but rushing out without breakfast and not eating lunch.

Lastly, I used to sometimes feel a bit of a renegade on these boards as I often took a slightly different view of what was best strategy. Not that anyone else is wrong, just you know your own DD. There are many commonalities but they also vary. Where I used to feel like I disagreed:

1. hiding cream, butter etc in food. I felt that it would mess with DD's head if she thought she were eating normal soup but put on weight.
2. I let her be 'healthy'. There are plenty of high calorie healthy foods so you don't need to go down the route of creamy brownie milkshakes. If you DM me I can send you some meal plans that were created by a nutritionist who was happy to lean into this. Sweet potato cubes and nut butters saved her.
3. I didn't stop all activity. She played a bit of football. My feeling was that I wanted her to have this to go back to and she enjoyed it.
4. Ditto seeing her friends, going on holiday etc. There can be a bit of a mantra that all life stops until they're a certain weight. I wanted to keep the window onto the good world as if she was isolated, she'd only have the ED for company.
5. We never aimed for 100% WFH. I don't know that she's ever been over 80% in fact, can't quite remember. She's always been taller and lighter than average and it would just never have happened naturally.

Thanks @Pearl97 . She's not put any weight on but not lost either. Not ideal but she's been eating better yesterday and so far today.

I'm so glad to read your daughter is better @Valleyofthedollymix Thanks for posting. My DD has already given up her brief dalliance with vegetarianism. I'm also on the same page with you about healthy food. Calories are king for sure, but I want her to have stuff that's nutritious if possible. I'll DM you, thank you.

I hear what you're saying about activities but I guess riding is a bit different. As other posters have pointed out, not having the strength to control the horses might be dangerous.

Unfortunately friends are a bit lacking but yeah, I do think it's important she actually has some fun stuff to look forward to. We'll work on that.

Oh don't get me wrong, there's never been an abudance of friends in DD's life! And during her illness, she wasn't a fun person to be around either so there wasn't huge amounts of socialising.

I realise what I didn't say in my post was well done, you seem like you're acting on your fears and that you have all the foundations to deal with this.

Oh no, not at all. There was nothing wrong with what you said or how you said it. I genuinely mean it when I said I'd have a think about how can I inject a bit of fun into her life while keeping her safe because I think you made a good point. Someone else said similar to me today - that they allowed their child to do some activity for the sake of her mental health. It's just unfortunate that my child's chosen activity is riding! I don't think there's a lot of room for compromise there unfortunately

As far as fun things go, dd never stopped college as she loved going to school, meeting friends there. Despite camhs not very happy about it, the school fully supported her

Not losing any weight is actually brilliant news. That means your dd is eating a lot of food. And it isn’t unusual to continue losing weight at the start even with increased intake.

When someone restricts for a protracted period, they often enter into hyper metabolism. This is when the body needs a massive amount of food, preferably energy dense, as it’s hard for anyone suffering from an ED to eat the amount the body needs. And if you can’t get what you would like in, just roll with it as long as your dd is eating a decent amount. At some stage, your dd will hopefully get her appetite back. By this, I mean when the body get physical hunger symptoms, which I imagine isn’t the case right now.

I said upthread your dd is going to need a minimum of 3000 calories to ride. But that could be more. I also said about my dd doing a horse riding camp quite early on in the process. She was easily eating 4000 calories to do that, possibly closer to 5000 as she put on weight that week. Every calorie your dd didn’t eat that she should have eaten before, she now needs to eat to get back to how she was.

And in case no one mentioned it, please don’t talk about calories with your dd.

Can your dd go and watch her friends ride or you take her to say hello to the horses? This is what I occasionally did with dd when she wanted to go.

I have to disagree about the healthy foods or nutritious foods..it is well regarded researched science that the quicker the weight goes back on the quicker the brain recovers.
I'd be wary of taking advice from a poster who thinks their child is well and recovered at 80% wfh.
Aim for 110%...you need a buffer plus adjusting for continued growth and weight gain a normal pubertal girl would have
Plus lots of fats are required.
It really is time for the creamy smoothies.
I fell into the trap at the beginning of thinking my dd just needed normal healthy food...I was wrong.
The amount of calories can also be staggering..my dd has / had hyper metabolic syndrome and needed 7000+ calories a day to start gaining weight.
She was 72% wfh.
She's now 21 and has BMI of 17.9... best it's been since she was 14. She still eats 3000 calories a day and an extra 500 on days she plays sports.

The part about not wanting to intervene rang very true for me. You don’t want to admit there’s a problem then when the niggling concern gets too strong you are scared of “putting your foot in it” and making it worse.

What I found most valuable from the Musby book and subsequent professional advice was the validation to act - that it’s so bad already you can’t actually make it worse and not acting and pussy footing around is the more dangerous approach . Sunlight is the best disinfectant and all that.

Definitely not talking to her about calories or mentioning them in her earshot. I have been using my fitnesspal to try and roughly calculate them though. I suppose that's where my interest in a nutrient dense meal comes from. We're meeting her for lunch every day and those lunches involve a Greggs or a meal deal as well as a packed lunch from home. If I'm making something at home I may as well pack in some nutrients AS WELL AS the calories. Definitely not at the expense of the weight going on. She's actually not fussy with food and if she's just as happy eating a bowl of nuts as a bowl of haribo for the same calories then I'm going to alternate the haribo with the nuts rather than just give haribo if that makes sense. All without comment on any food being good or bad or whatever of course.

The amount of calories is indeed staggering and I am happy to take any and all ideas and suggestions for meals and snacks.

Me and DH have found some courses in the beat website that we're probably going to sign up to.

She's taken a big step today and told her friend from riding what's going on. She was incredibly supportive. DD is going to go along and watch her ride in her next lesson.

I added double cream and/or butter to everything, things like scrambled eggs on toast really soak up cream and butter with think cut toast and more butter. Could add some smoked salmon as well.

Porridge can easily be 800-1000 calories if made with double cream and fruit and nuts.

Smoothies and milkshakes are brilliant ways to get extra calories in.

Anything with a white sauce is good, mash potatoes are another one that soaks up butter and cream.

I agree with the pp that you need them to go over their original weight and ideally over 100% wfh to give them a really good chance at recovery.

It’s good your dd is on board with it, my dd was surprisingly compliant in the start but I did get a lot of push back as time went on.

I have to disagree about the healthy foods or nutritious foods..it is well regarded researched science that the quicker the weight goes back on the quicker the brain recovers.
I'd be wary of taking advice from a poster who thinks their child is well and recovered at 80% wfh.
Aim for 110%...you need a buffer plus adjusting for continued growth and weight gain a normal pubertal girl would have
Plus lots of fats are required.
It really is time for the creamy smoothies.
I fell into the trap at the beginning of thinking my dd just needed normal healthy food...I was wrong.
The amount of calories can also be staggering..my dd has / had hyper metabolic syndrome and needed 7000+ calories a day to start gaining weight.
She was 72% wfh.
She's now 21 and has BMI of 17.9... best it's been since she was 14. She still eats 3000 calories a day and an extra 500 on days she plays sports.