Apologies for long post - trying not to drip feed although there’s bound to be things I’ve missed:
Our lovely ASD/ADHD DD13 who has had struggles with food for many years in ways that I (probably wrongly) wouldn’t have characterised as ED, now suddenly seems to be in the absolute grip of it. She has been eating a very regimented diet for some months of scrambled eggs (1-1.5 eggs) for breakfast, a tiny Greek style salad packed lunch for school, a mini cheese portion as a snack, fried egg and avocado bagel after school and then she would mostly eat whatever the rest of the family were having for dinner later in the evening. Then she stopped having dinner with the rest of us saying she was full from her bagel at 4pm. I could understand this and didn’t want to be pushy, reasoning to myself that overall her diet had a good balance of protein, veg, carbs etc and she was still enjoying treats here and there seemingly quite normally - an ice cream in the evening if we had some in, a brownie / cookie at cafe if we were out and about etc. I had noticed her being slightly more vigilant about food in general and she had lost some weight but looked and seemed healthy and energy generally ok etc…
Over the past two weeks she has drastically reduced her intake of food/ calories and is consuming barely 300-400 kcal per day, struggling when she eats anything - openly saying she does not want to eat - and we seem to be fully in a crisis. Her DSis16 nearly 17, DH and I are all desperately trying to support her and I am floundering, we all are. DD13 has lost about 3kg in the two weeks I would say. The only positive at this moment is it is all out in the open and she is talking to all of us (not loads or all the time and sometimes reluctantly) about this. I got in touch with her former therapist who was seeing her during eating difficulties and episodes of SH and she advised GP route first this time as she is actively losing weight. We have the GP booked for Tuesday.
I am really looking for advice on first steps here from parents who have walked this path. I am trying to educate myself on ED / AN etc. DD13 has also admitted recently that she previously had ‘around 3 weeks’ of making herself sick and says that she stopped that. She also says that she has a voice in her head that tells her not to eat etc. she believes she is fat even though rationally she knows she is not. She has become obsessed with coming with me on every dog walk (they are longish ones, about 3 miles twice a day) and I feel foolish for not putting all of these pieces together more quickly and realising how much difficulty our beloved DD is actually in.
She is 5’6” and says she is 58.8 kg. She was over 61kg about 3 weeks ago which I only know because we have to send her observations off when we want a repeat prescription of her ADHD meds. She weighs herself in private though so as much as I want to trust her, I can’t be sure she is telling me the real amount. Her appearance is very slim but not painfully thin, but she’s certainly heading in that direction if she loses more weight which of course she will unless she starts eating more. She seems absolutely trapped and I am desperate to help her. What is the seriousness of her situation right now (it seems very serious to me)? What first steps do we need to ensure we take immediately? What are the pitfalls to avoid and essentials? ED parents of teens who have been there, please can you advise us?