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 am by no means an expert but with regards to the cooking, I'd be asking myself is she trying to control it because then she can make it lower calories or fat? For example, replacing oil with the low calorie spray stuff. Or simply making and planning meals that she's calculated are lower calories.

I don't think the number of meals and snacks are relevant if she's losing weight and underweight. She's a tall girl and she's active. She isn't eating enough is basically what it comes down to isn't it? I assume you're supervising those meals and snacks too though?

I would definitely hope that CAMHs are going to help you guys. I don't know whether it's worth looking at their guidelines or nice guidelines or something in case you need to push.

Thank you @Weightlossworried , yes I'm sure the ED is involved in the cooking somewhere. Thing is she wants to get better, but she said she won't eat 'junk' like doughnuts etc. She wants to somehow put on the weight using 'healthy' fats like nuts and avocado. I know there are lots of red flags with this. I really wish CAMHS would hurry up and give us some guidance.

She does eat her own cooking, and she eats a full plate. Her snacks are all 'healthy' like cottage cheese (full fat) and fruit. Weetabix etc. Today she is going to eat some flapjack I made but it is really stressing her out already thinking about it this morning :( I need some more 'mantras' to use on her, as she hates 'food is medicine' and she said when I tell her 'well done' that makes it worse..

This is all such a misery honestly. Life has just been taken over by constant talk of food

I hear you. It's relentless. 3 meals and 3 snacks a day feels neverending. Wish I could advise you on what to say but I'm lost there too. She's still refusing to eat enough to put any weight back on

I hear you. We're right at the beginning of all this. My DD seems fairly determined and is coming to a GP appointment with me next week to get checked. But she says she's OK if she doesn't think back about what she's eaten over the last day as otherwise it stresses her. I feel like all I think about is food and calorific content, and it's only been three days since I realised what was going on. I am just putting butter, cream and full fat milk in everything. I'm not sure this is the wisest thing in the world, but she seems OK with it so far.

@Weightlossworried I'm so sorry to hear that. Yes I thought 3 x snacks / meals would be enough, but I wrote and calculated everything from yesterday and it only added up to 1900 calories which I know isn't enough. I would recommend following 'Healing hattie' on tiktok who is a great encouragement having been through it herself. She is fully recovered and gives good advice from an ED person point of view.

Is your DD in Year 11? That must be hard with exams coming up. Mine is Y10 and classic 'high achieving perfectionist' all her life. She still wants to do her DofE silver expedition, and keep exercising. I think the exercise will have to stop soon if I'm honest but I'm scared to make that happen. It's such an evil disease. I never understood it before, just thought - surely they just need to EAT! But now I know the real fear is there.

@Libre2 oh no sorry to hear that. I have since bought books and been all over this forum -which I think it has helped in lots of ways, BUT also has scared me shitless :(

It's such a minefield isn't it? On the one hand we need to think about calories, but on the other hand we are trying to get them NOT to think about calories. I find it so conflicting!

We stopped Dd even walking to school drove
her everywhere.

@baderror404 - we have DofE silver practice expedition coming up in 3 weeks. I'm going to talk to the GP about it when we have our first meeting. And yes, this forum is terrifying. I'm having to step back a bit I think otherwise I will drive myself crazy. I have got DD to have a break from running for 10 days until we have our GP appointment - I just hope the GP is supportive, it's no-one I've ever seen before.

DD said she will also engage with counselling but I'm struggling to find someone.

How low is her weight? We found our gp worse than useless. We had got Dd cooperating with the magic plate method then the gp told her she should take back control of her own eating 🙈. Months work undone.

No way Dd would have been going on a flipping D of E expedition. We didn’t let her walk round town. Might need to manage her expectations on that.

Yes, this is what I said on the main thread. Well, I said it depends when it actually is because @Libre2 didn’t clarify that. But I absolutely wouldn’t be letting her go 3 weeks away. Even if she’s putting on weight and cooperating with the process, it’s not that simple because she is currently being monitored. In 3 weeks’ time, she won’t have built any skills or resilience against the ED voices and will be extremely unlikely to be able to feed herself in this sort of situation.

I would be wary of what the GP says as they know very very little about ED when a lot of us have had to accumulate a wealth of knowledge.

My dd had to pull out of Gold as she’s not able to properly feed herself. The practice expedition is in the next few days and she had been in relapse from Christmas. She’s just come out of it now, eating enough to be slowly putting on weight, slightly more than before she rebelled completely against the meal plan, but I’m unable to get morning snack up to what it was before as she’s insisting she can do it herself at nearly 18. Except she can’t.

Her ED started 2.5 years ago and she went over the edge 2 years ago so I’ve been trying to get her recovered for all that time.

The CAMHS psychiatrist did this with my dd when dd pulled the wool over their eyes that she was ok as she decided to sign herself off at 16. She’d been on meal plan for 3.5 weeks. It took at least 4 months to undo that bullshit. We never did get any help from CAHMS.

@Libre2 I found one on the BEAT website, she was an hour away by car (we drove to her the first time) but since then she's been doing online appointments. It's £40 a session which I thought was quite reasonable. My DD has engaged with the process all the way, but the therapist has taken a cautious approach., She has often criticised CAMHS and said they just 'fatten you up and spit you out' without really dealing with the MH side of things. She said that CAMHS are very hardline and make you stop all exercise and take control of ALL meals. Of course we haven't seen CAMHS yet, just had the referral and one phone call so far... CAMHS did say that if they 'take us on' then she will have to stop with her therapist as they don't like them having two different therapists.

Wow @Mummyoflittledragon that sounds awful. You have been through such a lot :( Have you found a private therapist at all or done everything yourselves and with the GP?

You aren’t actually supposed to praise someone for eating. And well in anorexia speak means fat so you’re telling her ‘fat done’ so that will irritate her a lot.

Affirmations, direct or soft if she can’t handle direct ones, so stuff like:
I can see you’re really struggling with this (eg when eating a meal) and I’m here for you
You’re nourishing your body
lots of positive loving reinforcing messages
lots of connectivity

The messages will vary as it depends what does and doesn’t annoy your dd. If she tells you she’s eaten something especially if it’s nourishing, ‘that’s good to know’ or ‘thank you for telling me’.

All food is food and the terminology junk must only come from her mouth. The good news is your dd is actually eating not too badly if not enough.

If you want to praise her for an achievement and are tempted to use the doing well, turn it into ‘you’re doing great’.

As for your last comment, we are using an ED coach. Dd wouldn’t be alive without this, albeit it’s me mainly with some back up from dh getting her to where she is. And talking on these threads has been great. Dd has a seizure medical condition, where her heart stops beating and wouldn’t have coped with in patient care. We finally got her talking to the coach. Then she stopped, restarted and stopped again with the last relapse. I think that’s the 3rd relapse. I forget now. You learn a lot from relapses. Dd does too, well, she’s not yet ready to consciously acknowledge there’s an issue. She does now at a subconscious level.

Oh and of course Jenny Langley. She’s ace. I’ve probably talked about her on this thread if you do a see all.

I echo the GP involvement. Ours didn’t mention my daughters weight even though she was very underweight and losing weight. They just wanted to to bloods etc.

GP’s use BMI and CAmhs use weight to height. GP’s will refer but not do a lot more. Unless they send you to hospital if they see a medical concern xx

How do you work out weight to height?

I asked ChatGPT but this was only after it had already been quoted by the CAMHs nurse.

I would put your numbers through chat GPT. We were told below 80 percent meant no school etc and CHAMs involvement xx

DofE should be an easy absolutely no chance, they walk miles in the middle of nowhere, it could kill a child who is underweight and not eating enough 🤷‍♀️

Anorexia has a similiar mortality rate to leukaemia and you wouldn’t allow a child with leukaemia to run, dance, walk miles etc.

It is important to take control of what they eat, ime if they’re saying they don’t want doughnuts I would assume they are actually craving doughnuts and desperately do want them. All previous notions of healthy eating need to go out of the window.

That therapist is not helping if she is undermining Camhs, she is massively missing the point.

Anorexia is a biological illness linked to weight loss, so yes the aim is to regain the weight and then some. For most teens this is all that is required for recovery. A lot of the mental health conditions such as anxiety, depression and ocd that occur alongside the ED will naturally improve with weight gain.

FBT (family based treatment) ie parents taking full control of all food decision’s has a decent evidence base and success rate.

CAMHS are quite right, and the therapist sounds dangerous to me.

Your DD does need you to control all her eating (and cooking) and she does need to stop all the exercise she's doing.

The last thing your daughter needs at the moment is someone who actively undermines her recovery. And the therapist is doing just that.

If you weigh your DD don't tell her in advance. Anorexics often drink over a litre of fluid just before being weighed so they appear heavier. Make sure she wears normal clothes. Don't let her wear heavy clothing unless you can weigh the clothing after and deduct from her weight. I don't want to alarm you OP but anorexics often put weights in pockets when they know they are going to be weighed. Just be on the lookout for this type of behaviour.

Oh wow, I missed that post from you @baderror404 about the therapist. Absolutely listen to Girlie and Thebroom. They know their stuff and have both advised that your dd could be at risk of death from over exertion.

The Eating Disorder Coach we are using is highly professional and comes with a price tag to match. The standard cost for an hour of contact time with someone of her level of expertise is at least £150. She is a mental health nurse with over 20 years experience of working with ED, including in patient care, and she has won awards for her work. She worked at The Priory for many years and despite the limitations of NHS ED patient care in comparison to the care private specialist provision can offer (The Priory is eyewateringly expensive), she would never criticise CAMHS in this way.

You absolutely get what you pay for and a therapist at £40 an hour is already low for standard therapy and someone charging this amount will not have had substantial training in ED. It’s a highly specialist field. You need to cut this woman off and complain to BEAT. She sounds really dangerous. And did she say ‘they fatten you up and spit you out’ in front of your dd? Because if so, that is outrageous. Either way, I’m appalled at this even if she just said it to you.

And Girlie is right about the dangers of DofE. I was trying to be more subtle as it’s so scary being where you are right now. But with what the therapist is saying, you need to hear this and you absolutely need to protect your dd.

And to reiterate what I said above, my dd wouldn’t be alive without the work I’ve done with dd under the guidance of the ED coach. She has trained me to deal with many aspects of ED. Not many people have the resources to be spending 1.3k on their child every month. They rely on NHS mental health services, which you may need to as well with your dd. So please don’t listen to this woman. And please report her before she does more harm.

And I don’t know what else she said. But I am now thinking this is something to report to her professional body.

We found CAMHs very helpful. The man was so gentle and lovely.

We never did get to the bottom of why. Dd has zero other MH issues she’s always been remarkably well balanced and emotionally intelligent and very popular. Theys why I just couldn’t believe it was an ED.. We literally did fatten her up and it resolved. All she could say was “I just got into bad habits”.