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

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Hi there,

This is my first time posting on this forum. Our 11 year old son was diagnosed with anorexia in May 2016. We knew something was wrong straight way, but like many parents we went round and round being told 'not to worry' and that it is 'just a phase'. Although he had only lost a few kilograms, his health deteriorated rapidly and he was hospitalised for a couple of days after my husband took him to the emergency department in frustration that he was refusing to eat. His heart rate was 36. Sadly, but thankfully, this meant that he became a higher priority in terms of treatment. His weight is now restored and he is doing really well physically, but mentally the AN still has a strong hold.

Until the start of this year, he was a happy, confident young man. He was due to change from primary to intermediate school in Feb this year and was quite anxious about the transition, which is fairly typical for most kids I'd say. Although we knew the school was not perfect i.e. it is very conservative and very big on rules and consequences, we thought our son would be OK as he is very conscientious, well behaved and studious. Little did we realise or appreciate the effect this school culture would have on him... He became extremely anxious about  doing something wrong and getting detention (although the chances of this happening were virtually zero!) and found the schools overwhelming focus on achieving, really stressful. His nature is to prefer more relaxed environments and to have a little fun. He was struggling to function and was getting up earlier and earlier each morning so that he wouldn't be late for school.  He had days where he was hyperventilating in the car on the way to school, because he thought he was going to be late for school! We were in constant contact with his teacher because he would become completely stressed if he thought he had done something wrong at school. He missed out on lots of opportunities in those early days, because just getting to school and making it through the day, was more than he could cope with.

We are sure that his anorexia developed as a way of coping with school and we are really interested in knowing if other parents have had similar experiences, as in all the reading we have done, we have not read anything about these sorts of issues? A friend's daughter who is recovering from AN has provided amazing insight in to her relationship between AN and school. She feels that her AN developed as a way of coping with a school that placed a big focus on achieving high academic standards and had a culture of bullying. She described to us a vicious cycle of using AN as her way of being good at something when she was struggling to cope at school. When school was tough to cope with, AN was her better friend. It wasn't until she left school, that she was able to step out of this nasty cycle and start to make head way with her illness. Now the common professional and society view about this sort of conundrum is that the child needs to learn to deal with these experiences, as they will come up with these sorts of experiences again in their lives! However, we disagree. There are schools out there that are gentler  and more caring in their approach and we feel that choosing a school that better suits our child's needs makes sense.

But it gets even trickier....at the start our son openly acknowledged how stressful he was finding school and that he wasn't enjoying it, but more recently, there has been a switch in this thinking. He has started saying that he likes school and hates being at home because we have to supervise him all the time. Since his weight has been restored, he has had more freedom, but he has kept this narrative up and even although he has just had a wonderful 2 weeks of school holidays (lots of fun and laughter and even him saying things like 'I've had a great day!'), he told his psychologist last week that he was hating the holidays and was looking forward to getting back to school, which we know is not true. We worry that the anorexia is driving him to feel that he needs to succeed at his current school and he seems to be really 'hanging on to his AN'. This is worrying his psychologist, as they feel like he should have made more progress. Meanwhile, we have found an alternative school that we are keen to move him to, but need him to be in a healthier frame of mind before we do this, so that he is able to make new friends etc. When we took him to look at the alternative school, he liked it and found it warm and friendly, but on the way home he asked in an AN sounding voice, 'are you and Dad going to make me change schools?' The voice was reminiscent of the voice that asks 'are you going to make me eat ice-cream?' which is really a code for 'I really want to have some ice-cream!'

We feel confused as the professional advice is 'don't change anything', but in our hearts we feel that this is what he needs. We are really interested to hear if any other parents have had similar experiences.

We are also in a high achieving school district which my kids have found anxiety provoking. We pulled my son (not ED) out of public school after 4th grade for many reasons. Looking back, anxiety may have been a factor. He was struggling with stuttering and tics (Tourettes?). We just felt like we could do a better job homeschooling him than the school district was doing. It was the best thing for him. There's a huge network of homeschooling opportunities out there. He hs'ed through high school and is a happy, successful senior in college in Aerospace Engineering. My ED d has hs'ed, public schooled, currently is attending a charter school that is extremely laid back and tolerant of all kinds of kids - like the island of the misfit toys, but it's where she wants to be.

There are so many options out there public, private, home all day every day, textbooks, online courses, unschooling, park days, co-ops, field trips, core and extracurricular classes, sports, clubs, scouts, church, science fairs, spelling & geography bees, chess club, swim team, formal dances, graduation ceremonies, yearbooks, 1-day, 2-days, 3-days, 4-days/week, Christian, Catholic, secular - you name it, you can find what looks like the right fit for your child THIS year. There is no need to settle for a situation that isn't healthy for him.

For elementary and middle school, as parents, we have done our best to look at the options for that school year, and we, the parents, make a decision for each kid, depending on opportunities, strengths, etc. As they get into high school, we give more weight on the opinion of the kid - what does HE/SHE want to do for high school and be willing to stick with for 4 years? 

With an 11 year old, research options, and ask him what he thinks and take his opinion into consideration, but ultimately you, the parents, need to make the decision. Stick with it for 1 year. Take it 1 year at a time. Next summer you can re-evaluate and decide again for the next school year.

Go with your momma gut feel.
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
From what I've learned from the doctors we worked with, ED's aren't "caused" by any one thing. It's a combination of personality (high performers, perfectionist), biology (a hardwiring in the brain), genetics (not just ED''s but other mental disorders, as well) and a triggering event (high achieving school, in your case). Badda bing, badda boom, you have the perfect storm. School didn't cause his ED it was the trigger and because he has a hardwiring for ED, if it wasn't school, it could've been something else. Also, ED's have a comorbidity with other mental illnesses so it's common to see anxiety, depression, etc. develop.

Our D didn't have anxiety until she was refed and then school was absolutely a stressor for her. She is WR but when her anxiety peaks, her ED still challenges her. That's my cue to get lots more calories in her and make some temporary adjustments to her anxiety medication. She has also learned a lot of distress tolerance skill to help with her anxiety.

Since our kids are so young, managing ED through adolescents seems to be a pretty long road. I hear that once their hormones level out, growth slows, and brain is better developed it's supposed to get easier to manage.

Having said all of that, I do believe that as a mom you have to make decisions for your son based on his own needs. For example, I believe that the Obesity Campaign has triggered a lot of ED's in our schools so my D is not allowed to take part in any nutrition discussion during health class. I want to protect her from a relapse. If you understand all of the facts and still have that gut feeling, then you need to be your sons advocate and do what you feel is best. Good luck!!
Daughter diagnosed with anorexia at 12 in 2013 without having any image issues/concerns about calories or exercise. Hospitalized - 3 days. FBT at home along with outpatient therapy - 16 weeks. Recovered/weight restored - 4 years. Still gaining and growing but has no hunger signs yet.  
Welcome to the forum Dungbeetle.  Here  is how my d's AN evolved and some observations about academics:

- Towards the end of summer break 2015, I noticed my d scrutinizing her body in the mirror and a growing negative self image - calling herself "fat" and expressing general dissatisfaction with her appearance.  She had already started to skip a meal here and there, but nothing alarming. 
- School started in September and academically things were more challenging than the prior year, but she had always been a great student (perfectionist) and she of course rose to the challenge.  
- Looking back I can see that she had quite a bit of social anxiety at the start of school trying to figure out where she fit in, how to relate to boys who started to show interest in her, and expressing fear of growing up and leaving her childhood behind
- She started restricting and losing weight, and although she became socially withdrawn and depressed during this time her concentration and academic achievements were excellent.  
- Coincidentally the school (per government guidelines) conducted BMI calculations on all of the students in her grade.  I recall my d comparing BMI and weights with her friends.  This triggered her to restrict further and added some fuel to the fire already burning within her.
- I noticed that as her weight loss progressed, she would vocalize how unless she was getting all A's she felt she was worthless - lots of comparisons to other students academic achievements.  
- By Christmas she had lost 23 pounds and was diagnosed with AN. 

As we re-fed her in January and February and she got back to her pre-AN weight and she became absolutely obsessed with schoolwork. She spent hours and hours on her homework.  I quickly realized two things:

1) at times AN used homework was a way to delay mealtime
2) she had a very hard time focusing and processing information because as all of her brain energy was being used to heal itself from the starvation it suffered!

After she was weight restored for several weeks, her obsession with academic achievement started to wane.  Her grades slipped a little bit at the end of the academic year and although she acknowledged it she no longer stressed out about it.  As her brain healed her focus shifted away from academics and toward growing her social circle, deepening her relationships with her friends, and a growing interest in boys [eek]

You seem to have a lot of great insights into your son's challenges.  I would say however that anxiety is a complex issue that can be driven by a variety of variables - social, academic, fears/phobias, etc.  Removing one trigger (school) may help in the short term but you may find that other triggers pop up in it's place (the whack a mole analogy).  I agree that our kids need to develop skills to tolerate distress but there are no easy answers when you're dealing with such a serious illness.  It's so hard to tell what he really wants or needs at this stage, but you know your son best.  If you decide to switch schools, perhaps it could be a temporary until he is recovered to a point where he can handle the academics at his current school?  Keep in mind there many here on the forum who have pulled their child out of school for a period of time to focus on recovery.  Best of luck with your decision. 

"Lineage, personality and environment may shape you, but they do not define your full potential."    Mollie Marti  


15 yr old d diagnosed with AN late December 2015 at the age of 12 after a 23 lb weight loss during prior 3 months. Started FBT/Maudsley at home on Christmas Eve with support from amazing local nutritionist specializing in ED and trained in FBT. WR Feb 2016 and pushing our way through puberty and rapid growth.
Hi Dungbeetle,
Congratulations on the progress you've made feeding and restoring your son's weight but sorry the ED thoughts are still lingering. It's a tough beast. I had a similar question when I first joined this site in the winter when my daughter's ED was new and raging. Everyone here told me I was wrong, school didn't cause it, ED is biological, what we needed to do was keep feeding. The ED psychiatrist told us the same thing (almost) so it's hard to refute all that wisdom. The folks here are absolutely the best resource and feeding was indeed the answer but I still think school was the trigger and she couldn't recover and go to school at the same time. We still haven't found a solution and she is doing online school getting good grades but moving very slowly. Maybe some other stressor would have brought ED on later. We'll never know but since school was such a big source of stress, we pulled her out to focus on refeeding and it took maybe three months to start eating more normally, about another month after that to be weight restored and today I felt comfortable leaving her at home alone to make her own lunch while I went out and she cooked, fed herself and served herself an ice cream. She eats fine now but doesn't go to school.

I don't know why it was so hard for her to be at school or why she starved herself to cope. I don't know why she felt she had to be so perfect or why it made her so anxious to be there. I still feel concerned that we reinforced the avoidance cycle by taking her out and she still needs to learn healthy ways to cope with stress but somehow it seems like it might have saved her from having the ED become entrenched.

I don't know the answer about changing schools but with a younger child, I think you have a bit more leverage and you can decide what is best for him and if you could reduce his stress by changing schools and work on health coping strategies, it might be worth considering.

In our case, I feel like we have the ED beast at bay but the school avoidance has become entrenched so I don't know if we are really winners.

Lately I have met a lot of parents of bright, sensitive kids who have trouble coping in school, especially high school. It is just not set up to meet the needs of every kid and some beautiful, special kids end up getting knocked around. We should be able to do better.

Best wishes with whatever you decide for your son and keep on keeping on.

My 13 yr old  D's story was similar, I knew something was going on, but kept being told it was a "phase." Took her to the Dr and HR was 36, took almost 3 weeks to become "normal."  They say she is "weight restored" but she had previously been overweight. I worry that she's not at the right weight for her genetic build.

Going to a new school was a stress for her, and I think that along with other things "flipped the switch." She wants to go back to school (hasn't been regularly since end of April) and I think it's truly because she wants normalcy. (She's in a PHP program 7 1/2 hrs per day) I am going to get a 504 plan to so that meals/snacks are supervised. She will be LIVID.
we also felt that issues at school were a trigger for our d's AN.  though for her we believe she was being bullied (though perhaps unintentionally), and has been influenced by a friend we deem to be a bad influence...she tends to parent bash and feeds into our d's social anxiety.
our d had pre-existing social anxiety, border-line depression and ocd tendancies.  she has always been a good student but had a hard time last school year due to friend issues and her own anxieties (which we are now working through along with dealing with the ed (with the help of a wonderful care team). 
our d is now excited to go back to school in September and the school is being very supportive in helping her to recover...they are allowing us to help decide the best teacher for her, are willing to supervise her eating and guaranteeing a good friend (not the aforementioned questionable one) will be in her class.  is it possible to discuss options with your son's school before deciding to make a change?  we were at the point of changing school's before discussing things and working out a plan which involved the teacher and principal of her school.  now that they know her situation, they are willing to help us as much as they can.
Mom Up North
Welcome to the forum. Sorry that you have had to find your way here. What a great job you have done getting your son weight restored so soon. 

My D also had difficulties at school as one factor in the development of her AN. I in no way think this caused her eating disorder. My D was always a moderately anxious kid. She was at a high achieving academic school from the start, but then she is also a high achieving academic kid. She had been coping well one year, then the next moving to a class where there was less friends, with a teacher she was not fond of she all of a sudden felt more distressed and struggled to cope. She focused a lot on the academics as being a cause of distress but in truth everything was really causing distress and anxiety. 

When choosing a school for her she had been very keen to attend this school. She did not want to change when her eating disorder developed although like you I considered moving her to a more relaxed school environment. She was concerned about making new friends as well as about not being resilient enough to cope with an academic environment. In the end she did not change schools, she did learn to cope with the stresses. She has learnt that the stresses she was experiencing were often internal stresses and has learnt that she needs to be kinder to herself and accept that you cannot control every result no matter how hard you work. 
D diagnosed restrictive AN June 2010 age 13. Mostly recovered 10 years later.  Treatment: multiple hospitalisations and individual and family therapy.
I think there are some really valid points of view being shared about schooling options. I would also like to add that we did FBT while our D was in an IOP facility and she was out of school for 16 weeks. I was anxious about her missing so much school but she was so sick there was no way she could've done anything else. In our case it was clear that she was way too sick to be in school and her health was first priority. However, if your son isn't experiencing a lot of pain and doesn't need to be on bed rest, it could be harder to make the decision for him to be out of school. Our doctors were in no way concerned about our D missing that much school because these kids always catch up quickly. They were totally right, too. She finished the school year out like no time was ever missed. Our state requires the school to provide a tutor for children who are too ill to attend. Perhaps you could consider taking him out for the time being and focus on health and then add a tutor back into the schedule or any combination.

Also, my D hated being at the Center when she first started and then towards the end didn't want to leave the Center and go back to school. Just like food, our kids don't always have the best judgement when their brains aren't healthy enough to know what they really need. It's difficult for us to decipher what to do. We eventually tapered at the Center from full day (6 hours) to half day (3 hours) and slowly added some tutoring into her schedule. Once she started back to school, we only sent her for a few hours a few days and worked our way up to full day. I went in at lunch to supervise for awhile, as well. These high performers tend to get stressed easily by school work but 3 years of recovery has helped her brain heal and handle the stress better.

I thought I would give you this as an option. It doesn't always have to be all or nothing. This was all done at the supervision of a team of doctors and it worked well for us. 
Daughter diagnosed with anorexia at 12 in 2013 without having any image issues/concerns about calories or exercise. Hospitalized - 3 days. FBT at home along with outpatient therapy - 16 weeks. Recovered/weight restored - 4 years. Still gaining and growing but has no hunger signs yet.  
Our stories are so similar! Our Son's anorexia was also triggered by moving schools, in our case from primary (3-11yrs) to Secondary (11-18 yrs). In his case he moved from a small village school which had 30 children per year, only 210 in all, with a creative curriculum and no male teachers, to our local boys secondary school, much different discipline measures and 220 boys per year. We totally underestimated the effect it would have on him as he was always a very confident, popular child. He found the new school so hard, he worried all the time about getting in trouble, also became obsessed with not getting a 'behaviour point' (he's had 1 in 2 years, this was not a concern for him!!) and very very distressed about the possibility of being late. One of the biggest changes he found distressing was something quite hard to pin down - the way the teachers spoke to the boys. He had been used to the way the female teachers spoke to the children in his old school - very nurturing, many were mums themselves, the school doesn't believe in shouting at children but talking to them about how to change their behaviour. Then to change to the all boys school where there is a lot of shouting and strict discipline and not a lot of discussion made him feel very very anxious.
However we didn't move him. We did try, but for various reasons haven't, the biggest being he doesn't want to. He refuses to look around any other schools and they won't take him without doing a trial day which he won't do. In addition I've never felt strongly enough that the way the school is, which yes contributed to his issues, was at fault. I don't feel that the way they do discipline etc is a bad thing - they have 1500 boys to control! They have also (albeit with pressure from us) made attempts to support him - a teacher has eaten lunch with him for the last 12 months, he has great support from his sport coaches, and since he self harmed in a school exam they have redoubled their efforts to provide him with emotional support.
He also has many supportive friends and is doing well with his school work.
I can't be sure we have made the right decision, but on balance we are staying where we are for now. This could change - for instance we didn't see the self harm coming.
Hope it helps to at least know you are not alone!
13 yr old son diagnosed April 2015 with Anorexia.
I think my daughters anorexia was triggered by a number of things and school was the environment where she was exposed to those triggers. We knew she wasn't happy at school before the anorexia took hold, she struggled with friendship groups, was stressed about keeping up with work and spent hours and hours on homework. When she was first diagnosed we had already started the conversations about perhaps moving schools and even went to look at a few with her. However, as she regained weight (far more than the 'healthy weight' the doctors suggested) and then did some CBT with her therapist about some of the things that were issues her anxiety and obsessiveness began to ease and our happy daughter came back. We decided that for her it was a case of 'better the devil you know' than risk a big change that unsettle her again. She still doesn't really like her school and still finds her friendship groups difficult but she has found interests and friends outside school that seem to help with this. She is planning to change school next year when she has done her GCSE exams. 
Mum to 15yr old daughter diagnosed with Anorexia in July 2014. Weight restored in Jan 2015 and 'in recovery' (whatever that means!) 'Tomorrow is always fresh with no mistakes' Anne of Green Gables