Anorexia CC question--update post 98

[Pink and Green Mom]

I would venture to say that her parents, by leaving post it notes containing things like "eat!"  and "it's only food" are making the situation worse, not better.

 

OP, you really need to call CPS.  Or her doctor.  Or her school.  Someone.  Anyone.

[maize]

Part of the problem is that our society is so obsessed with thinness that we have a really, really hard time taking anorexia as seriously as it deserves to be taken.

 

It's not just the parents. Is the girl in school? Why have her teachers done nothing. Why have her ballet teachers done nothing? Why have her friends and her parents friends and her church leaders let a child get sicker and sicker right before their eyes and done nothing?

[rocassie]

This is a serious medical and psychological issue.  For your comments, I'm not sure how serious and deadly the parents realize this is.  I would encourage (not sure how) the mom to realize how serious it is. 

[Heatherwith4]

I agree with others who have suggested you call CPS. The girl could die, and she will die without help.

[Suzanne in ABQ]

My mom is only 4'9'', and she weighs 84 pounds.  She is skin and bones, and extremely frail.  I can't even imagine her being 8 inches taller and the same weight.  

 

Your young friend is in a dangerous situation.  She could be much closer to death than her parents realize.  I know that sounds harsh, but I am so concerned.  Your friend needs serious intervention, and her parents need a wake up call.  I have no idea how to get through to them.  Perhaps calling a therapist yourself, explaining the situation, and asking how you might help would be a start.

[maize]

I'm really hoping the OP comes back and tells us that she has either convinced the parents to get this girl to the dr. tomorrow, is driving her to the ER herself, or has called CPS.

 

I am just sickened to know that an entire community can sit by and watch a young person slowly starve to death.

[J-rap]

Thank you for being concerned about your friend's daughter.  Sometimes, all it takes is one person to make a difference.

 

Anorexia is extremely serious and very complex.  A young gal in our town just died from it last month.  It's not something someone can just "fix" easily.  Please be blunt with your friend and tell her her dd needs outside help, now.  Perhaps you can look up specialists who deal with this and have their names and phone numbers ready to give to your friend.

[Lady Florida.]

I am a Christian and agree that she needs medical treatment. Anorexia is not a 'self-help' condition, imo. My high school friend died from anorexia complications....she was 5'6 and 80 pounds. That's not far from where this girl currently is. There absolutely are Christian counselors and treatment centers specializing in eating disorders. If you are able to, I would try to find your friend these resources in your area.

 

 

...and from the little (more than I wish) I know, IT ISN'T ABOUT FOOD.  I hope that someone can get through to these parents that this is an issue that they need to get help with and soon.  I'm so sorry for this, but I am glad the OP cares enough to do *something*.  It must be a pretty helpless feeling at this point.  

 

 

I appreciate that you are trying to be respectful of your friend, but this is different from just a choice of approach. The daughter has a medical issue that could result in her death without prompt intervention. This is not an exaggeration.

 

 

 

The bolded in all three of the above quoted posts is extremely important to understand. This girl needs medical intervention and she needs it fast. She will very probably die without it. Die. And if she lives, she might still have lifelong health problems.

 

Oh, my yes...when I said it's not about the food, that doesn't mean that she doesn't need food.  She does and as suggested above.  My apologies if my point was badly made.

 

 

 

I understood your point and didn't think it was badly made. In fact, I quoted it with plans to highlight that part before I even saw this post of yours. It's a mental illness that has extremely serious physical side effects and needs proper treatment. Her parents commenting about her weight or someone giving her height/weight charts or caloric intake recommendations is not proper treatment.

[SproutMamaK]

Oh goodness, what they're doing right now is the opposite of helping, and she's in dire straights. She needs serious, immediate intervention or she WILL die of this. The death rates for anorexia are quite high, and that's taking in to account anorexics who are currently battling HARD and even recovering. This poor girl is in very serious danger of DYING, and SOON. Please call CPS, her slow death is not something that you can afford to just sit back and watch happen.

[umsami]

Agreeing with all of the others.

 

You mentioned that she can't return to ballet until she gains some weight.  Awareness of eating disorders among ballet students is so much better these days.  Her ballet teacher may be a good resource for programs or even to talk to her Mom. 

[Guest]

Thanks for the link--I may get it for her. The biology part sounds interesting.

I don't think they are working with a doctor. The mother printed out calorie guidelines for people her age and activity level. She has postits in her house stating that "It's just food!"

They have prohibited her from ballet until she gains some weight.

Not the approach I would have chosen, but, like I have said, I want to support her and help.

Wtf?!? Have they never read a book??

[LMV]

A friend of mine has twin girls age 17.

One has developed anorexia and has OCD.

Her eating disorder has been going on for over a year and a half.

She is 5'6" and 85 pounds.

I have known the girl since birth and feel strongly and have recommended that they get professional help but she stated that she would not take her to a therapist who is not Christian.  (I meekly stated that I thought there probably some who are...)

The mother said they are praying, studying the Bible, and are reading a couple of books written by recovered anorexics.

She is against medication though she has a son on medication.

They constantly comment on how bad the girl looks and how she needs to eat more.

My question for those who are Christians is:  can something like this be overcome by their plan of action? 

I am not a Christian but want to support them in the best way I can.

 

Anorexia nervosa  is a biological brain disorder. Unfortunately it may be very difficult (perhaps even impossible) for someone to recover while their brain is still malnourished and the anosognosic aspect of the eating disorder will make it even more difficult. For this reason, the first priority has to be on stopping the weight loss and starting the process of nutritional restoration.  Sometimes that can happen at home (but if you are going that route you do need regular physician visits and daily lab monitoring initially to assess for refeeding syndrome and associated complications), sometimes it is safer to start in the hospital, and for some patients that will only happen in the hospital. It is also critical to have a competent physician evaluate for complications of malnutrition. These can cause problems but also can sometimes interfere with optimizing nutrition.  A good physical exam along with vitals with orthostatics and temperature plus some basic nutritional screening labs is probably a reasonable bare minimum.  They also need to identify some approach to monitoring for refeeding syndrome when you start the nutritional restoration process.  Some clinicians will not do this outpatient and prefer to admit for this reason. Ideally this child's parents could discuss options with her doctor and come up with a plan.  Continuing with any plan that leaves her malnourished or leads to more weight loss is not something I would advocate.

 

Some more general  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.

-I would never 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.

-Depression, anxiety, and or, OCD can all co-exist with eating disorders. Exactly whether these are further complications of malnutrition or predisposing factors for ED seems to vary in different clinical situations. Further these comorbid conditions can interfere with achieving full nutrition so generally they should be addressed in the context of full nutrition. In some cases it may be reasonable to withhold formal diagnosis or consider medication withdrawal after recovery from the ED. 

-CBT and SSRI therapy are evidence based strategies OCD, anxiety, and depression. CBT protocols and medication dosing will vary. 

-Independent of comorbid conditions, there is not great evidence for pharmacologic therapy for anorexia nervosa although there is some softer evidence for benefit for atypical antipsychotics. High dose fluoxetine has been shown to be beneficial with bulimia. 

 

 

 

 

 

 

[LMV]

I recently read this book http://www.amazon.com/gp/product/006172548X?keywords=brave%20girl%20eating&qid=1456956977&ref_=sr_1_1&sr=8-1which discusses Family Based Treatment for eating disorders; it sounds like an approach that really puts the parents and family in charge--maybe this would be appealing to your friends? The book also discusses some of the biology involved in eating disorders.

 

Are they working with a dr? That may be more important than a therapist. I don't think medication is usually a huge help with eating disorders. The person affected needs to go through an intensive refeeding process that can be administered by parents but needs to be overseen a medical professional.

 

Harriet's book really shows the parent perspective and also gives a pretty good overview of FBT. Parents could also consider reading Help Your Teen Beat an Eating Disorder by Lock & Legrange.

[LMV]

Thanks for the link--I may get it for her.  The biology part sounds  interesting.

I don't think they are working with a doctor.  The mother printed out calorie guidelines for people her age and activity level.  She has postits in her house stating that "It's just food!"

They have prohibited her from ballet until she gains some weight.

Not the approach I would have chosen, but, like I have said, I want to support her and help.

 

It sounds like perhaps they are doing some variation on FBT without good medical support. 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.

 

Of course, 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.

 

As far as stopping ballet until the malnutrition is corrected, that I could absolutely get behind. I see that as just basic safety (because exercise can and does damage malnourished bodies) not as punishment.

[Tsuga]

I am not a Christian but I was one.

 

I belonged to a conservative, creationist, Baptist church.

 

Medical issues were considered medical issues and Christians were encouraged to seek out the best medical professionals possible. You wouldn't demand that your mechanic be a Christian (though, s/he should be honest) and the same with the doctor. You wouldn't demand a Christian oncologist, you'd demand the best oncologist. Same for anorexia.

 

I agree with Megrath. You need to let them know that this is a severe medical issue, not an issue of the soul. Nutrition or lack thereof is affecting her brain and body function.

 

You and your friends will be in my thoughts.

[nevergiveup]

I have read through all your responses and sincerely thank you all very much for your advice.

Asked why I have not done something sooner--I don't see them on a regular basis and her weight would fluctuate.  Mostly she looked thin normal (to me) but, I never saw her naked and she didn't dress to accentuate her thinness.

Someone asked why the church members who do see them on a regular basis have done nothing--the mother said how members of their congregation have expressed their love and support and are praying.  One woman, a therapist, counselled the girl for awhile but her advice seemed to be to count calories and stop exercising (she tends to be compulsive about that, too).

I am going to gather all the resources mentioned in the responses and approach her again. 

The hardest part is going to be to pull on my big girl panties and tell her that I would rather lose her as a friend than see her daughter lose her life.

[ezrabean2005]

We are all supporting you as you do the right thing and support this girl.  I have BTDT myself.  Therapy and deep intervention was the only "cure".  

 

You can do this.

[Daria]

I have a dear friend whose daughter has been in and out of hospital based treatment programs for over a year now.  The longer it goes the harder it is for the patient and the families to unwind unhealthy patterns.

 

People die from anorexia.  Die, dead.  5'6 and 85 pounds is -- I know, because I know the height and minimum weight that my friend's daughter has to maintain before she's released away from feeding tube capability -- within the range that there is an imminent medical risk of heart attack and organ failure.

 

Holding you in the light.  Do the right thing, please.

 

I would tell them this, bluntly, and ask them if they would withhold cancer treatment from their child while waiting for a Christian oncologist, and then make it clear that I would be calling CPS if they didn't make a decision to provide their child with medical care. 

 

There are absolutely Christian counselors who can work with this disease in a Christian context, and they can seek one out.  Here's a highly regarded program in my area:

 

http://renfrewcenter.com/services/specialized-programs/christian

 

But they shouldn't delay treatment while looking for a Christian team.

[nevergiveup]

Does it ever do any good to confront the person with the eating disorder directly?

[fairfarmhand]

I'm a Christian and no, they are in over their heads.

 

Can you find a recommendation for a Christian counselor? There are good ones out there,

[texasmama]

Does it ever do any good to confront the person with the eating disorder directly?

In this case, with a minor who is dependent on her parents to make good choices for her medically, no.  I would only speak with the parents - soon, bluntly, and with research in hand.  And, as others have said, if they do not follow through with medically-based treatment, I would not hesitate to call CPS.

[texasmama]

Re: Christian counseling - this is first and foremost a medical issue.  Counseling is secondary.  A good treatment team would address all aspects of the patient's person - body, mind and spirit.  But the medical issues come first.

[Pam in CT]

Does it ever do any good to confront the person with the eating disorder directly?

Any good?  Depending on where the young woman's mental state is -- whether or not deep down she wants to survive-- knowing that a trusted adult is concerned might possibly jog her mind a tiny bit.

 

But it cannot do enough good.  For you to reach out (as an aside, "confront" is unlikely to be the right type of reaching out) to the young woman cannot save her life.

 

If you knew a 17 year old had cancer, it would not be enough to say to her, hon, you really ought to see an oncologist.

 

If you knew a 17 year old was suicidal, it would not be enough to say to her, hon, you really ought to see a counselor.

 

Anorexia combines a life-threatening mental disorder (there's a direct risk of intentional suicide) and a life-threatening physical disorder (at her weight, there's a real risk of heart attack and/or organ failure).  Her brain is literally not getting enough fuel to be able to reason; and in addition she is only 17 years old living with a family that for whatever reason is not getting her the help she needs.  Even if she wanted to get herself into appropriate medical help (and anorexics generally resist treatment, vigorously) as a practical matter how could she?  

 

 

Not being dramatic: Her life is at risk.  It is a terrible position for you to be in.   :grouphug:

 

She could die.  Really.  That would be worse.

[speedmom4]

I have not read all the comments so I may be repeating what others have said.

 

Eating disorders have the HIGHEST mortality rate of any psychological disorder. I have personal experience with this. The heart can be severely and permanently damaged. Bones aren't receiving the proper minerals so osteoporosis may be setting in. It is EXTREMELY important that this child receive professional help.

 

Finding the right therapist is crucial and can take some time and trial and error. This will NOT get better on its own. You may need to explain that their daughter's life is at stake! The longer she goes without professional help the worse her outcome may be. I cannot stress enough how important professional help is!!!

 

If her child had a heart condition, would they take her to the doctor? If she had diabetes, cancer, muscular dystrophy??? This is just as serious.

 

Hoping your friend gets her daughter the help she so desperately needs.

[maize]

Does it ever do any good to confront the person with the eating disorder directly?

Starvation affects brain function; most people by the time they reach the point this girl is at are not capable of addressing the illness head-on themselves.

 

You mentioned compulsive exercise. Experiments on both rats and people fed a starvation diet have shown that a compulsion to exercise can develop because of starvation--it is caused by changes in the brain.

 

Digestion slows down and eating becomes physically uncomfortable.

 

At the point this girl is at, it is very, very unlikely she can do much to help herself. It's not a matter of just understanding there is a problem and choosing to eat. If you could convince her to go to a dr. That might be a first step, but recovery is going to require intensive intervention by both a medical team and her family; the only other option is in-patient treatment.

 

You mentioned she doesn't dress to accentuate her thinness. does she by chance dress in layers and bulky clothes? A body in starvation mode has difficulty maintaining its own heat, she may bundle up because she feels cold.

 

LMV who posted above is a medical doctor, she's given good advice. Read the book I linked.

 

Hugs to you, I hope you didn't feel I was condemning you for not intervening sooner. I come from a family with a multigenerational history of anorexia and the disease frankly terrifies me. I don't doubt that this girl's parents and community care about her; they unfortunately seem to have a profound misunderstanding about the nature and severity of the illness that is afflicting their daughter.

 

Thank you for caring and for reaching out yourself to better understand and learn what should be done. Yes, this is worth risking a friendship over. Gather your resources and present them to the family. Make the medical appointments yourself if you have to. Maybe enlist the help of the family's pastor if that person would be willing to talk to them about proper medical treatment (after becoming informed themself). If within two weeks you have not been able to get the family to act aggressively, call CPS.

 

The fact that this girls is almost 18 adds another layer of urgency. If the family are not able to safely pull off intensive treatment in a home setting, the only option will be inpatient. And once she is no longer a minor they can't make her participate in any treatment. She needs to be, one way or another, well on the path to recovery before her 18th birthday.

Edited March 3, 2016 by maize

[JFSinIL]

The teen needs medical intervention NOW.

 

http://jugglinglife.typepad.com/juggling_life/anorexia/

 

Jenn on the Edge has a ton of posts on her blog on the subject as her daughter has anorexia.  While she has "recovered" it is a life-long illness she has to stay on top of in order to not DIE!!!

I can not recommend enough that that family get their daughter proper medical attention before it is too late.  Prayers alone won't do the trick - anorexia is too evil and sneaky.  Better to pray that God lets the professionals help.  Whether or not the doctors and therapists are "Christian" should be beside the point. 

 

If need be, call CPS.  This teen needs help before she turns 18 and forcing her into therapy becomes more than a battle of wills. 

Edited March 3, 2016 by JFSinIL

[Heather in VA]

Does it ever do any good to confront the person with the eating disorder directly?

 

She's a minor so I don't think this is an option. I agree with those saying to confront the parents. If they refuse to get medical attention for her then CPS needs to be called. Is there any chance the girl wants professional help but is being prevented from getting it because of her parents beliefs? 

[maize]

She's a minor so I don't think this is an option. I agree with those saying to confront the parents. If they refuse to get medical attention for her then CPS needs to be called. Is there any chance the girl wants professional help but is being prevented from getting it because of her parents beliefs?

I very much doubt the girl is able to really understand her need for help; it's much more common for people with anorexia to fight treatment. Just the nature of the disease...

[FaithManor]

This is a life threatening medical condition. It is difficult to overcome with the best of medical and mental health plans so know I do not believe that what they are doing is adequate.

 

To be honest, if I knew for a fact that the girl was not under the care of a specialist, I would be inclined to call CPS because she could very easily die of the condition.

[Spryte]

This thread is haunting. I am terrified for the OP's friend's DD. She could die.

 

Hoping to hear that she's getting help soon. I suspect she'll need an inpatient program, from past experience, but could be wrong.

[maize]

This thread is haunting. I am terrified for the OP's friend's DD. She could die.

 

Hoping to hear that she's getting help soon. I suspect she'll need an inpatient program, from past experience, but could be wrong.

Inpatient may be necessary if adequate support and monitoring are not possible in an outpatient setting. Family Based Therapy (outpatient) is currently the best evidence-supported treatment, however. https://en.m.wikipedia.org/wiki/Maudsley_family_therapy

[Guest]

I have two grown friends who were anorexic.  Neither family could see what was happening.  Both were taken to the hospital by their then-boyfriends, now husbands.  

 

One of them is completely reconciled to her family; the other never sees her family.  The first family had their eyes opened to reality by the actions of an outsider; the second continued to decry the intervention because "they had it handled."  

 

A major shout-out to these two powerful young men (now also 20 years older) who took hard steps to save the lives of their beloved girlfriends.  

 

But I also will tell you, it wasn't pleasant for them at the time.  

 

[Laurie4b]

If they're looking for qualified Christian counselors please check the ACBC website. That's their best bet for qualified and highly trained counselors who won't ignore the medical issue but work with the family and doctors to come up with a comprehensive treatment plan that doesn't ignore either the mental/spiritual or physical side of the OCD.

 

http://www.biblicalcounseling.com/counselors

 

If you have had a "biblical counselor" that would not ignore the medical issue and would not use shaming, then you've been blessed. I know far of too many horror stories. 

 

I am not against Christian counseling, but "biblical" counseling often isn't anything like what people think is meant by the word "counseling."  

 

OP, find someone with an actual degree (like a psychologist, clinical social worker, etc.) who is also a Christian. You can ask around if you know anyone who does therapy to see if they know someone.

[Guest]

If you have had a "biblical counselor" that would not ignore the medical issue and would not use shaming, then you've been blessed. I know far of too many horror stories.

 

I am not against Christian counseling, but "biblical" counseling often isn't anything like what people think is meant by the word "counseling."

 

OP, find someone with an actual degree (like a psychologist, clinical social worker, etc.) who is also a Christian. You can ask around if you know anyone who does therapy to see if they know someone.

NANC/ACBC certification is very different than your standard 'pastor who counsels' or layperson. And they're the first to say ANY biological or lifestyle component must be addressed before the spiritual/emotional. I've been through a small portion of the training and was very impressed with how quickly they call in both medical and investigative/legal authority. Step one is assessing whether an individual is in danger or placing others in danger and triaging that appropriately.

 

I wouldn't recommend any other Christian counseling carte blanche, but this certification has enforcement of standards behind it, very detailed training, and the biblical component is *actually biblical*, which is surprisingly rare in the counseling world.

 

I've had poor Christian counseling from a psychologist who claimed to be Christian in her practices and had a wall of credentials. This is worlds better and I can endorse the organization from the end of provider and counselee. Their website is the best starting point for finding a certified counselor who has training and accountability, both.

[PeacefulChaos]

I have not read other replies.

 

There are ABSOLUTELY Christian counselors out there.  They have training for these things - my SIL is one and she works with one.  My SIL is absolutely certified for all of the same things as someone would get at a non-Christian psychologist - she majored and got her Bachelor's in Psychology, and has one Masters in Psychology.  She's finishing up her licensing.  The lady she works for is an LPC.

 

I know there are tons of them out there because they went to a national conference for Christian counselors in Nashville back in August.

 

 

And I guarantee you, that while there may be some quacks out there, the people who are Licensed are not those people.  

 

 

[Sun]

I have a dear friend whose daughter has been in and out of hospital based treatment programs for over a year now.  The longer it goes the harder it is for the patient and the families to unwind unhealthy patterns.

 

People die from anorexia.  Die, dead.  5'6 and 85 pounds is -- I know, because I know the height and minimum weight that my friend's daughter has to maintain before she's released away from feeding tube capability -- within the range that there is an imminent medical risk of heart attack and organ failure.

 

Holding you in the light.  Do the right thing, please.

 

 

Please ask your friend to find her an inpatient treatment program. She needs intensive medical help. If she doesn't agree, please call CPS. This can be a life and death situation.

 

 

At that height and weight, there is no way that a doctor shouldn't be involved. She needs professional help immediately. There is immediate physical risk of death or permanent harm.

 

 

What are you doing waiting around for a year and a half for without doing anything to help out the minor child of a friend?  Act now!

 

 

All of these and more a thousand times over. This girl does not need a therapist, Christian or otherwise. At this point, she almost certainly needs inpatient treatment to keep her from dying. Anorexics DIE at a rate that would horrify us for any other disease, and her family sounds as if they are doing everything possible to make it worse.

 

 

 

I am going to gather all the resources mentioned in the responses and approach her again. 

The hardest part is going to be to pull on my big girl panties and tell her that I would rather lose her as a friend than see her daughter lose her life.

 

Please do something now. Please, please don't wait. How would you feel if she were to collapse from cardiac arrest and you hadn't called CPS? I am terrified after having read your posts about this girl. Her "therapist" advised counting calories? For an anorexic at a dangerously low body weight???? Her parents criticize her appearance? Those two things coupled with her weight that is in the range where death or permanent and severe damage can easily happen at any point time means that girl needs intensive, qualified help NOW.

[Jean in Newcastle]

NANC/ACBC certification is very different than your standard 'pastor who counsels' or layperson. And they're the first to say ANY biological or lifestyle component must be addressed before the spiritual/emotional. I've been through a small portion of the training and was very impressed with how quickly they call in both medical and investigative/legal authority. Step one is assessing whether an individual is in danger or placing others in danger and triaging that appropriately.

 

I wouldn't recommend any other Christian counseling carte blanche, but this certification has enforcement of standards behind it, very detailed training, and the biblical component is *actually biblical*, which is surprisingly rare in the counseling world.

 

I've had poor Christian counseling from a psychologist who claimed to be Christian in her practices and had a wall of credentials. This is worlds better and I can endorse the organization from the end of provider and counselee. Their website is the best starting point for finding a certified counselor who has training and accountability, both.

 

None of this matters.  This girl needs MEDICAL intervention.  Yes, there should be a psychiatrist on the team but medical is first. 

[maize]

None of this matters. This girl needs MEDICAL intervention. Yes, there should be a psychiatrist on the team but medical is first.

THIS!!!

[maize]

This to me has been the scariest part of this scenario all along. The parents seem to be oblivious to the fact that their daughter has a critical, life-threatening MEDICAL condition that needs professional medical treatment.

 

I am sure they mean well, but they do not understand the nature of what they are dealing with. I am worried that they think the daughter will be able to just decide to start eating and will recover.

[Guest]

None of this matters. This girl needs MEDICAL intervention. Yes, there should be a psychiatrist on the team but medical is first.

Of course she does - however with the family in question if they are inclined toward a particular kind of help and phobic of others, they're going to take the advice to handle the serious medical side of it first better from someone they don't believe is biased against their views and for invasive treatment.

 

Do you think I'm an idiot? Of course it's medical primarily. Their resistance to that and desire for holistic treatment is something that can be worked with and not steamrolled, however, and for a friend on the outside giving the search page for a counselor who will help them is a good and useful step, and *these* counselors will immediately refer the girl for emergency medical care. Two birds, one stone.

Edited March 4, 2016 by Arctic Mama

[Spryte]

Do you think I'm an idiot?

That's pretty harsh sounding, AM.

 

I think Jean was highlighting the urgency of medical intervention immediately rather than awaiting therapist openings, appointments, etc.

 

Obviously everyone in this thread is concerned and well meaning.

[Guest]

Whatever. Not worth my time.

 

OP, good luck to the family, I hope my suggestions have given you another avenue to consider.

Edited March 4, 2016 by Arctic Mama

[clementine]

I have read through all your responses and sincerely thank you all very much for your advice.

Asked why I have not done something sooner--I don't see them on a regular basis and her weight would fluctuate.  Mostly she looked thin normal (to me) but, I never saw her naked and she didn't dress to accentuate her thinness.

Someone asked why the church members who do see them on a regular basis have done nothing--the mother said how members of their congregation have expressed their love and support and are praying.  One woman, a therapist, counselled the girl for awhile but her advice seemed to be to count calories and stop exercising (she tends to be compulsive about that, too).

I am going to gather all the resources mentioned in the responses and approach her again. 

The hardest part is going to be to pull on my big girl panties and tell her that I would rather lose her as a friend than see her daughter lose her life.

Please update after you've approached the mother again, if you are able.

 

"If a person with anorexia becomes severely malnourished, every organ in the body can be damaged, including the brain, heart and kidneys. This damage may not be fully reversible, even when the anorexia is under control."

 

Any action you take or encourage her parents to take could save her life.  That alone is reason to try and force someone to help her!

[livetoread]

I know of a situation where the girl was a couple of pounds over your friend's daughter's weight. She was admitted in-patient and still came very close to dying in the hospital because she caught a bug that her body was just too weak to fight. Your friend's daughter is one mild virus away from death, even if she doesn't lose any more weight. This is very, very serious.

[Jaz]

Any updates? Thinking of your friend's daughter.

[umsami]

Saw this article tonight and thought of this thread.

 

"Up to one in five people with chronic anorexia may die as a result of their illness, either due to the direct effects of starvation and malnutrition or due to suicide, making it the deadliest of all psychiatric disorders. Although scientists have made tremendous progress in decoding the underlying biology of eating disorders and in finding ways to intervene in cases of teenage anorexia before the disorder becomes chronic, this hasn’t translated into effective treatments for adults like Heather...."

 

"For adolescents with anorexia, a ground-breaking treatment developed at the Maudsley Hospital in London in the 1980s called family-based treatment (FBT) has significantly improved short-term recovery outcomes. It puts parents temporarily in charge of making food and exercise decisions for their child and places a priority on normalizing weight and eating habits. In a randomized clinical trial published in 2010, around half of teens treated with FBT met criteria for full recovery after a year, compared to 23 percent of teens receiving standard treatment."

Edited March 31, 2016 by umsami

[Guest]

Any update?

 

[nevergiveup]

Saw this article tonight and thought of this thread.

 

 

 

Thank you all for keeping this girl in your thoughts.  I saw her this past weekend--the first time in a while.

She has gained some weight and is now around 100 pounds (according to her mother).

Although she looked better, she did not look healthy (to me).  Her mother is using some techniques mentioned in the article for the Maudsley technique and really feels like the daughter has turned a corner.  She is letting her participate in ballet again.

I gave her advice/information gleaned from you intelligent ladies and just now forwarded her the article posted above since I never knew how many anorexics experience relapse.

Thanks again to all of you!

[maize]

Thank you for the update.

 

It sounds like they are not working with medical professionals? That is very, very worrisome still.

 

Also, I am not sure I trust the weight gain. People with anorexia frequently find ways to trick the scale. Weights sewn into underwear etc.

 

I am glad they are applying ideas from the Maudsley technique, but if they are going it alone they are still taking an enormous risk with their daughter's health and life.

 

Thanks for being a good friend and caring.