Eating disorders in teens.

[smartiejake]

For the past few months my DD (13) has been eating less and less. She has refused breakfast for a while which didn't worry me unduly as she has always eaten a good lunch and dinner. She is 5'5" and just under 7 stone which according to the charts is underweight for her height and age. She looks ok at the moment but only consuming about 500 calories a day which is surely not enough to maintain her weight.

She is showing all the signs of developing an eating disorder. Says she feels sick, full after two mouthfulls, extreme mood changes, saying she is fat, feeling cold in this heat wave saying she is repulsed by seeing others eat, refusing foods she has always loved, saying she doesn't need top eat as water is enough- it goes on and on.
I have just been on the B-eat website and she has classic symptoms.

At the moment I am still succeeding in getting her to eat a small amount for breakfast and a small dinner but she protests constantly. I don't think she is making herself sick and she does tell me how she is feeling. At the moment we have taken away her internet (she adores MSN) and said she has to earn it back. Eating sensibly also means she is allowed to go out with friends.

She is not in any serious danger with her weight at the moment but she looks decidedly thin (although she insists she is huge). I have been to see the doctor today (on my own but with her knowledge)to discuss what to do. I am taking her back with me tomorrow and he will make a decision what to do.

DD was under a paediatrician for mild fybromyalgia but unfortunately she has emigrated but I am not sure if a paediatrician would be the right way to go with an eating disorder?

I am wondering if CaMHS might be a better idea- my doctor is prepared to refer her.

Anyone experienced this with their DCs- any advice? What is the best way to tackle this sort of problem?

I am very very worried but determined to halt this before it gets serious.

Ideally there would be a joined up service between your local CAMHS/paediatrics/dietetics.

CAMHS would offer support and assess her mental health and help you to enforce a suitable diet plan which would be provided by dietetics with a physical health review by a paed. Unfortunately it often doesn't work out like this.

I think it's great that you are being proactive and seeking help for your dd but this can be a hugely long slog and eating disorders can make the affected individual horribly deceptive and manipulative and it's really important to get support for yourself just as you would if you thought that your dd had any other serious illness. I'd really advise being open with friends and family about what's happening.

Good Luck.

Thanks LaDiDaDi I worried that if we went to a paediatrician then got referred it would take longer than if the doctor did it. He also though that having too many doctors in the loop might not be such a good idea.

I haven't talked to anyone in my family about this yet as the problem has only just become horribly apparent in the last week and before that I just thought it was attention seeking.

I feel like I have failed her in some way and can't understand where I might have gone wrong for her to be developing such a problem.

She has always had such a good appetite and loved her food- she is the last person I could have ever imagined developing such a problem.

Took DD to the doctor this morning. She was very sullen at first and didn't say much but then there was a big explosion the end of the consultation, where she ranted a bit about being forced to eat, feeling sick and said I didn't listen and had called her mental (all I had said was that we might organise some counselling!)

He weighed her and I haven't quite got my figures right as she is not as tall as I thought so not quite as underweight as I had thought. But the doctor said he was concerned as she is still underweight and wants to lose more.

He thinks we can stop it before it gets any more serious and has arranged for her to see the nurse for monitoring as she has had great success with another teen who was showing signs of an eating disorder. If the situation gets worse he will refer her to CaHMS.

How long does he want her to see the nurse for and how often?

I would really push for a CAMHS referral tbh, whilst not wanting to scare you anorexia nervosa has one of the worst set of outcomes of all mental illnesses in terms of morbididty and mortality. It is a life-threatening condition and unfortunately appropriate resources for teens are often poorly available and should imo be sought out early on.

As I mentioned above please be aware of how devious your dd may become if she knows that her weight and physical state is being monitored. Watch out for fluid and caffeine loading prior to weights/physical check-ups, hiding weighty obejects in her clothing/underwear, secretive excessive exercise, hiding food, feeding food to pets, getting weighed with wet hair, wearing little clothing to try to burn off extra calories etc etc.

it doesn't sound very good, I must say - for you and her to be going through this.

A physical thing you can think about - the mineral zinc is very important in terms of appetite and digestion so I would make sure that whatever she does/will eat, it has a good level of zinc in it. Lack of zinc suppresses the appetite and also creates a cyclical problem, because zinc is required to make the hydrochloric acid in the stomach, which is necessary for proper digestion of proteins, which is necessary for the release of zinc from protein foods so that it can be absorbed.

Foods that have a good level of zinc in them are:

Oysters 25 + mg/100g
Shellfish 20mg /100g
Brewers Yeast 17mg /100g
Wheat Germ 17mg /100g
Wheat Bran 16mg /100g
All Bran cereal 6.8mg /100g
Pine Nuts 6.5mg /100g
Pecan Nuts 6.4mg /100g
Liver 6mg /100g
Cashew Nuts 5.7mg /100g
Parmesan Cheese 5.2mg /100g
Fish 3mg /100g
Eggs 2mg /100g
(taken from this website

And don't beat yourself up about having caused it. The nicest family I know had a teen with anorexia. I don't think we know quite why some girls are more susceptible than others; it's not just something the parents can do or not do. It's peer pressure, too. And it's personality; some people just are more vulnerable.

Thanks some very good advice here.

The nurse monitoring is just a starting point. I will push for very regular checks at this point and will have no qualms for pushing for a CaHms referral very soon if things don't improve. Her weight is actually ok at the moment (although less than average for her height)It was the desire to lose more which is worrying us.

The doctor has agreed that he will refer her if necessary and CaHMs are very quick with initial referrals round here.(The paed referred her there last year for the fybro and we were offered an appointment for a week later- as it was she was deemed not to need the counselling which I agreed with as she had the fybro well under control)

Strangely enough she has come home hungry today and eaten a late lunch. I also got her to eat some breakfast without too much fuss this morning. (She is keen on getting back a little internet time this evening)

I will be keeping a very close eye on her. I Surreptitiously listen outside the bathroom door to make sure she is not making herself sick and sit at the table while she eats to make sure she's not feeding it to the dog!

Pleased things are a little better today.

What was her BMI if you don't mind me asking?

I would carefully monitor her internet use, pro-ana sites are awful and offer lots of "top tips" to loose weight and decieve carers.

I have been both an eating disordered teen (many years ago now) and come across young people with e.d. sometimes through work so I have seen it from a couple of view points. Even though I am now physically healthy and pregnant for the second time the "morbid fear of fatness" that is one of the diagnostic criteria for AN has never left me even though I was not very ill as a teen.

Would definetly push for some talking help now. B-eat website is a good one. Has an advice line too.

No worries on internet sites- we have a very strict cyberpatrol sofware package on her computer and we keep a very tight control on all the sites she can visit. We also have all our home computers networked and we can have access to everything she looks at including her MSN (not that we invade her privacy but she knows we can.)All our other computers have pass words so she can't use those either!

I think the doctor said her BMI was 18 and she was on 25th centile for her weight/height/and age. As I say although this is considered to be a healthy weight, it was more her perception of her weight, some of the things she was saying and the fact that she wants to lose more that was the problem.

The day has improved further as she has now eaten a small tea too!