Any words of wisdom for possible ED DD16?

[OrcasRock]

What should I be doing here?

DD16, ASD. (Has two sibs with ARFID but they are both managing OK although sub optimal eating; one has seen a dietician in the past, and they both live on the right side of the line of concern.) DD in question definitely has sensory issues and restricted eating but has usually muddled along like her sibs. Recently been complaining of stomach pains / issues and loss of appetite. Is eating virtually nothing.

Is not underweight (yet). Goes through long periods of eating next to nothing and then eating chocolate / ice cream / random shit.

Avoids family dinners (restricted though they are, see above) because she doesn't like the sound of other people eating / smelly food.

My spidey senses are telling me this is different than ASD / ARFID stuff I see in her sibs (and indeed, in her previously). I think this is another layer in here as well about body image and wanting to be reed thin, although she says it isn't.

We recently made a GP appointment and went; GP has referred her to a dietician. (Is this the beginning of the eating disorder stuff? I hope so but not sure -- can a dietician diagnose ED and trigger treatment stuff?)

Meantime DD is eating next to nothing and I'm worried sick. I managed to get her to eat some ice cream yesterday when she came home from dance (yes, lots of physical exercise too, recently taken up running). She unsurprisingly has low energy a lot of the time at the moment and says she just doesn't want to eat because the very idea of it turns her stomach.

I guess my question is: is the referral to the dietician enough and I just sit on my hands and encourage where I can (working on "healthy bodies need food, sweetie" atm) or should I be doing something else? (And if so, what?)

Thanks for reading the ramble, and any thoughts you might have.

Yes, lots of red flags. Decreased intake, increased exercise is very typical of anorexia. This is evolutionary. Some of us were designed to move vast distances in search of food when it became scarce.

She doesn’t have to be underweight to have a lot of side effects, especially if she has been at the higher end of normal, to start with. And she can get something called atypical anorexia. My dd fits into that box. She was definitely underweight on the height / weight charts in the red book. But nothing that would set off extreme alarm bells, due to body composition and type. Yet she was clearly very emaciated and very very unwell.

I would say your dd needs referral to ED services, ie CAMHS. At 16, she can refuse unfortunately. Did you tell the GP about the exercise? I would go back and ask for ED services as well.

Generally anorexics will want to eat diet food. Your dd is eating ice cream. That indicates she may have ARFID or ARFID tendencies. My dd is the same. Her diet has a fair amount of processed foods, eg chocolate biscuits and ketchup. Then on the other end, cucumber and green grapes.

I forgot to mention the stomach pains. These sound also like my dd. Not uncommon with SEN. Most likely stomach migraines caused by stress. If your dd isn’t eating, it’s possibly because of them. My dd can’t eat when she has one. Well, I have to micro dose her. Leave her body to rest for the day, then get her to eat tiny amounts, then build it up the next day slowly. Dd is not getting them often anymore as she recovers.

Is your dd taking GCSEs? Just wondering if this is the source of stress.

Wow, thank you @Mummyoflittledragon. She was diagnosed with stomach migraines when she was small (then presenting as cyclical vomiting hadn't put those together) and yes, stress. She is definitely more stressed now she is back at school she was better over the holidays. She's doing A'levels (Y12) but finding school really hard (her twin isn't in school at all). She's not underweight so even though we've been to the GP a few times about eating stuff she just gets weighed and looked at (and again, compared to her twin she is in the pink of health) and is clearly not thin enough or ill enough for the depth of the problem to be obvious (yet) to the doctor's eye.

I didn't tell the GP about the exercise: I got in touch with them today and they have asked her to go on omeprazole to see if that rules out any stomach ache stuff. The more I think about it, though, this is the way she now expresses stress / dysregulation. I talked to DD this afternoon about my concern that we are walking into ED territory will talk to her again to see where she wants to take this next. Your posts have been so helpful thank you. Have made me realise that there is almost certainly an additional component here which is ASD dysregulation / stress and I wonder if that's another way in.

THANK YOU.

You’re welcome. It sounds as if you’ve got a lot on. Keeping your dd’s weight up will help to keep the anxiety down.