Concerned about 14-year-old restricting food and losing weight, GP refusal

[MumofCandR]

My daughter is nearly 14. She's restricting what she eats and getting thinner and thinner. It probably started 6-12 months ago. She kept asking why her legs are thicker than her friends. She's very tall and was always naturally well built but never overweight. She played football yesterday for example and said she wasn't hungry for dinner, ate very little. Avoids all sweets she used to enjoy. I think I had anorexia and bulimia as an older teen 18-20 ish following dropping out of university - I never got help nor was ever diagnosed and was fine for years but a couple of years ago I had some routine blood tests and cholesterol was high. I started going to the gym and intermittent fasting. I lost 5kg and have a stable healthy weight but she did see this and I think it's had an influence. My husband unhelpfully constantly comments on my son's intake of sugar as he does gorge. My son also uses words like ' you're fat' when he wants to wind her up. He's 12. I pull him up on it every time and explain it's unacceptable but it can't be unsaid. I've said I'm worried about her but she denies there's an issue and won't engage and when I ask her to eat more she says ' I'm full, you also don't have a lot on your plate'. This is true but it's what I need as a 47 year old woman. She'll refuse to see the GP, What's the best course of action? Advice please.

She will refuse to see a GP. So you haven’t asked?
I would take her to GP for a check up or say it’s time discuss her vaccination record or to discuss birth control/periods. They will weigh her and if she is underweight, they will mention it to her.

She’s got a mean brother, and she’s copying you too.
He needs reining in with the fat comments and she needs to see you eat as much as you want her to.

You are all quite bad role models. Your son needs harsh punishments for calling his sister fat. No wonder she has issues. You all seem to have issues around food tbh. Your dh needs to shut up about sugar intake too

I got called fat by an ex though and the damage usually stays with you

Of course I've asked and she has refused.

I know there's an issue that's why I'm asking for help. You're not being helpful at all, it feels like mean girls ganging up - not nice behaviour, please self reflect. The reason I gave the detail is to take advice on how to navigate this, I know all of the things I said are issues. I don't need to eat more than I do, I'm a healthy 47 year old with a slow metabolism and I am a healthy weight. I know my son shouldn't be mean and I've pulled him up on that, but it's still coming out in anger. So how to address this in the right way so he stops, what techniques are helpful? Advice is being sought please, not judgemental responses.

Please see GP asap and read up on family based treatment for anorexia. We are in the trenches and wish we'd sought help sooner. Eating disorders forum is helpful on here, plus this FB group. Good luck. www.facebook.com/groups/430874960395142/?ref=share

I’m sorry you’re going through this, it must be very worrying for you. Her food restricting needs nipping in the bud before it escalates further but you know that. I don’t have much helpful advice really, having not been through this as a parent, but could you privately and sensitively have a word with the school, as they may be able to signpost you to local organisations and resources? This was a widespread issue at my school when I was younger, so they started giving talks and offering pastoral help specific to eating disorders.

Or, could you make an appointment to speak to the gp for advice, just tell her matter of factly that that’s what’s happening. If she refuses to go with you, if you really can’t get her in the car, just go alone and ask for help?

As a mum with higher cholesterol myself, I understand your need to be careful around your diet. Just make sure it’s clear that it is because it was advised by the gp, and make sure that you don’t talk about your body, or how it looks, or weight loss - it needs to be about cholesterol only.

I had anorexia as a teen. My parents went to a local support group for parents with children with eating disorders (the kids didn't go). This was local to me, and I don’t know what the organisation was, but I would have thought that there’s similar groups all over the country. I think it was a good space for them to ask for help, who to speak to, etc.

DD2 18 went through a phase of not eating triggered by her antidepressants, not by wanting to be thin although it did turn into wanting to lose weight.

Anyway the issues aren’t the same as your DD but I would say it’s important not to put any pressure on around food - far easier said than done! Don’t comment on what she’s eaten/not eaten, etc. just have healthy food available, including snacks, regular meals which you all eat and try to keep communication with her open. This helped my DD although at that stage she did accept there was a problem. She is eating ok again now but had a BMI of 15 at one point so I was worried sick.

I hope you manage to get her to the GP somehow.

Oh, and thinking about what social media she may have access to at her age - there are so many accounts on TikTok and Instagram, girls with EDs, emaciated teens on psych wards doing dances together, fitness and ‘recovery’ accounts which are anything but. Be aware of what she might be exposed to, it’s dangerous.

You'll probably know from your own experience that eating disorders are not normally at their base about food, that's the symptom. They are about self esteem and feeling out of control.

Are you having conversations with her about how her life is going and how she feels?

From personal history of being "Miss Potato 1975" to my brothers, you have to stop her brother.

Sorry to hear this. It does sound as if your DD has an eating disorder, the behaviours are very similar to those I'm seeing in my own DD and others on the ED support threads. Please come and join us there, we understand

Whilst your DS's comments are unkind, and your DH's comments on sugar intake won't be helpful if your daughter does have an ED, the key is changing what you can to help her recover, not speculating whether they 'caused' it. There is a strong genetic factor, so your own issues as a teen mean she was likely to be susceptible, and once food intake is restricted a susceptible person can become ill. Assigning blame isn't helpful, be proud you have noticed this and are trying to help

The GP would be the best place to go, but of course you can't force her. There are helpful resources on the Beat website, and Feast, which can help you start the conversations. If you can restrict exercise and supervise meals that would help. If she resists that perhaps suggest the GP just to 'rule out a problem', if the GP says she's not underweight then nothing needs to change. The approach of calmly explaining you know what is best for her and her food is her medicine is the mindset to adopt for now

good luck

Your daughter needs urgent medical help.

You need to stop all exercise with your dd right now as she’s been losing weight for quite a while. If she’s not hungry after playing an energetic football match, she’s in big trouble and basically eating through her muscles. It’s likely that she’s not year showing signs of being physically unwell because of the amount of muscle she has built up over the years.

My dd was the same, until she was not. At some stage, my dd suddenly lost all energy and needed to be on bed rest to keep her out of hospital. She was very mentally and physically unwell.

The exercise your dd is doing will not just be shredding her muscle but also depleting her bones. The heart is also a muscle and depending on where she is, it can be very dangerous to raise the heart rate when emaciated. If the heart is compromised and electrolytes not in balance (which you won’t know without blood tests and an ecg), it takes longer for the heart to recover. If it needs to beat within the recovery period, the heart fails. Ie stops.

As your dd wasn’t slender to begin with, don’t be fobbed off by the fact that she may be the same size as any naturally small framed, very slim girls her age. You can be severely unwell with a body weight in the normal range. My dd at 16 never got down the weight that I was at 16 and I am taller than her because we have a very different muscular skeletal structure. And she was very physically unwell when I was not.

It sounds as if your dd needs an urgent referral to CAMHS. Going to the GP is absolutely non negotiable and if you need 2 of you to take her, that’s the priority, not work.

As for her brother and her dad, they need to bloody stop right now. Your ds needs to be told the punishment will be something quite severe each time he says bad things to her. And explain why. She is seriously unwell and if he cannot contain himself then he doesn’t get to do x beloved activity or have y thing. And your dh needs to know the impact of his words.

As for you, I can understand your health risks and I would suggest doing what you can so that your dd sees you eating a decent quantity of food.

Have her periods stopped btw?

How much does your daughter weigh?