5LittleMonkeys Posted February 12, 2014 Share Posted February 12, 2014 Update: Just wanted to update in case anyone was wondering what's going on with this. Things are going well. I'm glad I took action before any damage was done physically or mentally. We started out with her primary care doctor since we had to have a referral for a specialist. Well, she had a really good talk with dd ... didn't berate her but definitely made it clear that the path she was on was definitely going to end badly. Instead of jumping right to a spec. we opted to set up an appointment with a nutritionist first. It went well and dd was very receptive to the suggestions made. Dd and I talked a lot about her thought processes when it came to food and I believe that it boiled down to mostly her just being completely lazy about food prep and making good choices. We talked about toning versus loosing weight as well and now she is focusing more on toning exercises vs. burning calories. I've made some big changes regarding having healthy (for her) food more easily available and we've come up with alternatives for her for when she doesn't find the meal I make for us palatable. I'm still observant and pay attention to her daily eating habits, though I'm not obtrusive about it. I'm really pleased with her improvement. Thanks for everyone's input and concern. :) Dd16 has always been concerned with her weight. She went through a stage when she was pre-pubescent during which she was on the top end of the recommended weight for her height, however she hit a growth spurt and became what I consider a healthy balance of height vs. weight. She would complain that she was "fat" but never tried to loose weight. Lately though - I'd say in the last year - she has purposefully tried to loose weight to become thinner. She is 5'4" and weighs 105. Size 8 skinny jeans are slightly loose on her. To my untrained eye she has almost 0 body fat. She tells me that she still thinks her thighs are too big. Aside from the size of her body I'm mostly concerned with her eating habits. She will regularly eat her last meal at 6pm and then not eat again until 2 or 3 the next afternoon...and then only eat a container of yogurt or a couple wheat crackers. She'll eat probably a 1/4 of what is considered a serving of food for dinner. I would say, based on my observations, that she is only eating 800 calories on most days. Occasionally she will eat upwards of 2000 if I've made some type of food that she loves or if we happen to go out to eat, and there are days when I think she only probably gets 500 calories at the most. When I tell her she isn't getting enough nutrients\calories she tells me that she only eats when she's hungry and then only enough to fill her stomach. I've tried to talk to her about healthy food choices and about the importance of nutrition especially while her body is still growing\changing. She agrees with me and actually does understand calorie input\energy output, processed foods vs. whole foods, and how to make good choices based on carbs\fats\fiber,etc. But yet she still makes poor choices (or no choices at all). Today she had green tea for breakfast and then planned to go without any more food until dinner. I told her to eat lunch before she went to her science tutorial and she said she wasn't hungry (no doubt her stomach has shrunk to nothing). She went out to walk her dog for 30 minutes and when she came back I'd made her a sandwich (whole wheat bread, ham, swiss, tomato and spinach). She said she didn't want it but took two bites to appease me and said she was done - I ended up making her eat it. I sat next to her and wouldn't get up until she'd eaten the whole thing. She didn't get mad at me or anything but it made me feel like a control freak. :( Am I dealing with anorexia or is this typical teenage girl eating habits? I know I should take her to the doctor but I've been loathe too because I don't want this to turn into me against her thing. We have a good relationship and she is such a level headed reasonable girl who is always willing to take my advice on matters - except this. I feel as if I didn't catch this soon enough and now it's going to be a struggle to repair her mindset (which to me is skewed...but maybe it's normal (?)). Advice? Been there? Quote Link to comment Share on other sites More sharing options...
Jean in Newcastle Posted February 12, 2014 Share Posted February 12, 2014 What you described is very worrisome to me. And yes, it screams the beginning of anorexia to me. Quote Link to comment Share on other sites More sharing options...
Liz CA Posted February 12, 2014 Share Posted February 12, 2014 I have been there done that. I was an overweight child and wanted to lose weight - then overshot the target and became underweight for a period of time. Can you take her to see a nutritionist? She may need to hear that she is impairing other functions by depriving herself of food. I had memory problems for years even after I was back at a normal weight. There seem to be no lasting effects... :), however, the focus of any discussion should probably shift to being healthy and fit, rather than to being thin or having a target weight. During my worst times - when I was about your daughter's age, I weighed myself morning, noon and night and obsessed over every pound. Perhaps set a goal of learning about healthy food and what certain foods accomplish in the body, vitamin content, enzymes, etc. This may refocus her on health rather than thin. Oh...and I would avoid trying to force food on her because I'd be worried this could lead to bulimic behavior (induced vomiting) when she is alone. Quote Link to comment Share on other sites More sharing options...
Wildiris Posted February 12, 2014 Share Posted February 12, 2014 My DD, also 16, sounds very much like your DD, but my DD doesn't think her legs are too big. I bring my DD food. I get her to drink a dbl instant breakfast (Dr. suggestion). Yes, this behavior is worrisome. My DD is 5'4" and 100 lbs. She is very waif-like with small bones and feet. I keep ice cream in the house just so she gets some fat calories. I wish I had advice. It is a control issue and and image issue. Quote Link to comment Share on other sites More sharing options...
MysteryJen Posted February 12, 2014 Share Posted February 12, 2014 :grouphug: The behavior you describe is worrisome. You need to find some professional help. :grouphug: Quote Link to comment Share on other sites More sharing options...
shukriyya Posted February 12, 2014 Share Posted February 12, 2014 Red flags in a lot of areas that you mention but whether it will turn into full blown anorexia and then again how severe a case it would be is unknown. Does she only want to eat her own food? Does she want to eat alone? Does she avoid social situations with food? Has she become more withdrawn lately? Does she see her friends regularly? How rigid are her rituals around her intake? These are questions you want to ask yourself. Quote Link to comment Share on other sites More sharing options...
Mimm Posted February 12, 2014 Share Posted February 12, 2014 Can you throw away the scale in your house? I would be very worried as well. I don't have a lot of suggestions. But I know people with anorexia get fixated on numbers. Quote Link to comment Share on other sites More sharing options...
texasmama Posted February 12, 2014 Share Posted February 12, 2014 Yes, I think this may very well be turning into a problem. I would seek out professional help. Quote Link to comment Share on other sites More sharing options...
Pawz4me Posted February 12, 2014 Share Posted February 12, 2014 I had my own bout with anorexia about 25 years ago. So very much BTDT. If she were my daughter I would be very concerned. One thing to watch is her periods -- make sure they don't (or haven't already) stopped. That's a huge warning sign of a body in starvation mode. Quote Link to comment Share on other sites More sharing options...
gingersmom Posted February 12, 2014 Share Posted February 12, 2014 My daughter had to faint and get a stern talking from the doctor (who told her she has had to hospitalize girls) before she realized the path she was heading down. Quote Link to comment Share on other sites More sharing options...
LucyStoner Posted February 12, 2014 Share Posted February 12, 2014 It's better to get professional help early than late with eating disorders. Quote Link to comment Share on other sites More sharing options...
5LittleMonkeys Posted February 12, 2014 Author Share Posted February 12, 2014 Perhaps set a goal of learning about healthy food and what certain foods accomplish in the body, vitamin content, enzymes, etc. This may refocus her on health rather than thin. Oh...and I would avoid trying to force food on her because I'd be worried this could lead to bulimic behavior (induced vomiting) when she is alone. I thought about the forcing food thing while I was sitting there watching her eat. I just couldn't fathom her being able to focus on science without some food in her, especially after she just went on a 30 minute walk. I'll definitely keep that in mind though. She is learning about healthy food, vitamins, enzymes, building muscle, what nutrients are needed for different organs to work properly at her science tutorial (Honors Anatomy and Physiology) and through her Health program. She has a 4.0 in both so I know she gets it ... there's just a disconnect when it comes to applying it to herself. Does she only want to eat her own food? Does she want to eat alone? Does she avoid social situations with food? Has she become more withdrawn lately? Does she see her friends regularly? How rigid are her rituals around her intake? These are questions you want to ask yourself. Good questions. She has no aversions to eating around others. The only time she eats a normal amount of food is if we go out to eat (which I can't afford to do everyday!) No changes in behavior really - she's never had a lot of friends and will sometimes lament that she wishes she had more acquaintances but doesn't seemed depressed about it. Regarding rituals around her intake - I'm not sure what that would look like. When she does eat there's no odd, quirky behavior...she just eats. Quote Link to comment Share on other sites More sharing options...
Upward Journey Posted February 12, 2014 Share Posted February 12, 2014 I was that teen. I don't think that I ever had full blown anorexia, as in I never had to be hospitalized, but it wasn't healthy, that's for sure. When I went to college and was surounded by all that amazing food in the dining hall my "little" problem turned into bulimia. It took my first pregnancy and throwing out the scale to cure me. 23 years later I STILL don't own a scale. Get her help now, instead of later. It most likely won't get better on it's own :( Quote Link to comment Share on other sites More sharing options...
5LittleMonkeys Posted February 12, 2014 Author Share Posted February 12, 2014 Her periods are normal right now, but that is something I've been watching. Along with her sleep patterns. No issues there right now either. Quote Link to comment Share on other sites More sharing options...
ktgrok Posted February 12, 2014 Share Posted February 12, 2014 Eating 500 calories a day IS an eating disorder. Get her help. Quote Link to comment Share on other sites More sharing options...
Upward Journey Posted February 12, 2014 Share Posted February 12, 2014 I want to add, anorexia and bulimia are NOT about the food. They are about having control when life seems out of control in some respect, if that makes sense. Do you have a sense that life may seem overwhelming for her atm, or that she's feeling powerless about some big thing? Quote Link to comment Share on other sites More sharing options...
5LittleMonkeys Posted February 12, 2014 Author Share Posted February 12, 2014 Get her help now, instead of later. It most likely won't get better on it's own :( I'll get rid of the scale. I know it won't get better on it's own...just not sure how aggressively I need to intervene right now. For those of you who went through this...if a parent had intervened early on with a workable plan to help you eat more healthy (making several small meals\snacks through out the day instead of allowing you to fend for yourself) would it have made a difference? Right now we aren't angry at each other; she doesn't feel I'm trying to control her... Or am I just being naive in thinking that I can prevent her from slipping further without professional involvement? Quote Link to comment Share on other sites More sharing options...
LMV Posted February 12, 2014 Share Posted February 12, 2014 Dd16 has always been concerned with her weight. She went through a stage when she was pre-pubescent during which she was on the top end of the recommended weight for her height, however she hit a growth spurt and became what I consider a healthy balance of height vs. weight. She would complain that she was "fat" but never tried to loose weight. Lately though - I'd say in the last year - she has purposefully tried to loose weight to become thinner. She is 5'4" and weighs 105. Size 8 skinny jeans are slightly loose on her. To my untrained eye she has almost 0 body fat. She tells me that she still thinks her thighs are too big. Aside from the size of her body I'm mostly concerned with her eating habits. She will regularly eat her last meal at 6pm and then not eat again until 2 or 3 the next afternoon...and then only eat a container of yogurt or a couple wheat crackers. She'll eat probably a 1/4 of what is considered a serving of food for dinner. I would say, based on my observations, that she is only eating 800 calories on most days. Occasionally she will eat upwards of 2000 if I've made some type of food that she loves or if we happen to go out to eat, and there are days when I think she only probably gets 500 calories at the most. When I tell her she isn't getting enough nutrients\calories she tells me that she only eats when she's hungry and then only enough to fill her stomach. I've tried to talk to her about healthy food choices and about the importance of nutrition especially while her body is still growing\changing. She agrees with me and actually does understand calorie input\energy output, processed foods vs. whole foods, and how to make good choices based on carbs\fats\fiber,etc. But yet she still makes poor choices (or no choices at all). Today she had green tea for breakfast and then planned to go without any more food until dinner. I told her to eat lunch before she went to her science tutorial and she said she wasn't hungry (no doubt her stomach has shrunk to nothing). She went out to walk her dog for 30 minutes and when she came back I'd made her a sandwich (whole wheat bread, ham, swiss, tomato and spinach). She said she didn't want it but took two bites to appease me and said she was done - I ended up making her eat it. I sat next to her and wouldn't get up until she'd eaten the whole thing. She didn't get mad at me or anything but it made me feel like a control freak. :( Am I dealing with anorexia or is this typical teenage girl eating habits? I know I should take her to the doctor but I've been loathe too because I don't want this to turn into me against her thing. We have a good relationship and she is such a level headed reasonable girl who is always willing to take my advice on matters - except this. I feel as if I didn't catch this soon enough and now it's going to be a struggle to repair her mindset (which to me is skewed...but maybe it's normal (?)). Advice? Been there? We haven't exactly been there, our fourteen year old's biological parents used food withholding as part of their abusive practices. They were also physically and emotionally abusive and it was really a mess. She was severely malnourished and had other medical problems as a result of all of this when we met her. She never had the distorted body image and never truly intentionally restricted but after awhile starvation had a bit of a numbing effect so it was hard for her to eat when she was upset and she was also very not used to the sensation of having food in her stomach which made refeeding more of a challenge. She was diagnosed with Food Avoidance Emotional Disorder (which is now part of the ARFID group in DSM-5) and we refed when she was ten when she came to live with us. We used a modified FBT approach with a therapist who also had experience in attachment/adoption issues. She dealt with a lot PTSD issues about a year after that partly because one of her biological parents was stalking her but the child psychiatrist also felt that some of the starvation was in the short term pseudo protective because of the numbing effect. She/we did TF-CBT for the PTSD with extra meal support through this and now at fourteen she is really doing very well. My husband and I still see that she isn't as secure and confident as our oldest daughter was at this age or exactly at the level we would like for her (so we are continuing to help her with this)but she is so far from where she was when we met her four years and really making her own way through all of this. She is really an amazing young woman and we're blessed to have her as part of our family. So my thoughts: -There is a lot of variation on what is a healthy weight. The best guide is often to look at your child's own growth curve over time. Is where she is now where you would expect from looking at her historic curve? Puberty is a peak time for developing a energy mismatch because kids are growing and expending energy in that direction, so it is easy to fall into a cycle where intake isn't really adequate. I think we see a lot of eating disorders, female athlete triad, etc in this age group for this reason. -Malnutrition is a medical issue whether it caused by the social situation(including food scarcity, and abusive food withholding), a psychiatric illness, or an underlying medical/organic illness. Addressing the malnutrition promptly and effectively, screening for possible complications, and monitoring for refeeding syndrome need to be priorities regardless of the etiology. -No one should be giving you a diagnosis online but I agree that there are some concerns from your post that your daughter has some disordered eating behavior, and some distorted perceptions. These symptoms are certainly seen with anorexia nervosa and various variants but can also be seen with other illnesses in some cases. -I would not delay medical evaluation. -I would not proceed with a treatment plan that didn't incorporate nutritional restoration as the top priority. -If you're looking at evidence based treatment for eating disorders the unfortunate reality is that we're probably still a few decades away from having a good evidence base. Of the literature that exists the strongest evidence seems to be for FBT (at least in children 12-18 with anorexia nervosa) but unfortunately there just isn't the evidence base we have for some other conditions. Good luck and feel free to PM if you have more specific questions. Quote Link to comment Share on other sites More sharing options...
LucyStoner Posted February 12, 2014 Share Posted February 12, 2014 While there is a possibility that she will get better without professional help, it is also quite possible that she will get much much worse without professional help. I don't see any downsides to getting her some professional help. I've seen people go downhill fast once disordered eating habits emerge and it's extremely scary and extremely dangerous. Quote Link to comment Share on other sites More sharing options...
Jerico Posted February 12, 2014 Share Posted February 12, 2014 She needs help. I hope you can get help for her. Quote Link to comment Share on other sites More sharing options...
MissKNG Posted February 12, 2014 Share Posted February 12, 2014 Or am I just being naive in thinking that I can prevent her from slipping further without professional involvement? Yes. If it is a true eating disorder, it simply does not just go away. It's a life long struggle because everything needs to be rewired - your relationship with food, how to eat again, your relationship with your body, etc, etc, etc. If you seek professional help, I can NOT stress this enough: find someone who SPECIALIZES in eating disorders. EDs are a world of their own, full of secrets, quirks and lots of other things that just a "regular" professional has absolutely no idea on how to deal with. Quote Link to comment Share on other sites More sharing options...
texasmama Posted February 12, 2014 Share Posted February 12, 2014 Or am I just being naive in thinking that I can prevent her from slipping further without professional involvement? I think you are being naive, stated with all kindness. It is a parent's impulse and deepest desire to help their kids and to disbelieve that something more serious than a loving mom can handle at home might be going on or beginning to go on. That can cause parents to try and help when they are "in over their heads", so to speak. A professional intervention earlier rather than later is a good course of action, I think. Not every professional (MD or therapist) has knowledge of eating disorders so you may need to do a bit of research into local resources for eating disorders to find a knowledgeable person. Quote Link to comment Share on other sites More sharing options...
Jean in Newcastle Posted February 12, 2014 Share Posted February 12, 2014 I would get professional help instead of trying to force her to eat. Forcing her may make things worse by making it a control issue (the heart of anorexia) even if it wasn't that at first. Quote Link to comment Share on other sites More sharing options...
LMV Posted February 12, 2014 Share Posted February 12, 2014 Yes. If it is a true eating disorder, it simply does not just go away. It's a life long struggle. If you seek professional help, I can NOT stress this enough: find someone who SPECIALIZES in eating disorders. EDs are a world of their own, full of secrets, quirks and lots of other things that just a "regular" professional has absolutely no idea on how to deal with. I agree with this as long as you are getting someone who specializes in eating disorders and has also kept up with the literature so they agree that nutritional restoration, cessation of purging etc need to be a high priority, and when you ask about FBT/Maudsley they know what you're talking about at least. Ideally they would be certified in FBT as well. I also can't stress enough the importance of having a physician involved who is capable and willing to evaluate for and address potential complications of malnutrition and refeeding. Quote Link to comment Share on other sites More sharing options...
hillfarm Posted February 12, 2014 Share Posted February 12, 2014 I'm pretty sure this is not typical teen eating behavior. My 15yo teen dd and her friends love to eat. She does try to be conscious of the choices she makes, and at 5'8" weighs around 128 lb., I would say she is at a healthy weight. More typical of teen girls, IMO (which may just be what I am used to), is dd's habit of differentiating between public eating and home eating, as she calls it. In public, she goes for easy to eat things that don't require risky manipulation (no spaghetti or fried chicken), and tries to portray a somewhat dainty, polite, restrained image. She says she wants to project a well mannered image. At home (even at a sleep over, with lots of other girls around) is another story. We have a fairly casual dining style and for the most part, dd has reasonable table manners, but she certainly doesn't hesitate to eat healthy portions. She has sometimes been seen with her elbows on the table, gobbling pizza like it is going out of style, pinching a favored bit out of her salad with her fingers, all the while squealing, giggling and talking non-stop. I have noticed, however, that her food preferences and hunger levels have been all over the place in the last couple of years since her hormones really took hold. There have been a few brief (one to two week periods) where she would fix food, but then say the smell made her sick and she couldn't eat it. For a few months, she will love a certain food and request it frequently. Then practically overnight, she will declare that she can't even stand the smell of that food and could not possibly eat it. Seems this only happens with vegetables and entrees, never with desserts for some reason... :glare: Hope this helps to provide some comparison. Good luck to both of you in getting this figured out. Quote Link to comment Share on other sites More sharing options...
texasmama Posted February 12, 2014 Share Posted February 12, 2014 I agree with this as long as you are getting someone who specializes in eating disorders and has also kept up with the literature so they agree that nutritional restoration, cessation of purging etc need to be a high priority, and when you ask about FBT/Maudsley they know what you're talking about at least. Ideally they would be certified in FBT as well. I also can't stress enough the importance of having a physician involved who is capable and willing to evaluate for and address potential complications of malnutrition and refeeding. This is a good point. Anorexia has a 10% fatality rate. It is a medical in addition to a psychological condition. (Not that OP'd dd has anorexia at this point.) FWIW, I am a therapist with 15 years experience with kids/adolescents and families, but I would not take on a client whose primary issue was an eating disoder. I would refer out to specialists in the field of eating disorder treatments. Quote Link to comment Share on other sites More sharing options...
Upward Journey Posted February 12, 2014 Share Posted February 12, 2014 I'll get rid of the scale. I know it won't get better on it's own...just not sure how aggressively I need to intervene right now. For those of you who went through this...if a parent had intervened early on with a workable plan to help you eat more healthy (making several small meals\snacks through out the day instead of allowing you to fend for yourself) would it have made a difference? Right now we aren't angry at each other; she doesn't feel I'm trying to control her... Or am I just being naive in thinking that I can prevent her from slipping further without professional involvement? I did not have a great relationship with my mother, but even if I had, I don't think it would have helped. I HAD the head knowledge, I knew EXACTLY what I was doing. What I needed was professional help. Like I said up thread, it's not about the food. It's about control. If you make her eat, it could go the other direction. Quote Link to comment Share on other sites More sharing options...
Pawz4me Posted February 12, 2014 Share Posted February 12, 2014 I'll get rid of the scale. I know it won't get better on it's own...just not sure how aggressively I need to intervene right now. For those of you who went through this...if a parent had intervened early on with a workable plan to help you eat more healthy (making several small meals\snacks through out the day instead of allowing you to fend for yourself) would it have made a difference? Right now we aren't angry at each other; she doesn't feel I'm trying to control her... Or am I just being naive in thinking that I can prevent her from slipping further without professional involvement? I can't answer that from a teen's perspective because I was an adult (25-30) when I had issues. As an adult . . . I think the only thing that would have helped me sooner would have been some sort of counseling from a professional. A person who becomes anorexic (or even close to it) has a lot of mixed-up mental conflicts going on. It's about a LOT more than just food or weight. But I can tell you that I didn't take my family or friends' concerns seriously. When people questioned my weight or eating habits I attributed their concern to jealousy, or to that person not understanding healthy eating and exercise. What "cured" me was infertility and desperately wanting to get pregnant after years of trying, and a wise fertility specialist who sat me down and told me it was never going to happen unless/until I started eating more and gained some weight. And he was smart enough to know (and tell me) that even though my weight wasn't all that low according to what the charts said I should weigh, it was a much lower weight than my body knew was healthy for it. And he was exactly right. I've got two boys to prove it. ;) But even after our talk, and as desperately as I wanted to get pregnant, it still took me over two years to "force" myself to gain enough weight to be able to get pregnant. That's how strong the hold of an eating disorder can be, even on an adult who desperately wants to be rid of it. Quote Link to comment Share on other sites More sharing options...
LMV Posted February 12, 2014 Share Posted February 12, 2014 I would get professional help instead of trying to force her to eat. Forcing her may make things worse by making it a control issue (the heart of anorexia) even if it wasn't that at first. FBT actually relies on parents selecting appropriate meals and ensuring that they are eaten during the first stage of treatment. This is currently the best evidenced and most successful approach so I wouldn't want people to think that a parent ensuring that nutritional restoration happens at home with the support and monitoring of their medical team would be making things worse. Again I want to underscore that parents should not be going into this without professional support and that medical monitoring is an important essential piece and I personally wouldn't advise any one to refeed at home without physician oversight. I also think it is very important that parents don't use physical force to ensure that food is eaten. Some children shouldn't/can't be refed at home for these reasons. Other children shouldn't be refed at home initially because they need closer medical monitoring during the initial period. Refeeding syndrome can and does happen and can be very dangerous. Quote Link to comment Share on other sites More sharing options...
hillfarm Posted February 12, 2014 Share Posted February 12, 2014 While you are investigating professional help options, could you present situations to her that would allow her to have more control over her life? Emphasize when the choice is hers and provide encouraging feedback when she makes good decisions? It would be interesting to see if that could help her to start moving in the right direction. But I definitely would seek professional evaluation and support at the same time, and as soon as reasonably possible. Many employment insurance packages offer psychological treatment benefits along with the physical treatment ones. Quote Link to comment Share on other sites More sharing options...
shukriyya Posted February 12, 2014 Share Posted February 12, 2014 To clarify FBT is family-based treatment. And the DSM-5 no longer includes lack of menstruation as a criterion for the diagnosis of anorexia. There is also growing evidence that the biological component of anorexia is far greater than was previously thought. That it's less a psychological illness and more an actual physical one based on studies of the brain. Here is a fascinating book on the subject. The author's blog is a wealth of info. Quote Link to comment Share on other sites More sharing options...
Pawz4me Posted February 12, 2014 Share Posted February 12, 2014 To clarify FBT is family-based treatment. And the DSM-5 no longer includes lack of menstruation as a criterion for the diagnosis of anorexia. There is also growing evidence that the biological component of anorexia is far greater than was previously thought. That it's less a psychological illness and more an actual physical one based on studies of the brain. Here is a fascinating book on the subject. The author's blog is a wealth of info. Just for the record, I never said it was necessary for diagnosis. I did say it's a huge red flag. Quote Link to comment Share on other sites More sharing options...
shukriyya Posted February 12, 2014 Share Posted February 12, 2014 Understood. Quote Link to comment Share on other sites More sharing options...
5LittleMonkeys Posted February 12, 2014 Author Share Posted February 12, 2014 Heading out the door in a minute but wanted to let you all know that I'm reading. Thank you all so much so far for your opinions and experiences. I'm going to read more thoroughly when I get home. I understand that this has the potential to get really scary... I've not admitted that to myself in the last few months but am glad that I posted today about my concerns. Quote Link to comment Share on other sites More sharing options...
Learning fun Posted February 12, 2014 Share Posted February 12, 2014 FBT actually relies on parents selecting appropriate meals and ensuring that they are eaten during the first stage of treatment. This is currently the best evidenced and most successful approach so I wouldn't want people to think that a parent ensuring that nutritional restoration happens at home with the support and monitoring of their medical team would be making things worse.Yes! It sounds like you did the right thing by having her eat the sandwich. Anorexia starts out with the girl (or boy) in control but quickly spirals to where the disease is the one controlling how much she eats. Even if she wants to eat more she won't because she's not calling the shots anymore. It's a compulsion, and she might need to rely on you or others to help her control that compulsion so her body can get the nourishment it needs and the disease's grip can be loosened. I'm so glad that you are getting help sooner than later. Hugs Quote Link to comment Share on other sites More sharing options...
Incognito Posted February 12, 2014 Share Posted February 12, 2014 I guess it depends what world you are living in - as a teen there were a lot of girls around me who did things like your DD is doing. I had a time where I was stressed and not particularly interested in eating when I got a bit too skinny, but I was taller than your DD and weighed a bit more than she does. FWIW, what got me back to eating more was an adult I knew and respected asking me if it was a problem. I did not want anyone meddling in my eating habits and telling me what to do, so I re-assessed what I was doing and got myself to eat in a more healthy way. If someone would have brought me to professional intervention - I know I would have been irate, and I don't know that the results would have been any better. So, my totally non-professional advice is to either have the conversation yourself, or have someone your daughter admires have the conversation first. Give her the chance to wake up and choose healthy eating. If she doesn't, then you will know she has a problem that needs to be addressed. If she does make positive changes, you'll have saved her and yourself a lot of grief, money, and energy. Also, FWIW, I was by no means the worst about eating amongst my girl peers. It was part of what made me want to spend time with the guys instead - girls were always talking calories and exercise, but not in a good way. Quote Link to comment Share on other sites More sharing options...
sassenach Posted February 12, 2014 Share Posted February 12, 2014 Major red flags. I would seek professional help immediately. Quote Link to comment Share on other sites More sharing options...
Upward Journey Posted February 12, 2014 Share Posted February 12, 2014 Heading out the door in a minute but wanted to let you all know that I'm reading. Thank you all so much so far for your opinions and experiences. I'm going to read more thoroughly when I get home. I understand that this has the potential to get really scary... I've not admitted that to myself in the last few months but am glad that I posted today about my concerns. {{{{hugs}}}} Quote Link to comment Share on other sites More sharing options...
rmtzc2009 Posted February 12, 2014 Share Posted February 12, 2014 From my families experience: take this very seriously & start getting help now. Look into who is recommended for this specific issue. Call your Ped. Search online for reviews. Get any recommendations as quickly as you can. Indeed these type of behaviors can quickly spiral out of control. She is already showing signs of wanting to control her food and I'm not sure how much she walks the dog, but 500 cal. & exercise are not a good fit. There's external things you can do to help manage the situation: remove the scale, force her to eat, minimize exercise but none of those deal with the actual problem like a professional will. I do think taking the scale away is good but I wouldn't force her to eat- as others have said, this is a control thing & depending on her mindset she may just find a way to outsmart you with eating and start down the binge/purge road. Ultimately with the proper help & you as her support she will have to make the decisions to get healthy. You'll be in my thoughts and I wish you the best of luck in getting her help. Quote Link to comment Share on other sites More sharing options...
LMV Posted February 12, 2014 Share Posted February 12, 2014 I guess it depends what world you are living in - as a teen there were a lot of girls around me who did things like your DD is doing. I had a time where I was stressed and not particularly interested in eating when I got a bit too skinny, but I was taller than your DD and weighed a bit more than she does. FWIW, what got me back to eating more was an adult I knew and respected asking me if it was a problem. I did not want anyone meddling in my eating habits and telling me what to do, so I re-assessed what I was doing and got myself to eat in a more healthy way. If someone would have brought me to professional intervention - I know I would have been irate, and I don't know that the results would have been any better. So, my totally non-professional advice is to either have the conversation yourself, or have someone your daughter admires have the conversation first. Give her the chance to wake up and choose healthy eating. If she doesn't, then you will know she has a problem that needs to be addressed. If she does make positive changes, you'll have saved her and yourself a lot of grief, money, and energy. Also, FWIW, I was by no means the worst about eating amongst my girl peers. It was part of what made me want to spend time with the guys instead - girls were always talking calories and exercise, but not in a good way. I think this is a good example of the concept that disordered eating is a behavior [which can have it's own adverse impacts on health]. In contrast, anorexia nervosa, bulimia, and compulsive overeating are biologically based brain disorders. If you have disordered eating without anorexia, etc then you can make a behavioral change and things can get better. If you have an eating disorder it may be very difficult (perhaps even impossible) for someone to make this change while their brain is still malnourished and the anosognosic aspect of the eating disorder will make it even more difficult. This is the best rationale behind FBT which basically takes the ill child out of making these difficult choices, allows for nutritional restoration, provides time for the brain to heal, and then transitions back into supported and eventually age appropriate autonomy. Some clinicians put substance abuse and addiction on the same dichotomy and I've been blessed to not have to deal with this in my personal life or within our family but some of my experiences and observations with my Emergency Department patients bear this out. My experiences also would support 90 day programs for these patients but I know that is not reality within our current mental health infrastructure and health care payer system. I find that unfortunate so I try to be understanding and compassionate with patients (and often their families who may be very stuck between a rock and hard place). As I mentioned above we went through aspects of an eating disorder with our fourteen year old and aspects of malnutrition due to other illnesses but not an eating disorder with two other children. We've had some hard times but we've been blessed with a lot of support from various angles and we and our children have made it thus far. One thing that was quite poignant for us was having a conversation with a parent at the program our adopted daughter was in and their comment that at least we knew it wasn't our fault because she came to us with this problem and that really made me realize how much guilt gets wrapped up in this and I hate that. There definitely seems to be some kind of underlying genetic component to eating disorders. However, the genetics behind anorexia nervosa [bulimia, and COE are likely different although not entirely clear either] are still very poorly understood. It doesn't appear that there is a single gene and it is likely that there are multiple genes, intersection between genetics and environment, and rather variable penetrance. It is generally believed that you do need a nutritional deficient state to trigger AN, however, this doesn't require intentional dieting and can sometimes be triggered just be an energy mismatch during a growth spurt. I do think it's wise for parents to try to avoid this [not just to prevent AN but because nutritional deficient states can have other consequences] if possible. I also think it's great for parents to encourage children to eat a wide variety of foods and to work for balance and adequacy overall over the day/week. Having good/bad foods often sets up a slippery slope that may be regretted later. Having said that I'm also well aware that you can do all of this, have regular family meals, and a great relationship with your kid and still have a child with an eating disorder. I think sometimes parents get caught up in a lot of guilt and I don't think that is warranted or helpful. I also think sometimes parents struggle to do what they need to do because their child insists that they don't need that or want that but I think sometimes we need to realize that there is a fine line between nurturing age appropriate autonomy and letting a child make age inappropriate decisions. So I guess I offer to any parent who is reading this, take a deep breath, and get your child the help they need, if your child has special needs you often have to change your parenting approach so do that as needed but don't waste time beating yourself up because it doesn't help. On that note, I'm off to go prepare dinner. Quote Link to comment Share on other sites More sharing options...
Joyofsixreboot Posted February 12, 2014 Share Posted February 12, 2014 I'm not saying don't seek appropriate help but what you are describing was pretty common among myself and my peers and I see it again with my oldest two dd's friends. It's not healthy but I don't think it is uncommon. Quote Link to comment Share on other sites More sharing options...
Guest submarines Posted February 12, 2014 Share Posted February 12, 2014 So what is the difference between anorexia (which is not about food) and extreme dieting (which is about food)? Quote Link to comment Share on other sites More sharing options...
Guest submarines Posted February 12, 2014 Share Posted February 12, 2014 I'm not saying don't seek appropriate help but what you are describing was pretty common among myself and my peers and I see it again with my oldest two dd's friends. It's not healthy but I don't think it is uncommon. :iagree: In the absence of other signs, this sounds like a diet fad, not an eating disorder. Quote Link to comment Share on other sites More sharing options...
J-rap Posted February 12, 2014 Share Posted February 12, 2014 I think it IS uncommon, and I would be worried. If she is only eating between 3:00 and 6:00pm, and in such small portions as you mention, I would be very worried that this could escalate. Especially since this is so different from her previous behavior. I have had 4 teenage daughters and they had lots of friends over during the teen years, and they did not eat like that. Please don't let it go. I do not have experience in this but perhaps a good place to start would for you to call a professional who deals with eating disorders. I'm sorry you and your daughter are going through this and you are a great mother for stepping in! Quote Link to comment Share on other sites More sharing options...
plansrme Posted February 13, 2014 Share Posted February 13, 2014 I am having a hard time figuring out how she could eat 500 calories a day, weigh 105 and still be a size 8. That does not add up to me. My girls are as dense as they come (think Shawn Johnson), weigh way more than 105, eat all of the time and wear size 2, maybe 4 if it runs small. Are you sure she is not fudging her weight or size or the amount she eats? Those possibilities would raise their own red flags, I suppose, but a size 6 or 8 is not that thin for a 16 year old. Anyway, my point is not to discourage you from checking with a professional, but maybe just to encourage you to consider that she may be eating more than you see. Best of luck to both of you. Quote Link to comment Share on other sites More sharing options...
Sisyphus Posted February 13, 2014 Share Posted February 13, 2014 The eating on a time table (ie, never after 6, never between am and dinner) sends up more flags than the amount eaten for me. Those food rituals are a classic eating disorder sign. I hope it's just dieting or teen girl weirdness run amok, but you need professional advice asap. I'm sorry, I know how worried you must be. Quote Link to comment Share on other sites More sharing options...
Learning fun Posted February 13, 2014 Share Posted February 13, 2014 So what is the difference between anorexia (which is not about food) and extreme dieting (which is about food)? I think it could be analogous to an alcoholic vs someone who drinks a lot. Even though the behavior is similar, it's different. The one who drinks a lot can realize that his behavior isn't healthy, set a few goals, and cut back. An alcoholic needs extensive help and support often times giving up control of his life for awhile (rehab) before he gets the situation under control. Quote Link to comment Share on other sites More sharing options...
Joker Posted February 13, 2014 Share Posted February 13, 2014 I am having a hard time figuring out how she could eat 500 calories a day, weigh 105 and still be a size 8. That does not add up to me. My girls are as dense as they come (think Shawn Johnson), weigh way more than 105, eat all of the time and wear size 2, maybe 4 if it runs small. Are you sure she is not fudging her weight or size or the amount she eats? Those possibilities would raise their own red flags, I suppose, but a size 6 or 8 is not that thin for a 16 year old. Anyway, my point is not to discourage you from checking with a professional, but maybe just to encourage you to consider that she may be eating more than you see. Best of luck to both of you. This stumped me as well when I read it. My 14 year old is the same height and almost the same weight (my dd is a bit more) than the OP, but she wears a size 0 or 2 in regular jeans and wears a size 2 or 4 in skinny jeans. A size 8 in any cut wouldn't fit my dd. Quote Link to comment Share on other sites More sharing options...
tabinfl Posted February 13, 2014 Share Posted February 13, 2014 Good questions. She has no aversions to eating around others. The only time she eats a normal amount of food is if we go out to eat (which I can't afford to do everyday!) No changes in behavior really - she's never had a lot of friends and will sometimes lament that she wishes she had more acquaintances but doesn't seemed depressed about it. Regarding rituals around her intake - I'm not sure what that would look like. When she does eat there's no odd, quirky behavior...she just eats. I'm not saying don't seek appropriate help but what you are describing was pretty common among myself and my peers and I see it again with my oldest two dd's friends. It's not healthy but I don't think it is uncommon. Definitely get it checked out, but be careful about going overboard trying to find something that may not be there. Some people just don't have much of an aooetite, and/or don't enjoy food. I'm one of them. I have had many periods of my life when I'd drink coffee in the morning and not eat until dinner time. Even then it was a bother. This had nothing to do with dieting or an eating disorder (though I've never been particularly happy with my thighs), it's just that most food doesn't bring me much pleasure and there are other things I'd rather be doing than eating. Other times, I'm just plain not hungry, even if i haven't eaten all day. Trying to force down a sandwich when I feel that way would be very unpleasant. Does she generally prepare her own food? That's a chore I really dislike, and it definitely affects my eating as well. I prepare good food for my kids, but if it's exta work to make a portion for me (e.g sandwiches vs. casserole), I'll often eat terribly myself. You say that she eats well when you go out or make food she loves, could you prepare those foods for her more often and see what happens? Keep the snacks she does like around in plain sight (yogurt, crackers, what else? -- maybe find add-ons like pre-cut cheese for the crackers to get some more nutritious food into her in a form she likes, without forcing it). Quote Link to comment Share on other sites More sharing options...
5LittleMonkeys Posted February 13, 2014 Author Share Posted February 13, 2014 Definitely get it checked out, but be careful about going overboard trying to find something that may not be there. Some people just don't have much of an aooetite, and/or don't enjoy food. I'm one of them. I have had many periods of my life when I'd drink coffee in the morning and not eat until dinner time. Even then it was a bother. This had nothing to do with dieting or an eating disorder (though I've never been particularly happy with my thighs), it's just that most food doesn't bring me much pleasure and there are other things I'd rather be doing than eating. Other times, I'm just plain not hungry, even if i haven't eaten all day. Trying to force down a sandwich when I feel that way would be very unpleasant. Does she generally prepare her own food? That's a chore I really dislike, and it definitely affects my eating as well. I prepare good food for my kids, but if it's exta work to make a portion for me (e.g sandwiches vs. casserole), I'll often eat terribly myself. You say that she eats well when you go out or make food she loves, could you prepare those foods for her more often and see what happens? Keep the snacks she does like around in plain sight (yogurt, crackers, what else? -- maybe find add-ons like pre-cut cheese for the crackers to get some more nutritious food into her in a form she likes, without forcing it). I think there is something to what you're saying. There have been times that dd will come downstairs, open the fridge or pantry then close them and go back upstairs or at the most grab a couple crackers or a container of yogurt. If she doesn't grab anything I'll call after her and ask if she's hungry and she'll say that she's not...but maybe she doesn't want to take the time to make something or doesn't see anything worth eating? I don't keep a lot of quick food products in the house. For example I buy block cheese but don't cut it up ahead of time - we cut it as we want it. I buy lots of raw veggies for snacking but, again, I don't pre-cut them for easier anytime snacking. I can definitely remedy those types of things (which admittedly, would make things easier for all of us). Thanks for this perspective. I'll add this point of view to the dialog I'll be having with dd. Quote Link to comment Share on other sites More sharing options...
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