Avoiding eating disorders

[garddwr]

nm

[amy g.]

How much exposure has she had to TV, commercials and popular culture?

 

My teenage girls are very satisfied with their healthy weight. They don't even understand why some people obsess about it. I have made it a point to expose them to as little advertising as possible.

 

We were playing pictionary this weekend and they were asking questions like,"Who is Sylverster Stallone? And what is the Bradly Bunch?"

 

So far, pictionary handicap is the only negative side effect I've found of avoiding popular culture.

[garddwr]

How much exposure has she had to TV, commercials and popular culture?

 

My teenage girls are very satisfied with their healthy weight. They don't even understand why some people obsess about it. I have made it a point to expose them to as little advertising as possible.

 

We were playing pictionary this weekend and they were asking questions like,"Who is Sylverster Stallone? And what is the Bradly Bunch?"

 

So far, pictionary handicap is the only negative side effect I've found of avoiding popular culture.

 

No TV, I doubt she would recognize a single celebrity name unless she's read it off the tabloids at the checkout counter--and even then it wouldn't mean anything. I'm pretty pop-culture illiterate myself and like it that way:D. I honestly can't figure out where this could be coming from, outside of her own head. She is around other girls at church and in activities, so there are probably occasional comments about weight and dieting--seems pre-teens these days tend to think and act like teenagers.

 

My concern is that when she starts to worry about something it easily turns into an obsession. There are others in the family who struggle with OCD, so I think there is a genetic component there. And because I have seen eating disorders in action I know how dangerous they are--and how easily this issue can get out of control. Like other mental health issues, it works in a realm beyond reason. Most girls who worry about weight and diet don't develop eating disorders, but because of family history and this particular child's temperament, I think she is at risk.

 

So, prevention being the best medicine, what can I do?

[freesia]

No TV, I doubt she would recognize a single celebrity name unless she's read it off the tabloids at the checkout counter--and even then it wouldn't mean anything. I'm pretty pop-culture illiterate myself and like it that way:D. I honestly can't figure out where this could be coming from, outside of her own head. She is around other girls at church and in activities, so there are probably occasional comments about weight and dieting--seems pre-teens these days tend to think and act like teenagers.

 

My concern is that when she starts to worry about something it easily turns into an obsession. There are others in the family who struggle with OCD, so I think there is a genetic component there. And because I have seen eating disorders in action I know how dangerous they are--and how easily this issue can get out of control. Like other mental health issues, it works in a realm beyond reason. Most girls who worry about weight and diet don't develop eating disorders, but because of family history and this particular child's temperament, I think she is at risk.

 

So, prevention being the best medicine, what can I do?

 

I am not an expert here but I did read that there is a connection between OCD and anorexia. This is a subject close to my heart as we, too, have anorexia in the family. My son was showing OCD tendencies at one point so I did a lot of reading. I think there is some thought that is has to do with a deficit of the same hormone??? I think I read it in Freeing Your Child From OCD. If I were you, I would get a book like What to Do When Your Brain Gets Stuck and work through it with her in order to give her some tools. The main thing is to stay calm and be proactive. It sounds like you are doing that so far. It may be nothing but a phase, but given your family background and concern, it couldn't hurt and could only help to "catch" it now.

[Chris in VA]

I worry about my dd, too. Her dad is healthy BMI-wise, but could lose a few pounds. I am obese. I have a history of bulimia--never got far with it, but I'm definitely an overeater. We try to emphasize healthy over skinny, but it is tough to screen out all the cultural stuff and the peer stuff.

 

I am trying to not insist she eat breakfast (where the control issue first came up) and just let her gauge her own hunger. We have treats and junk every once in a while (we had black bean nachos for dinner a couple of nights ago and watched a LOST episode while eating--Dad's away, and it was a fun thing to do, but not the norm) and I never raise an eyebrow over how much or how little she eats.

 

I try to give her control over other areas of her life, too--she can paint her nails, for example, but dark polish is for toes. She can wear what she wants, with minimum modesty guidelines. So, freedom within boundaries.

 

I know most ED are about control, but yours seems to have the OCD component, so maybe talk to your ped?

[abbeyej]

Given the background, I would treat this (at least for now) more as a manifestation of her anxiety disorder (of which OCD is an element) rather than as the early stages of an eating disorder. Is she receiving any type of counseling or treatment for the OCD and anxiety? If you haven't already, I would start reading up on ways to help her with her obsessive thoughts and begin talking openly about ways to combat them.

 

I think you can make the mistake of jumping in too quickly to this *particular* obsession and feeding it (sorry for the pun). Instead, concentrate on helping her free herself when she recognizes the obsessive thoughts coming on. There are several books on OCD written to both parents and kids that might be helpful to the two of you... Here's one: http://www.amazon.com/Freeing-Your-Child-Obsessive-Compulsive-Disorder/dp/0812931173

 

I'd continue the current plan with regard to food and eating: talk about healthy choices, assure her (briefly -- not ad nauseaum) that her body is strong and just the right size for her... Don't try to *argue* with her about her body image, 'cause it just won't do any good -- it's not a *rational* concern. Just say, "No, you're not fat. You're just the right size for you, and your body *needs* healthy foods with protein and good fats and lots of produce to continue growing and becoming strong and healthy." And move on. Make sure lots of healthy foods are available...

 

But mostly, given her age and background, focus on giving her tools to deal with the obsessive thoughts...

[garddwr]

I am not an expert here but I did read that there is a connection between OCD and anorexia. This is a subject close to my heart as we, too, have anorexia in the family. My son was showing OCD tendencies at one point so I did a lot of reading. I think there is some thought that is has to do with a deficit of the same hormone??? I think I read it in Freeing Your Child From OCD. If I were you, I would get a book like What to Do When Your Brain Gets Stuck and work through it with her in order to give her some tools. The main thing is to stay calm and be proactive. It sounds like you are doing that so far. It may be nothing but a phase, but given your family background and concern, it couldn't hurt and could only help to "catch" it now.

 

Given the background, I would treat this (at least for now) more as a manifestation of her anxiety disorder (of which OCD is an element) rather than as the early stages of an eating disorder. Is she receiving any type of counseling or treatment for the OCD and anxiety? If you haven't already, I would start reading up on ways to help her with her obsessive thoughts and begin talking openly about ways to combat them.

 

I think you can make the mistake of jumping in too quickly to this *particular* obsession and feeding it (sorry for the pun). Instead, concentrate on helping her free herself when she recognizes the obsessive thoughts coming on. There are several books on OCD written to both parents and kids that might be helpful to the two of you... Here's one: http://www.amazon.com/Freeing-Your-Child-Obsessive-Compulsive-Disorder/dp/0812931173

 

I'd continue the current plan with regard to food and eating: talk about healthy choices, assure her (briefly -- not ad nauseaum) that her body is strong and just the right size for her... Don't try to *argue* with her about her body image, 'cause it just won't do any good -- it's not a *rational* concern. Just say, "No, you're not fat. You're just the right size for you, and your body *needs* healthy foods with protein and good fats and lots of produce to continue growing and becoming strong and healthy." And move on. Make sure lots of healthy foods are available...

 

But mostly, given her age and background, focus on giving her tools to deal with the obsessive thoughts...

 

I agree that at this point this is primarily a manifestation of OCD. When dd came to me to talk about it she said something along the lines of "mom, how can I stop thinking about weight?"--she doesn't want to be obsessed with it, but doesn't know how to stop the thoughts from coming. Thank you both for the book recommendations--I have a book about OCD called Brain Lock, but that one is definitely geared towards adults. I will read these and see what I can help her with. I do have several books about helping children overcome anxiety, and I need to revisit those.

 

Thanks for the encouragement and support. She's such a sweetheart, and I just want her to grow up happy and not stressed and anxious.

[Dory]

I grew up in a family full of women with borderline eating disorders. I struggle with it too. The scales in my house are not within sight and I find that helps. I have done a lot of studying on where my healthy weight range is so that if I feel a need to focus on something I at least know where I should be. I have also given myself exercise options for when I feel the need to control my weight.

All of those things were things that I have found help keep me from counting calories, throwing up, or simply not eating. They are also things that I am teaching my daughter ahead of time. It's not bad to want to be a healthy weight. It's important to know what that means though.

The biggest one is hiding the scales. A young girl shouldn't be weighing herself more than once or twice a month. I think more than that and it starts to become a bit of an obsession.

[SKL]

Whenever this comes up in my house, I say that as long as they eat healthy foods and get plenty of exercise, they will be fine. I also point out that good food is necessary for a smart brain. There are times when they honestly need to change behavior a bit in order to stay healthy, and then I will briefly mention it, but it's always with a focus on exercise, sleep, and eating fruits/veggies/protein. I think it's better to be matter of fact about these things than to act like it's "the elephant in the room."

 

I think your daughter wants your honest wisdom on how to keep a healthy, attractive figure. She does not want or need to hear "you are fine." Hearing "good food and exercise" again and again will make a difference. If she's going to get obsessed, better to be obsessed with fruit and yoga than some other things.

 

Consider showing her how to check herself against physical averages and ideals (such as BMI calculators). Always point out that there is a healthy range, an overweight range, AND an underweight range. Tell her about the different body types we're all born with and how if you're one type, no action you take will change you into a different type.

 

Show her photos of historic beauties such as Marilyn Monroe, who have/had truly healthy, attractive bodies that were not "skinny." Talk to her about the unhealthy and dishonest aspects of modern advertising.

 

But most of the time, keep focusing on things other than physical image. (I assume you already do that.)

[Night Elf]

My youngest dd said the same thing to me at the same age as your dd. It floored me because I never talked about dieting or being fat. I was afraid it meant something bad so I started talking to her about healthy foods. I told her that she could learn all she can about how important it is to eat healthy and how to create healthy menus. Basically, I shifted the focus off the idea of weight and onto healthy eating. It led us into a unit study about the food groups. I can't remember what resources I found but I had some pretty cool stuff. And after that, she didn't mention it again until she was 12. At that age, I knew I had to do something more serious so I took her to her pediatrician who told her that kids should not diet without close supervision from a physician and only if their medical status warrants it. She discussed healthy eating and assured dd that as her body grew in height, the weight would redistribute.

 

And that's exactly what happened. She's 14 now but she seems to have accepted that her body type is simply never going to be that of a super model. I worry that it's hard for her because my older dd is as thin as a rail. I believe she's actually become a bit vain about how good she looks. But that's another worry.

[Jan in SC]

I don't think your dd is asking you about weight issues. I think, as a pp mentioned, that she is asking you to help her stop obsessive thoughts. I would consult a doctor/ therapist about this. I think it would be easier to get a handle on it now. It might be just some anxiety that is manifesting itself as weight concern now. :grouphug:

[VeganCupcake]

I am currently reading Freeing Your Child from Anxiety and it's a great book--just to add another recommendation for it.

[duckens]

Lots of good advice here, and OP, you seem to be aware of sooooo much.

 

I wouldn't make an extra visit with the doctor, but the next time you go (give the doctor a heads up before you attend), ask the doctor in your daughter's presence if your dd is a healthy weight. Of course, the doctor will say, "YES!!" and this will be one more tool in the toolbox. "What did the doctor say the last time you went?"

 

I used to nanny for a mom who had had ED issues in the past. She started to be very concerned that her 2nd grader was getting too fat and eating too much. (No! She was very healthy and active. She wasn't a skinny minnie, but she certainly wasn't fat!!!) I got lucky when the mom asked me to take the daughter to the doctor for a potential cold/virus/whatever, and I pointedly asked the doctor if the child was overweight. "Uh....No...." I then had this as a tool to reassure the daughter that she was exactly where she was supposed to be.

[tadah]

I just read this thread very quickly, and I don't want to overlook or oversimplify any (potential) anxiety issues here.

 

But absent any particular complications, I wanted to say that I think for girls in particular, marital arts are a one-way ticket away from disordered eating tendencies. The emphasis is on being strong and being respectful of your body and its capabilities. No one cares what your body type is under a gi. The emphasis instead in a good studio is on being strong, capable, and developing one's character.

 

Best wishes to the OP and her daughter. It's a challenging issue.

[garddwr]

I'm reviving this thread because things seem to be getting worse with dd, and I'm wondering what to do next. We've started working through the "What to do when you Brain Gets Stuck" book with her--thanks for the recommendation. We've talked about how much her growing body needs healthy food, looked up height and weight charts for her age (she's above average height and below average weight)--she seems to understand. But then she spends ALL DAY obsessively exercising (she runs laps in our backyard and has warn a track in the grass, whenever she isn't doing something else she starts marching in place)--and this week I have realized that if I don't make sure she eats at every meal she tries to skip meals entirely. I've asked her if there is a reason she worries about weight and she says "I don't know" and breaks down crying :sad::sad:

 

I will be taking her in for a yearly check-up soon and plan to talk to the doctor in advance so she can at least reinforce the fact that dd is not overweight and needs to focus on eating nutritious food and generally being healthy. I'm also going to start calling around to see about getting a recommendation for a therapist to work with her. What else can I do? Has anyone dealt with these kinds of issues in a pre-teen before? Dh suggested we try to keep her busy throughout the day to redirect her mind and pre-empt the obsessive exercising.

 

I would welcome any ideas, advice, experience, or prayers!

 

--Sarah

[Annie G]

Good for you for planning to speak to the doctor in advance. I had a dd who was battling anorexia and I talked to the doc during the visit and he chastised ME saying that dd was focused on eating healthy foods and exercising and that *I* needed to quit trying to feed her. He went on to say that if all his patients ate as healthy as dd then he wouldn't have overweight kids coming in every day. Yeah, 5'4", 80 pounds was under the 5% range and it went down after that.

 

If I had spoken to him in advance and known he was not going to be supportive, I could have come up with a plan B. As it turned out, dd was there and heard that (she was 14) and it just set her back more.

 

I think doctors are more aware now and you'll get more support than I did- but talking in advance is a great plan so you aren't surprised.

 

FWIW, in our case, pop culture didn't play a role.

[Alice]

 

I will be taking her in for a yearly check-up soon and plan to talk to the doctor in advance so she can at least reinforce the fact that dd is not overweight and needs to focus on eating nutritious food and generally being healthy. I'm also going to start calling around to see about getting a recommendation for a therapist to work with her. What else can I do? Has anyone dealt with these kinds of issues in a pre-teen before? Dh suggested we try to keep her busy throughout the day to redirect her mind and pre-empt the obsessive exercising.

 

I would welcome any ideas, advice, experience, or prayers!

 

--Sarah

 

Definitely talk to your doctor. Around here we have several very good programs we can refer to depending on the severity of the issue. We have several psychologists we refer to that just deal with eating disorders, of all varieties. We also usually have the girls meet with specific nutritionists that can work with them to learn about what is healthy and what they are willing to eat.

 

Also, good for you for taking it seriously early. In my experience the girls who seem to do the best are ones who have parents who are supportive but also get help early. The ones that I’ve seen have the hardest recovery are those where everyone was in denial until very late in the game.

 

Just last week I saw a girl who we had diagnosed with an eating disorder when she was young (around 12ish). She had very supportive parents and a desire to get better. She is going off to to college now and doing fabulous.

[abbeyej]

I would still mostly want to treat the *anxiety*. It really doesn't sound like this is a *food* issue so much as an anxiety disorder that's really getting its teeth into her, poor baby.

 

At her check-up, I would request all the basic blood work (look for signs of infection or of common mineral deficiencies) and also a strep *culture* (not rapid test).

 

I would start her on a good daily multivitamin and extra zinc and magnesium.

 

I would start calling around to find a good children's psych with experience in anxiety disorders and OCD.

 

Poor mama. Poor baby. This is rough stuff. :(

[Reflections]

I'm concerned because dd9 told me recently she can't stop worrying about weight. She is a very healthy weight. The only times weight issues have been discussed in my home are with regards to dh who would like to lose a few pounds and talks about diet, but mostly in the context of wanting to be healthy. I have intentionally avoided making weight an issue in our home because I have two sisters who went through periods of anorexia as teenagers, and it is scary. It's possible she is getting ideas about needing to diet from somewhere else, although she doesn't spend a ton of time with other kids away from me...I don't know.

 

The trouble is, I already know dd has tendencies towards anxiety and OCD thought patterns--and her worrying about weight at such a young age really scares me.

 

When you speak with the doctor I would bring up the bolded.

[Stacy in NJ]

I'd give her some emperical evidence to measure her body.

 

Find one of those height/weight charts that the pediatrians use, and also some information about what a healthy weight is for her height and body type. (what percentage is she at?) "Look dd, you're in the 50% of your peers in weight. The doctors say that's exactly where you need to be for your height..."

 

Giving her factuals from a professional gives her something concrete to reassure.

[Stacy in NJ]

focus on body image - NO DANCING. If she's not already participating in something - as a prior poster mentioned martial arts are terrific, as are sports like soccer and softball. The productive exercise will probably comfort her and she'll be with girls that will more focused on athleticism rather than thinness.

 

I'm reviving this thread because things seem to be getting worse with dd, and I'm wondering what to do next. We've started working through the "What to do when you Brain Gets Stuck" book with her--thanks for the recommendation. We've talked about how much her growing body needs healthy food, looked up height and weight charts for her age (she's above average height and below average weight)--she seems to understand. But then she spends ALL DAY obsessively exercising (she runs laps in our backyard and has warn a track in the grass, whenever she isn't doing something else she starts marching in place)--and this week I have realized that if I don't make sure she eats at every meal she tries to skip meals entirely. I've asked her if there is a reason she worries about weight and she says "I don't know" and breaks down crying :sad::sad:

 

I will be taking her in for a yearly check-up soon and plan to talk to the doctor in advance so she can at least reinforce the fact that dd is not overweight and needs to focus on eating nutritious food and generally being healthy. I'm also going to start calling around to see about getting a recommendation for a therapist to work with her. What else can I do? Has anyone dealt with these kinds of issues in a pre-teen before? Dh suggested we try to keep her busy throughout the day to redirect her mind and pre-empt the obsessive exercising.

 

I would welcome any ideas, advice, experience, or prayers!

 

--Sarah

[Karen in CO]

As someone that still struggles with this I can offer a couple of things. First is to give her facts. You won't change her OCD tendancies, but you can reassure her with real information. Without her knowing, first check her BMI according to her age to make sure she's at a healthy weight someplace like kidshealth shows a great chart with great information. If she is above the healthy range, please don't show her and disreguard this bit of advice.

 

Then find good and detailed guidelines for food and exercise for her age and help her learn about nutrition and exercise. Give her something more complex to focus on besides simply weight. Help her learn the signs and side effects of malnutrition. Teach her the importance of balance. Teach her to cook and get her involved in meal planning and preparation for the whole family. Let her be involved in everyone's health instead of focused on her own weight. Don't let her narrow down to just the one measure of herself. Keep the communication open and non-judgmental, or she might try to silently disappear.

 

Talk to a doctor about her overall OCD tendencies. :grouphug:

[justLisa]

I was an extreme case of eating disorder. Much too personal/awful to even post it all.

 

I would seek a therapist. No one found out until I was 19 I believe, habits were in place for YEARS already and it was an awful, awful road to recovery.

 

She is young, the really bad behaviours have not started, but they CAN. She will get to an age where she can find out "how" to do it without you knowing, and you will have no control over that.

 

Not trying to sound grim or this WILL happen to your dd, but there are experts that can help. I wished someone would have found me someone years prior. Feel free to PM if you want. I have no shame, I just don't want to put it all out there.

 

I would gently talk to her, tell her you know she is struggling with it and the two of you will find someone who understands this and help. She really doesn't know why. I never did, still don't. I am a very healthy and happy weight now.

[DianeW88]

Well, my dd is a professional ballerina, so we have attended lots of workshops on eating disorders over the years. LOL

 

The first thing to realize is that most eating disorders have NOTHING to do with food. It is an anxiety disorder (or OCD disorder) that manifests itself by controlling food intake. These children generally feel a loss of control in life and have problems with panic and anxiety, and by controlling what they eat, it helps them to calm down.

 

There is a definite genetic component to this, so if it is something that runs in your family, I would jump on this with her pediatrician. It is possible that by taking anti-anxiety medication you could head this off.

 

I've found it really interesting to watch the dancers my dd spends most of her time with. Most ballerinas, although they must strictly control their weight, DO NOT have an eating disorder. Their relationship with food is a healthy one, and keeping their weight at a certain level is simply part of their job. Also, most ballerinas who make it to a professional level, have a tendency to be naturally thin anyway, so food really isn't an issue. And the ballerinas I've been with usually eat more food than you would imagine they would. As in an entire order of nachos grande just last night. :lol: Dancing eight hours a day burns that off pretty quickly.

 

The ballerinas who do develop eating disorders are the ones who are more naturally anxious and have other issues in their lives. They are not the ones who are "heavy" (for a dancer, that's relative), but they still feel a compulsive need to control their food intake. They become very easy to spot. They push food around on their plate and don't actually eat it. They're obsessed with looking in the mirror when they're at barre and are constantly comparing their body parts to others (my thighs are so HUGE compared to hers). They are very, very controlling with the little food they do eat. It's regimented behavior and obvious.

 

So I would definitely talk to your pediatrician. He or she can recommend a counselor who specializes in eating disorders. That, plus a mild anti-anxiety medication can help this from becoming full blown anorexia or bulimia.

 

Good luck!!

[LibraryLover]

Given the background, I would treat this (at least for now) more as a manifestation of her anxiety disorder (of which OCD is an element) rather than as the early stages of an eating disorder. Is she receiving any type of counseling or treatment for the OCD and anxiety? If you haven't already, I would start reading up on ways to help her with her obsessive thoughts and begin talking openly about ways to combat them.

 

I think you can make the mistake of jumping in too quickly to this *particular* obsession and feeding it (sorry for the pun). Instead, concentrate on helping her free herself when she recognizes the obsessive thoughts coming on. There are several books on OCD written to both parents and kids that might be helpful to the two of you... Here's one: http://www.amazon.com/Freeing-Your-Child-Obsessive-Compulsive-Disorder/dp/0812931173

 

I'd continue the current plan with regard to food and eating: talk about healthy choices, assure her (briefly -- not ad nauseaum) that her body is strong and just the right size for her... Don't try to *argue* with her about her body image, 'cause it just won't do any good -- it's not a *rational* concern. Just say, "No, you're not fat. You're just the right size for you, and your body *needs* healthy foods with protein and good fats and lots of produce to continue growing and becoming strong and healthy." And move on. Make sure lots of healthy foods are available...

 

But mostly, given her age and background, focus on giving her tools to deal with the obsessive thoughts...

 

 

This is a brilliant post. And I could not agree more with the bolded.

 

I have a perfectionist who dances. We haven't had food issues at this point, but it is a concern in the back of my mind as she gets older. Dc does not appear to have OCD issues, but they run in the family.

 

There is no way for a parent to screen out all outside ideas/conversations, or control genetics. If someone with OCD is a complusive handwasher, for instance, nobody 'put that idea' in his head.

 

Depriving oneself of food is not a new way of manifesting certain neurological issues, especially for girls. In the 19th century, these young women were called "Fasting Girls". Of course there is a cultural component to eating disorders, but it's starts in the brain.

Edited August 14, 2012 by LibraryLover

[wonderchica]

This is a brilliant post. And I could not agree more with the bolded.

 

I have a perfectionist who dances. We haven't had food issues at this point, but it is a concern in the back of my mind as she gets older. Dc does not appear to have OCD issues, but they run in the family.

 

There is no way for a parent to screen out all outside ideas/conversations, or control genetics. If someone with OCD is a complusive handwasher, for instance nobody 'put that idea' in his head.

 

Depriving oneself of food is not a new way of manifesting certain neurological issues, especially for girls. In the 19th century these young women were called "Fasting Girls". Of course there is a cultural component to eating disorders, but it's starts in the brain.

:iagree:

I think this is far more about the anxiety/OCD component than truly being concerned about weight and food. As someone who struggled with anxiety and food issues as a child, my mother could have shown me all the charts and research in the world and it wouldn't have convinced me to eat properly. I think finding a good therapist and possibly a mild anti-anxiety med is going to be key here.

[garddwr]

Thank you to all who have replied. I called a family friend who is a MFT and got some recommendations for therapists who work with children. Since I have a baby due any day now actually meeting with someone will probably have to wait. In the meantime we're going to keep working through the OCD and anxiety books. I'm thinking that helping her plan out a daily schedule may help--with specific time set aside for meals, for exercise, and for relaxation time as well as schoolwork etc. I'm hoping that if we plan some reasonable exercise into the day it will be easier for her to resist the urge to exercise compulsively at other times--she can remind herself that she has already exercised.

I have thought about medication--I've seen it help in other cases, and I recognize its value. I'm hoping not to have to take that step quite yet though--no medication is without side effects. I think we'll see what progress we can make with other methods first.

 

--Sarah

[Punks in Ontario]

Given the background, I would treat this (at least for now) more as a manifestation of her anxiety disorder (of which OCD is an element) rather than as the early stages of an eating disorder. Is she receiving any type of counseling or treatment for the OCD and anxiety? If you haven't already, I would start reading up on ways to help her with her obsessive thoughts and begin talking openly about ways to combat them.

 

I think you can make the mistake of jumping in too quickly to this *particular* obsession and feeding it (sorry for the pun). Instead, concentrate on helping her free herself when she recognizes the obsessive thoughts coming on. There are several books on OCD written to both parents and kids that might be helpful to the two of you... Here's one: http://www.amazon.com/Freeing-Your-Child-Obsessive-Compulsive-Disorder/dp/0812931173

 

I'd continue the current plan with regard to food and eating: talk about healthy choices, assure her (briefly -- not ad nauseaum) that her body is strong and just the right size for her... Don't try to *argue* with her about her body image, 'cause it just won't do any good -- it's not a *rational* concern. Just say, "No, you're not fat. You're just the right size for you, and your body *needs* healthy foods with protein and good fats and lots of produce to continue growing and becoming strong and healthy." And move on. Make sure lots of healthy foods are available...

 

But mostly, given her age and background, focus on giving her tools to deal with the obsessive thoughts...

:iagree:Having a daughter who's had an eating disorder, I'd focus on the anxiety/OCD.