F.E.A.S.T's Around The Dinner Table forum

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Hi there
This is my first post on the forum, although I registered a couple of months ago.
DD, who is 14, "came out" about having problems with eating at Easter time, following which she has been having FBT at the local NHS clinic, and then been diagnosed as having depression and anxiety, being the root cause of her eating disorder.
She is receiving weekly therapy now, for her depression, anxiety and low self-esteem, as well as less frequent visits to the NHS clinic for FBT, which is mostly about monitoring her eating.
She is not very underweight, the problems are mental rather than physical.
My current concern is that, among her group of school friends (in fact, she is in more than one friendship group at school; they overlap like Venn diagrams!), there are several other girls with similar problems.  It seems to be a mini-epidemic and it seems to be getting worse, with one new case of anorexia over the summer and one already-depressed girl now exhibiting anorexic symptoms.
DD is very unhappy (it's only her first week back in Y9) as she feels she can't get away from it, and is talking about not being able to cope at school.  Other girls come to her with their problems, which has always been the case, but is very hard for her when she has similar problems but still wants to help them.
She is at a fee-paying all-girls school, which seemed to us like the best choice for her.  She has been doing very well academically, and made some good friends (although this took a while and they have come with their own problems), but her feelings about the school have always been varied.
What I am wondering is, could it really be the case that the all-girl teenage environment is a breeding ground for these sorts of problems, and might she be better off if we moved her to a local co-ed state school?  Of course the internet is full of newspaper articles suggesting that high-achieving all-girl environments are exactly the sort of place where eating disorders thrive, but what I don't know is whether things would really be better in a co-ed environment.  I went to an all-girls school myself, so don't know any different!
Does anyone have experience of moving their child to a different school and finding it a significant benefit?  I feel like we ought to hang on to see the benefits of the therapy, and this is likely to be a knee-jerk reaction rather than a quick fix, but it's so hard to see her unhappy and know what to do for her. 
D, b.2002, diagnosed with depression, anxiety and EDNOS Spring/Summer 2016.
Some restricting, some vomiting, some self-harm for good measure.
FBT, CBT, now on 3rd type of anti-d's.
D is "cured" of the ED but still on low dose of anti-d's. Will I ever be cured?

Hi cbmum, Welcome to the forum, and congratulations at having made your first post. I am sorry you have to find yourself here but since you need to be, you have found a place full of support and good information.

We live in a town where there is a private all girls high school for girls in grades 9-12, ages 14-18. When we first moved here, before my d was born, even, someone said to me 'that place is a breeding ground for eating disorders'. I never gave it much thought.

14 years later my d attended that private all girls high school. And was diagnosed with an ED. Though to be honest the ED was showing signs in late 8th grade, before she got to hs.

I don't know if it's factual that all girls schools are the sort of place where ED's thrive, but given the choice I probably would not have placed my d there if I had to do it over again.

If your d is not happy where she's at you might begin a serious conversation about whether she thinks she'd be happier elsewhere. It can't hurt and it may help. I know of girls who tried the private high school route only to go back a year later to their familiar public school surroundings and all worked out for them with regard to connecting again with friends.

All best to you, Francie


Hi cbmum, welcome to the forum, a place you hope you never need but one that will support you and offer amazing advice.

My D also goes to an all-girls school, a selective grammar school, and, like your D's school, eating disorders are extremely common.  I have often wondered if she would have become ill if I had sent her to the local comprehensive (which, incidentally, is where her brothers went and did extremely well).  All my D's friends seem to have either EDs or anxiety issues and I do honestly believe that her environment has at least partly contributed to her illness.  My D suffers from extreme anxiety and is really struggling to go back to school after 6 months off due to her AN.  She doesn't want to go back, isn't eating again and has so far only managed one lesson and a half hour tutor group all week. Like you, I just don't know what to do but my deep instinct is to pull her out of that school - but, irrationally, she also doesn't want that.  Her anxiety levels are so high she really just can't face any life outside of home and it may well be that we end up pulling her out of school completely for now.

Sorry, I have probably waffled a bit but what I am trying to say is that I do believe that a mixed-gender environment is healthier, with far fewer EDs and anxiety issues, so if your D can cope with the idea of change, I would move her now.  At the start of a year it is still relatively easy to settle in, with everyone in different tutor groups and classes having to make new friends.  

Good luck with whatever you decide.
Here's an alternative point of view. Eating disorders affect predominantly girls. They also seem to affect predominantly anxious/ perfectionist children. So you would logically expect more anorexia in an all-girls private school that is likely to attract high achieving parents and their similar children. It doesn't mean that the school environment caused the ED. However, if the environment is causing someone with an ED additional stress, then that is certainly an extremely good reason to consider changing schools/ removing from school.
My daughter went to a private, co-ed school which was fairly relaxed, but she has always been anxious and was anxious at that school.
Hi cbmum -

So sorry you needed to join us here.

My d is in a public school, and I can tell you that the troubled kids attract each other like N and S poles of magnets.

I can't tell you if it's worth considering a change of schools, but I can tell you that there are plenty of AN kids in the public schools, too. And, as I said, they tend to find each other.

There are never any easy answers, are there? xx

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

My d also attended and a private all girls' school.  It was full of high achieving, highly academic girls.  Eating disorders were rampant there.

It helped me to learn that eating disorders are biologically based brain diseases.  Your d did not choose to have it you didn't cause it. You can't catch an ED from being around someone who has one.  They don't know the exact causation, but they know that genetics play a big role.  It's not just the genetics of an eating disorder, but also substance abuse, depression, anxiety, etc. Typically (but not always), people are highly sensitive and highly intuitive and have had issues with managing their emotions are more susceptible to EDs.  As hyacinth pointed out, this personality type is usually going to be attracted to a high achieving school. EDs are always triggered by weight loss. I think it is pretty much a consensus now among evidence based treatment providers that the weight loss is the trigger and not the other way around. 

I think my d is a good example.  When I look back on it now, I can see that my d was always very sensitive and highly intuitive.  She would pick up on things that happened and things that were said or unsaid and internalize them.  Your comment about your d being the one that everyone looked to for help with their problems and how hard that is on your d personifies my daughter. I can also see now that she was anxious her whole life.  My h and I didn't realize it was anxiety, but I see it now.  We also have depression, anxiety, substance abuse on both sides of our families.  I told my d her genes stink. Looking back on it, had I known, I would have gotten my d skills based therapy to learn to more effectively handle her emotions. Instead, my h and I just tried to minimize stresses for her and control her environment.  Of course that really never works and becomes completely impossible as they get older. Plus, in the real world she has to learn how to handle things not working out the way she wants without is destroying her.

She developed anorexia just as she turned 17 I think, but it took about 4-5 months for me to figure it all out and seek treatment. My d was also not hugely underweight, but her weight was very wrong for HER body type and based on her lifelong and predetermined weight range.  It was hard for me to see it as that for a long time - like a year as we tried to deal with her emotional issues.  We really made no progress until she got back to her weight range her whole life which had tracked about 75th percentile. Don't underestimate the damage that can be done to the brain by improper nutrition.  I only say that because I did.  Are you familiar with the Minnesota Starvation Experiment?  that was a real eye opener for me.  Google it and you can read all about it.  Healthy men developed eating disorders as a result of a starvation experiment at the close of WWII.  It was SO helpful to me in realizing what we were up against.

What worked for us was getting my d back to HER right weight range.  It is often higher than you think and always higher than what they want.  Once there for awhile we saw high improvements in her mood. (She had been suicidal and panic attacks for over a year.)  However, she did then need that skills based therapy to learn to handle those emotions. 

Now back to your original question.  Chances are things are going to be tough for your d as she is normalizing her weight and nutrition no matter where she goes to school.  My d had to miss the better part of two years and work with a tutor because of her eating disorder and the resulting depression and anxiety. My d also experienced a lot of social media bullying as a result of her ED.  She was the sick, crazy girl at her school - who was never there.  It's kind of funny when you think about because there were lots of sick girls.  The only reason I think my d would have maybe done better had she been at a large co-ed school is that her very public struggles would not have played out on such a small stage.  I really don't know though if it would have made that much of a difference. Does that make sense?

In the end, my d had to learn how to handle it all.  She is at university now out of state and of course EDs are rampant there too as is just too much diet talk.  My d needed to learn that other people might diet, but she never can in order to maintain her recovery.  For her, healthy eating is all foods in moderation and moderate exercise. It's all about balance, which is all the more challenging when you have always looked at things as black and white. Eventually your d will have to be able to handle it, but it was the case for my d that she needed to pull out of that environment for a while in order to recover and build skills before she could manage it.

Good luck to you as you move forward helping your d.  You will find amazing support and knowledge on this forum!!!

Enjoying my 23 year-old daughter's achievement of active recovery that was made possible by the resources and education I found on this forum.

Don't give up hope!
Hello,I would have to agree with Torie we are at a coed public school here in Australia and it just seems wether it be an Ed or anxiety based illness my daughters friends all seem to have their issues.Like minded, low confidence,kids seem to draw one another like moths to a flame.
I do remember reading an article which stated that the highest incidence of ED's in the UK was found in the independent girls schools.  This could possibly be to do with the characteristics of ED's being high achievers etc though.  My d went to an independent coed school and there were three girls in her year with ED.  We ended up with d being tutored at home with a tutor coming from her school.  Have you spoken to the school about the problem as they may not be as alert to this as you.
Thank you all for your kind words and wisdom; it's a big help.  I should come here more often!
I think I believe, deep down, that DD's depression and ED haven't arisen because of where she is at school, whether the all-girl environment or the private-high-achieving side of things.  It's reassuring (in the wrong way) to hear that both state/public schools and co-ed schools also have their share.
That's not to say that she still might not be better off, given the state that she's in, making a clean break with this school and starting at another.  I just think that move would, in itself, cause so much upheaval, and possibly still lead to her gravitating to (and attracting) other girls with problems.  I also worry that it would be bowing to what she wants (she really wanted to go to our catchment, not very good, state school, with her best friend who has anxiety and an ED herself - that's not going to happen) but not solving the problem.
The school are completely informed, and the school nurses have been great.  I am reserving judgement on the Y9 heads and tutors, as they haven't covered themselves with glory this week, but we're only 4 days in!  Apparently one of the tutors gave DD and a friend a lecture on healthy eating yesterday, when DD was trying to persuade her friend to eat lunch (having, she says, already eaten her own) - surely lecturing someone with an ED about healthy eating is like lecturing someone with a broken leg to go running!
Hey ho, another day today.  Nobody said parenting would be this hard...
D, b.2002, diagnosed with depression, anxiety and EDNOS Spring/Summer 2016.
Some restricting, some vomiting, some self-harm for good measure.
FBT, CBT, now on 3rd type of anti-d's.
D is "cured" of the ED but still on low dose of anti-d's. Will I ever be cured?

My d's first symptoms, long before there was any sign on the growth chart of an ED, surfaced when she was homeschooling. If she had been schooling outside the home, I'm not sure that I, or anyone else, would have noticed. 
When she went to public school 5th grade, her weight dropped, but we didn't catch it as anything to worry about.
Homeschooled again 6th grade, and she gained more than ever before. We figured getting ready for the big teen year's growth. They have to grow "out" before growing "up".
Back in public school in 7th & 8th grade, weight dropped, we didn't catch it.
She was miserable, and wanted to attend a charter school.
Beginning of 9th grade at the charter school, she was at her lowest - BMI = 16, is when we first caught it.
I hear the local public school is rampant with ED kids, possibly due to the strong emphasis on sports and overall competitiveness.
My d tells me everyone at her charter school is ED; nobody eats lunch. Very few of the kids are receiving any kind of treatment for it.

So, I think it's everywhere. We're at a point of asking her where she feels least anxiety and best able to make modifications to help her eat. She chooses the charter school. It's not the best place, in my opinion, as I think every kid at that school has issues, and they all mix and mingle and get ideas from each other, but here we are.
d=18, R-AN, Generalized Anxiety Disorder. Refed at home with information gathered from this forum and lots of books. Relapsed. Refed. Relapsed. Refed. 17 sessions with an excellent individual therapist. 19 sessions with unhelpful dietician. 3 sessions of DBT (didn't like it). Psychiatrist available if needed. Prozac - fail. Lexapro - fail. 5HTP - fail. Clorazepam/Klonopin = major improvement, only used when necessary. Genomind SLC6A4 short/short - not able to process SSRI's.
d=15, lost 14 lbs in 8 months, Ped [nono]diagnosed as a crystal on a hair in the ear canal

This thread is actually making me very uncomfortable.
Eating disorders are not contagious. You cannot choose to have a true eating disorder.
Kids not eating lunch in high school may well be " disordered eating" but it is not an ED. When I was in high school in 1988 a lot of people didn't eat much for lunch or had Diet Coke and a candy bar. I myself went on a zillion diets, I remember the " broccoli hotdog diet" I did WITH my dad.... And I did not get an eating disorder.

When my daughter got sick in 5 th grade she had a large group of friends. We kept things private as long as we could but when the parents got wind that my daughter had anorexia, a few of the mothers were telling other mothers not to let their girls hang out with my daughter. It was incredibly, horribly painful for my family.

There may be statistically more EDs in an all girls private school. I could see that. Like stated above the statistics show more girls get eds, that their are some common traits etc. But you know what? My daughter had ZERO of those stereotypical traits. And my other daughter has a lot of them and never has had an ED.

As I try to fight the stereotypes and wrong information that the common person has about eating disorders, discussions like on this thread to me are dangerous.

Eating disorders are not contagious.
Persistent, consistent vigilance!
When I sit in the waiting room in adolescent medicine at the children's hospital for our state I realise that anorexia doesn't discriminate by culture. Ethnicity, religion, socio-economic status or school. There are 10:1 ratio of girls to boys. All the parents look as exhausted as each other, although some of us have been on this journey for different lengths of time.
Mum to 17yr old girl with AN. Fighting hard for recovery since she was 13.
Discussions like this are NOT dangerous.rather, they are a way of people discussing things that are often taboo to even think about.anorexia has many trigger points and no one-no one- can say for sure what tips people over the edge from a disposition towards having an eating disorder to actually having one.
They are biologically based mental illnesses but his they are activated is different for each sufferer.this never means discussion shouldn't happen, even if it makes us uncomfortable.its better for people to get those feelings out and for it to be actively discussed here bringing everyone's viewpoints into the mix.
I don't need to be told what to think, or for rational discourse to be in any way shut down.i am clever enough to work out what I need from here by myself.
My d is another girl who went to a semi private girls school, as does her sister.one has an ed, one doesn't.they both have slightly different attitudes to learning, one is an internaliser and one is an externaliser.their friendship groups are very different too.external factors do matter-just not as much as we wish they did.if it was that simple eh?
In the end this illness doesn't care but we still have to work through how we feel and rid ourselves of blame gradually.this feels like a good discussion to work through some of those self blame issues that many of us on here struggle with.
Strength to us all in the journey,
There is another important aspect to anorexia nervosa in particular which frequently gets ignored.

Apart from the brain's genetic wiring and perfectionist tendencies, the person has usually inherited physiological traits which facilitate the illness too.

My husband was not very sensitive to hunger cues and could have breakfast and then survive on coffee and cigarettes until late evening when he would eat a huge dinner if he wanted it.  I simply cannot go that long without food and function.  I feel physically sick, I would have to sit down - my stomach does not tolerate going without food.  On top of this I tend to 'comfort eat' when stressed.  When a case of anorexia presents in a child - you often find that one parent has a response of stopping eating when worried, or can go long stretches without needing to eat.  That tendency needs to be present as well.

I remember trying to get my weight right down so I could get into a skirt I really liked.  I starved myself for about two weeks, felt wonderful but realised I could not live my life like that and decided I had to go back to eating in a way I enjoyed.  If I had the tendencies at that stage I could have been triggered into an anorexic route, or been so hungry I went on to a binge.  I just wasn't like that.  I just went back to eating normally.  

On the other hand, my d inherited the family depression and does best when she takes an ssri.  So there are so many other factors besides perfectionism and high-achieving tendencies. I think I have slight body dysmorphia too - so that probably came into the picture for my d as well.  
Believe you can and you're halfway there.
Theodore Roosevelt.

To go back to your original post:

'the root cause of her eating disorder'

This expression, more than any other, is where the danger lies and has been responsible for poor treatment interventions and outcomes for eating disorders over the years.

The 'root cause' could probably be described as malnutrition of the brain which, for susceptible individuals, triggers eating disorder illnesses.  Which is why successful treatment has to be about getting weight back on and a nourished brain, and equally for bulimic or EDNOS patients, preventing b/p cycles, as this plays havoc with the heart but also the brain is affected.

But Dr. O'Toole at the Kartini clinic stated, fairly recently as I remember, that although eating disorders are much better understood, clinicians and scientists still don't really know why they occur.
Ultimately, what stops the brain from 'kicking in' and ensuring that a patient eats - what biological reason could there be?

Believe you can and you're halfway there.
Theodore Roosevelt.
melstevUK wrote:
To go back to your original post:

'the root cause of her eating disorder'

This expression, more than any other, is where the danger lies and has been responsible for poor treatment interventions and outcomes for eating disorders over the years.

Agree. A while back, they used to look for the "root cause" of autism, schizophrenia, etc. by scrutinizing the family (read: moms) for signs of refrigerator mom, etc. Didn't do a hill of beans good, and did a good deal of harm in the process. 

The ED professionals will get there, eventually. xx

"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
I think we got a bit off track and so want to focus on where you said your DD was unhappy and feeling she could not cope with the way things are at her school.
Regardless of what else is going on with the other girls, your daughter recognizes this isn't a healthy or helpful environment for HER right now.

I do believe that her environment now that she is battling ED is important to evaluate. For whatever reason, she is expressing to you it is challenging. I wouldn't worry out statistics, I would be attentive to her concerns. I feel you are fortunate at this point she is able to voice her struggles and concerns because often ED won't let someone openly speak up or fight against it.

Two years ago I started as an after school sitter for a family. After dealing with my s anorexia, I noticed the 11 yr old daughter would bring home her lunch not eaten and she had other red flags that she could have an eating disorder. When she would have friends over after school, they would all have a snack but she would play with hers and not eat it. On other days I could get her to eat one. She was usually very hungry after school because she hadn't eaten lunch but had "rules" she insisted on. Also I noticed every time she had to eat in front of these friends, she would pretend to eat but not eat. I mentioned these things to her parents who weren't concerned, saying she'll eat when she gets hungry enough. But I was concerned.
She also complained that she was so short and never grew. Now I didn't know this family well but I knew that this wasn't a healthy thing. So I started adding to her diet as often as I could, bringing extra snacks to eat in the car ride home, adding extra butter/oil//cheese to her portions, etc. She and I had battles over her eating.
She changed schools the next year and is at a totally new school. The school tuition includes a full cafeteria with tons of lunch stations and options, all you can eat. The kids there are excited to eat lunch. She still is a picky eater but her "rules" have disappeared and she is enjoying eating now what she does like. . Before, even if she liked it, she was worried about eating it.
I can say that the lunch environment/peer pressure made a huge difference for her not only at school but her overall outlook on food as well. The new school made a difference. She grew two inches last year! She still is on my radar to watch for signs but I feel like she came dangerously close to going over the cliff while at the school where it was not cool to eat lunch and much more overall anxiety.

We were told that when it comes to ED, life stops, and that becomes the number one priority. So I think if your daughter is telling you this is too much for her as far as dealing with her ED, I'd stop life as it is and take a new direction.

(Just my opinion)

(edit): new direction does not necessarily mean you have to switch schools. It could just mean you have to change where and with whom she has lunch.
Very true quillingbee, we did get off track.

I moved my d from a private girls' school to a local state school for the last school year and she had a really happy year.

However her cousins and a few friends were already at that school, and she also finds it easy to socialise and make new friends.

So if your d is unhappy at her present school - does she have a school to which she would like to move, and is she mentally strong enough to cope with an environment where she will have to meet lots of new pupils?

I would not hesitate to move her - provided she feels able to deal with the other challenges that moving to a new environment will bring up.

Believe you can and you're halfway there.
Theodore Roosevelt.
Mixed feelings about this one. If a child is unhappy at school and has an eating disorder too - could it be the case that a child with an eating disorder is unlikely to be happy while they are ill because they are ill, regardless of the school.?

Having said that , I can relate to the idea of what could almost be described or thought of as a mini-epidemic at a school - it was certainly the case in my Ds all girls fee paying school, with about 10% of the year with ed related issues/ depression/anxiety and probably 5% becoming very ill . I also know That I saw children from all kinds of schools when my D was in treatment.

I do believe that an all girls environment can be ferociously bitchy, competitive and difficult - if you are not feeling particularly good about life or yourself it must be hard. It is also very hard to "go back" when you have been ill if your peers know what was wrong. They do scrutinise , compare and gossip , bullying is subtle If you are different (unwell makes you different too)and the cliques and groups shift and change at this age too. The ED doctors we saw also said that they saw "a lot" from her school.

I removed my D , facilitating her coming to that decision herself by gradually lining up other possible options and then telling her "you don't have to go there actually - there ARE lots of other options too". The move was not without its problems , she had been badly hurt by the bullying, it had made her very anxious , and she missed a lot anyway through illness . The eventual new co-ed environment was considerly less pressurised , less competitive and far less bitchy and she found she could always chat to the boys anyway. She had to take her time, had time out, her health was number one priority above everything else. It took a while . It was interesting to see, for what it's worth, that her eventual results were really great - at the very least just as good - probably better , than what the so called "brilliant" school does, but without any of the school pressure at all ! Food for thought....
Hi cbmum,

   My daughter started exhibiting signs of ed when she was in eighth grade at a small private co-ed school.  We then moved her to a slightly larger private co-ed school for high school.  The ed was in remission for a few years but came back with a vengeance in the spring of grade 11.  It didn't seem to be brought on by the other girls in school, but it was more because of anxiety and the pressures my daughter put on herself.  After spending the summer at a residential ED facility, she decided to try an all-girls college prep school.  She is again floundering.  If your daughter is happy at her school, perhaps it would be better to not add any more stress for her to deal with.  There are kids with problems no matter where you go.  If the staff is caring and supportive, then this might be the best place for her.  Good luck!

Hmmm - I agree that this one is contentious. My d is also at a private all-girls high school, and they openly admit that they have higher than the national average of girls with eating disorders, but they also have higher proportions of high achieving, perfectionist girls. So I don't think there is cause and effect here. My d has always been happy at school, but I do think her competitive, perfectionist nature has been challenged at the school as she went from a state primary where she was head and shoulders above her peers academically, to an environment where she was among equals or better.

Don't get me wrong, in the early days h and I often asked ourselves whether choice of school had some influence on her illness, but I've since come to realise that her self-esteem was low before she started there and my h had a disordered eating pattern as a teenager (he was never diagnosed with an ED) so the genetic link is there too. I truly believe that we would have had the same outcome regardless of school.
My son goes to our local comprehensive and got an ED. It is all boys, very competitive in the top sets, sporty, but it's just the nearest local school. However I am sure there are plenty of boys who aren't in the top sets, maybe don't drive themselves hard like he does, don't get into all the first teams or don't even play sport. We didn't send him to a grammar school because I didn't think it would suit his personality. Made no difference to him developing Anorexia. Tbh that perfectionist, over drive to over achieve at his own detriment is within him, and it's that that we are trying to get him to recognise and change through therapy. The school did tell us that he's their first boy with Anorexia ever, which I do query out of 1500!

We have thought about changing schools to a small private school with a big emphasis on pastoral care but he doesn't want to move. If he did I think we would have done so although my instinct is that he would have taken his problems with him.

Does your daughter want to move? If so yr 9 is probably your last chance before they start GCSE's so maybe a good time?
13 yr old son diagnosed April 2015 with Anorexia.