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Haggis

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Reply with quote  #1 
My 13 year old son has orthorexia/anorexia. We were not getting anywhere with professionals as although he had lost lots of weight and was restricting food/over excercising, he was only slightly underweight. But I know!!! Anyway by enrolling him in a gym( I know the owner and the gyms ethos)where he is surrounded by a healthy attitude to muscle gain, he has stopped the hundreds of sit-ups and press ups. He still however ‘has’ to walk the dogs after his meals. He also has limited what foods he will eat. To the point where when on holiday for 2 weeks he lost a horrendous amount of weight as he couldn’t access ‘his foods’. These foods are store specific ie pancakes but only from the co op because he trusts them. He eats his main meal with us and eats what he is given as long as it’s meat heavy and contains no fatty foods. He eats only salmon/chicken for lunch and does not snack. My question is : I am just glad we have him back to an average weight however am I enabling his control of foods? My other son is always telling me that his brothers eating patterns are not right. Deep down I know this and feel a bit like a coward for not addressing it. I am just focusing on keeping him at a good weight but I know that I am not tackling the issue.
I feel that if I stopped buying in the foods he will eat, he would just not eat. Do I tackle this now? Or do I wait a while longer. It was July we were on holiday and he has since made up the weight he lost.
Many thanks
Foodsupport_AUS

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Reply with quote  #2 
Welcome to the forum, sorry that you have had to find your way here. 

The focus on only certain foods with very strict food rules is something that really needs to be tackled. His exercise at the gym may also be contributing to  fixed rigidity and rules. Although his weight sounds like it is in a healthy range it sounds as  though he continues to have a great need for control of that too. 

We have all had that fear that if we don't give in to the ED that they will stop eating or not eat enough - this is in part how we get manipulated by the eating disorder ourselves. It makes it even harder for you that you have been left without professional support. All of those food rules need to be challenged for the eating disorder to be gone. Further the longer they are left it is likely the deeper his beliefs and habits are going to become ingrained.  

Is it possible to revisit the need for a diagnosis? Is he having any sort of medical oversight ?

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D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
toothfairy

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Reply with quote  #3 
Hi Haggis,
Welcome from another boys mum.
My S got ill at 13 and is nearly 17 now in strong recovery.
We have so far had 3 solid years of needing 4000-5000 cals per day for S to grow from boy to a man.
We have had to cycle through all the fear foods to get him into recovery.
From your post your son sounds very ill and entrenched in his anorexia/orthorexia.
Please do not wait, the longer this goes on the more entrenched it gets.
This is very serious, our kids are tortured by the disorder and it is so dangerous.


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Food is the medicine. Recovery is possible.
Torie

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Reply with quote  #4 
Welcome, Haggis - So sorry you needed to join us here.   It is really hard to take the bull by the horns, especially when (as in your situation) there is no immediate crisis.  However, it is actually a kindness to drag them back to health and extinguish all the ED habits.

I would suggest that you join him as he "walks the dog" to ensure that the walk is not in fact a run.  Also, it is possible he is waking up in the middle of the night to exercise secretly as others have found.

It sounds as though your non-ED son is very sensible and might provide a good model for what healthy male behavior looks like - not in the sense of recruiting his help but rather in seeing how much, what and when food is eaten.  That is your goal - getting rid of all the ED behaviors.

I know it is scary and difficult to tackle this, but really, it just gets harder as habits become more entrenched and he becomes physically bigger and stronger.  Also, you will want as many years as possible in a good state before he heads off to university away from your watchful eye. 

In general, it is possible to require gradual changes toward normal eating and exercise or - as an alternative - to sort of rip off the bandaid and require all changes immediately.  One way or other, I urge you to act now - he really needs your help to put this behind him. 

Please feel free to ask all the questions you like. xx

-Torie

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"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
toothfairy

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Reply with quote  #5 

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Food is the medicine. Recovery is possible.
toothfairy

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Reply with quote  #6 
https://www.kartiniclinic.com/blog/post/why-wait-for-treatment/We/
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toothfairy

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Reply with quote  #7 
http://ucsdhealthsciences.tumblr.com/post/159989112425/whats-weight-got-to-do-with-it
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toothfairy

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Reply with quote  #8 
https://www.kartiniclinic.com/blog/post/the-eleventh-hour/#.Wgblq5Ki4kU.facebook
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Food is the medicine. Recovery is possible.
deenl

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Reply with quote  #9 

Hi Haggis and welcome to the forum,

I identify so much with where you are at. In the beginning, I kept telling my husband that we didn't want to be making a mountain out of a molehill. *Regrets*  To keep the corny sayings going, I now say where there's smoke there's fire. Your other son sees this and I think deep down you do too.

The very first thing you can do is to gather information. Below is an extract from a recent book that might strike a chord with you. The author and name of the book are below.

Quote:

Orthorexia Nervosa
Orthorexia nervosa is not an accepted eating disorder according to the DSM-5, although recently it has attracted significant attention as a proposed diagnosis. It involves adhering to a theory and practice of healthy eating so strictly that one’s health, school, work, or social life suffers. It has many similarities to anorexia nervosa and is treated similarly. The primary difference is that a person with orthorexia restricts food in order to be healthy rather than to control shape or weight. Orthorexia typically begins as an interest in healthy eating that escalates and becomes compulsive. Over time, the person’s preoccupation with healthy eating intensifies and squeezes out other interests.

Muscle Dysmorphia
Muscle dysmorphia is a body dysmorphic disorder (itself a form of obsessive-compulsive disorder or OCD) that some researchers believe is really a manifestation of anorexia nervosa that is more common in males (Griffiths, Murray, and Touyz 2013). While people with muscle dysmorphia may have similarly rigid thoughts about food and body, they desire a bigger and more muscular body, rather than the thinness associated with traditional anorexia nervosa. Consequently, people with muscle dysmorphia are more likely to focus on weight lifting, eating high-protein foods to build muscle, and using supplements or steroids. It is believed that a large percentage of body builders may have muscle dysmorphia.

 

Muhlheim, Lauren. When Your Teen Has an Eating Disorder: Practical Strategies to Help Your Teen Recover from Anorexia, Bulimia, and Binge Eating (Kindle Locations 331-337). New Harbinger Publications. Kindle Edition.

From what you say, your son is at a healthy weight so from that point of view there is no need for panic but it does seem likely that his eating patterns  are out of control and that needs to be urgently addressed. One other thing, though, please ensure he is not purging (vomiting his meals; signs would be going to bathroom or outside immediately after meals, marks on knuckles, long showers, containers of vomit hidden) as this can alter the potassium in the blood and is very dangerous for the heart.

Please feel free to ask any questions you have while you try to figure out what's going on and how to proceed. We are all here to help each other.

Warm wishes,

D

PS There is another great chapter in that book asking  How do I know if my child has a problem? I thought it would be a bit cheeky to copy and paste a whole chapter but if finances are an issue for you please email me back channel by clicking on my name and using the email address that comes up.


__________________
2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, stable but no progress. Medical hosp to kick start recovery Feb 2016. Slowly and cautiously gaining weight at home and seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, tons of variety in food, stepping back into social life. Sept 2017, back to school full time for the first time in 2 years. Happy and relaxed, just usual non ED hassles. 

  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal. (but don't give up on the plan too soon, maybe it just needs a tweak or a bit more time and determination [wink] )
  • We cannot control the wind but we can direct the sail.
Holroyd957

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Reply with quote  #10 
Unless i’ve read your post wrong it sounds as though although you’ve done a great job restoring the weight lost on holiday and your son is now average weight for his age that he is still underweight for him. You can have a serious eating disorder at any size and it’s a common mistake made by professionals to assume that if you’re in a “healthy” weight range that you must be healthy! If he has a relatively high muscle mass from working out at the gym his BMI will appear artificially high as well also fooling people into thinking he’s ok. Remaining underweight for him will keep him trapped in these eating disorder behaviours and cognitions. If i’ve got the wrong end of the stick then I apologise and ignore me! I would advise you to restore his weight to a weight that is healthy for him and tackle these food rules as others have suggested. You will get great advice on here how to do that. I would also get him checked out at the GP (orthostatic BP and pulse and blood biochem) to make sure he’s ok from a physical perspective as weight per se is no indication of health. Sorry to bang on about but it’s a real frustration of mine!
Haggis

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Reply with quote  #11 
Thanks so much for your perspective guys. Sometimes being closely involved means I can’t see the wood for the trees! I am definitely not convinced that he is a healthy weight for himself and his frame even though in the children’s chart he is classed as such. He is pure muscle so should be heavier. We walk the dogs together so he definitely isn’t running or vomiting then. Also we live in a bungalow and his bedroom is right next to mine/ I’m a light sleeper so I’m pretty sure he isn’t night time excercising. Surprisingly he is still pretty honest about what he does/ eats. Probably because he is so convinced that it’s normal. I’m going to go back to GP. We paid for a dietitian way back in the beginning but he refused to engage because he deemed her overweight and therefore in his eyes obviously knew nothing about nutrition! Maybe I need to be looking at a psychologist instead of a dietician?
I’m scared to rock the boat with him but you are right, I need him to be in a healthy relationship with food before he becomes independent so I need to be brave!
Thanks again to all who replied I really appreciate it.
deenl

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Reply with quote  #12 
Hi again Haggis,

Eva Musby is based in Scotland. Here is a link from her website about the options for care in Scotland. She also has a service where you can contact her for direct, personal guidance. She is very good and very experienced.

Warm wishes,

D

__________________
2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, stable but no progress. Medical hosp to kick start recovery Feb 2016. Slowly and cautiously gaining weight at home and seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, tons of variety in food, stepping back into social life. Sept 2017, back to school full time for the first time in 2 years. Happy and relaxed, just usual non ED hassles. 

  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal. (but don't give up on the plan too soon, maybe it just needs a tweak or a bit more time and determination [wink] )
  • We cannot control the wind but we can direct the sail.
Mamaroo

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Posts: 682
Reply with quote  #13 
Hi Haggis and welcome from me as well.

I always say that weight loss is the last symptom of an eating disorder. My daughter start to refuse ice cream for dessert, claiming it made her nauseous during dance practice. Stupid me praised her for eating more 'healthy' and drove her to class (and enrolled her into gymnastics as well, ED is very sneaky). If I knew then what I knew now, I would've insisted she sat at the table and finish the ice cream before I would take her to dance class. I would not have allowed her to pick her food or snacks. I catered too much to ED. All these behaviours started when she was still at a good weight. As ED progressed I allowed her to pick her food, because 'at least she is eating'. The list became more restricted with time and she ended up in IP with an NG tube. ED knows no bottom. No amount of food would ever be enough.

Professionals (dietitian, GP, psychologist, psychiatrist) can only assist you during refeeding, but the heavy lifting will be done by you. You need to take control of his eating and plate the food and serve it to your son. Do not take his preferences into account. 'Life stop until you eat' (LSUYE) is a saying on this forum. As is 'feedback not failure'. This is a very steep learning curve and took me nearly 2 months before I was able to feed her at home.

Please ask more questions and come here to vent as well. We understand!



__________________
D became obsessed with exercise at age 9. Started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. She is back to her old happy self and can eat anything put in front of her. Now working on intuitive eating.
tina72

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Reply with quote  #14 
"We paid for a dietitian way back in the beginning but he refused to engage because he deemed her overweight and therefore in his eyes obviously knew nothing about nutrition! Maybe I need to be looking at a psychologist instead of a dietician?"

Hi Haggis and a very warm welcome from Germany!

You do not need to bring him to a dietitian. If someone needs a dietitian here that might be YOU if you need ideas how to make him gain more weight in refeeding, not he. He should not be involved with that.

A psychologist could help you if he/she is doing FBT. If not, a psychologist could make more damage than help you. Many old fashioned professionals tell the parents to "not be the food police" and to back off because of his age. But at the moment you NEED to be the food police because he is not able to make good decisions.
So please try to find a FBT therapist in your region, that would be the best.
You can find them here: http://www.maudsleyparents.org/findtreatment.html

Tina72


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d off to University now 22 months after diagnose, still doing FBT and relapse prevention 
Ronson

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Reply with quote  #15 
Hi Haggis

I would make an appointment with your gp and get a referral to camhs - this is your best route for treatment in Scotland. Where it is an ed then the guidelines are you are seen quickly. Camhs will provide you with access to a dietician who has specialist knowledge in ed and who can assist with calorie intake etc. They will also be able to provide support in the form of fbt.

We are also in Scotland and our d is the same age as your son so if there is anything I can help with regarding our experience then let me know.

And my d initially was a healthy weight but they saw us anyway given her starting to restrict and her body dysmorphia so it shouldn’t matter that he is not underweight. If you get the right team at camhs they will know this.

I think if you can’t get anywhere with your gp you can self refer to the camhs eating disorder team - but we didn’t have to do this.



R
tammy

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Reply with quote  #16 
Hi Haggis,
We too are in Scotland but my son was much younger when going through this. He was only 8. There must be something in the water in Scotland! There have been a few people from here lately.
Please do not wait. Trust your instincts. My son was never classed as underweight but he had lost a lot of weight and had dropped down from the 95th centile to about the 70th on his weight chart. Your son is still growing and it is vital that he puts in weight as he grows. Gave you had his heart rate and bloods checked.
My son was not underweight but his heart rate had dropped really low and his mental state was terrible. Our GP was great and referred him to CAMHs. For eating disorders you will get seen pretty soon. Eva Musby has lots of information on her website about services in Scotland.
If you are in Glasgow you will get access to FBT regardless of weight. Unfortunately we were denied FBT originally as we do not fall under Glasgow. I fought for it and eventually we got it.
I did not wait though. I started refeeding using Eva Musbys book and videos and advice from this forum. They can become unwell so quick so you really need to tackle this. I know it is scary and you will get lots of resistance and his behaviour may shock you but it is worth it in the end. No amount of reasoning will help your son. You need to take control of food and it is non negotiable. Unfortunately I had to stop all his exercise too.
I now have my son back and he even commented last week that he loved food!
You can do this.
If you need any advice just ask.
Tammy
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