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

Welcome to F.E.A.S.T's Around The Dinner Table forum. This is a free service provided for parents of those suffering from eating disorders. It is moderated by kind, experienced, parent caregivers trained to guide you in how to use the forum and how to find resources to help you support your family member. This forum is for parents of patients with all eating disorder diagnoses, all ages, around the world.

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DR
Hello, my wife and I are in need of advice.  We both believe our 22 year old adult son has an eating disorder.  For background he played football in high school as a lineman and was on the heavy side weighing 250 lbs and is 6'4" tall.  After high school he went to college and began losing weight - - he counts calories and diets and runs regularly.  We have noticed in the past year that he has lost alot of weight, can see his ribs through his skin when takes shirt off and he is likely 170 lbs now.  His face is very gaunt. We think he purges his food after meals, because after every meal when he is home with us he goes to the bathroom and in some cases we have seen food particles in the toilet.  We have also seen boxes/wrappers of sweets under left under his bed when he visits.  Family and friends have commented on his weight loss and if he is alright. He does not live with us but visits us on weekends a couple times a month.
 
He has a twin brother who was a college athlete and although they get along, my son has always been jealous of his twin brother's physique.
 
My son is extremely bright, excelled in academics in college, and is doing very well in his first job after graduating. He is also very sensitive and thin skinned.  He has a strong religious faith.   He will almost assuredly deny that he has an eating disorder, but we see all the signs.  He is also very money and time sensitive and would likely balk at going to any kind of therapy.
 
My wife and I are very worried.  We want to know what the best approach would be in this situation and how to even bring the issue up to our son who we love very much.
 
Please feel free to share any advice you may have.
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Enn

Hello and welcome!
I do hope you find the information you need to help your child.
This is a good tool  https://www.feedyourinstinct.com.au/
Parental intuition is usually  very good. I would strongly suggest that he see a medical doctor to get a proper assessment. I would let the doctor know first that you are concerned about an eating disorder and I would ask them to read up on them prior to seeing them. Many are not well trained and they are not as common an illness so the doctor may not have seen many or missed some as they were not fully educated on how to detect them.


The doctor needs to do lying and standing blood pressure and heart rate.
if there is a significant drop in BP or very low heart rate, that may be hard as he is an athlete and may have a low heart rate to begin with - but nevertheless if less than 40 he needs urgent medical care . Also if the heart rate is very high he may also require urgent medical care. 

We all understand what your are feeling. We hope we can help you move forward, but first you need a diagnosis . Write all the behaviours you have seen for the doctors and write all your questions down too. That way if you become overwhelmed you will have your questions so you don’t forget. 

Write out all the answers too. It will help when you play back the meeting and conversations in your mind.
I am sending you courage and strength and hoping for quick forward movement with your professionals .
Strike now please, don’t wait. If you feel there is something wrong you are probably correct.

When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Enn
I understand how hard it may be to get him to go to the doctor as an adult and yes he will likely balk at your concerns . Would you or his brother be able to coax him, or can you just say that he should get a check up
as it may have been a few years? 
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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LaraB

Hello @DR, welcome to the forum. i am sorry you have had to find your way here . you will get very good advice here from people with a wealth of experience.
I have a daughter with an eating disorder. She is a teenager so I cannot give personal advice about a young adult. From what you describe, there are lots of worrying signs of an eating disorder, and I think you and your wife are right to be concerned and to want to gather information and take action. 

there are some very good resources on the main FEAST website. This is the link. If you click on the “I need help” tab, you will be brought to resources page. There are useful links about warning signs of an eating disorder and also one on what parents can do.  https://www.feast-ed.org

Your son has lost a lot of weight and needs a medical evaluation. The doctor should check blood pressure and pulse lying and standing after 1 minute and 3 minutes, as eating disorders can affect the blood pressure and pulse. 
I know others will be along soon with more advice. 

 

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DR
Thanks for the advice so far.  One thing that is frustrating is when he had a recent physical exam his doctor told him his weight is fine.  I hate the BMI index that is out there.  What if his blood pressure and pulse are fine?  What other things should we ask the doctor to look for?  Does an eating disorder contribute to hair loss?  My son seems to have lost a lot of his hairline in past two years.  Many thanks to everyone for your comments
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Enn
Yes  the BMI is flawed. I would discuss the rapidity and amount of weight loss he has suffered and the behaviours are more telling than the weight per se.
Yes hair can be lost but it is more diffuse.
If it ‘male pattern’ hair loss that can be genetic. It depends what it looks like on his head. Clumps of hair loss and generalized thinning is consistent with Telogen effluvium which is common with eating disorders.
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Foodsupport_AUS
Welcome. Sorry that you have had to come here. Trying to convince someone with an eating disorder that they need to seek treatment is often very, very difficult. Denial is common. These illnesses often hide in plain sight. 
The degree of weight loss and rapidity along with the other behaviours all sound of concern. Unfortunately so many doctors and other professionals don't understand that you cannot determine health based on body weight, nor many other single measures. 
Learning as much as you can about ED's will get you into the best position when you are trying to get your son into treatment. 
There are a number of suggested strategies - these include discussing your concern with your loved one about things you have observed, in particular behaviours, not appearance. Making a note of them, to raise can help. Letting him know that you are concerned for his health because of these behaviours. If money is likely to be a preventative barrier, sometimes removing that as a barrier could be helpful. 
Is there anything that you think could be used as a strategy to help him move forward - for example concerns about how his behaviours may affect his ability to work, to do things in the future?
D diagnosed restrictive AN June 2010 age 13. Initially weight restored 2012. Relapse and continuously edging towards recovery. Treatment: multiple hospitalisations and individual and family therapy.
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DR
Thanks, I am most concerned about my son's short and long term health.  His work is not affected by this.  I am very interested in anyone's advice on how a parent should bring the subject up with their adult son/daughter.  My son can get very defensive and I want to prevent that if at all possible.  I am also interested in how to ensure his doctor would handle this situation properly if we are able to get our son to visit his primary internist.  Many thanks for any advice anyone can share.  Thank you
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melstevUK
Hi DR,

Sorry for what you are going through.  Most parents are spot on when they think that an eating disorder has developed.  At first there is an inkling that something is wrong and then it suddenly becomes very obvious.

So often patients are in denial - especially initially.  My own way of dealing with difficult conversations is to inform the person that I want to speak to them, that they may get upset or angry, but I ask them to stay calm so that I can say what I need to say..  Warning the person about the difficult subject matter gives them a chance to calm themselves first.  I have used this technique with teenagers with behavioural problems and it always worked well. This might work with your son if you are anxious that he may storm off when confronted.  
Believe you can and you're halfway there.
Theodore Roosevelt.
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LaraB

hi
it may be helpful to share the purple book with the doctor. See at following link:

https://www.aedweb.org/resources/online-library/publications/medical-care-standards


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Foodsupport_AUS
As per MelstevUK he is going to get upset, and probably angry no matter what you do. Giving a warning that a discussion needs to be had can be a good idea, though of course he may just work to avoid the conversation. 
These sites https://nedc.com.au/support-and-services-2/supporting-someone/what-to-say-and-do/
and here https://mirror-mirror.org/getting-help/talking-to-someone-with-an-eating-disorder
will give you more of an idea. 
D diagnosed restrictive AN June 2010 age 13. Initially weight restored 2012. Relapse and continuously edging towards recovery. Treatment: multiple hospitalisations and individual and family therapy.
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LaraB

there is some practical advice here on how you can start a discussion about an eating disorder with someone you are worried about. 

https://www.beateatingdisorders.org.uk/supporting-someone/worried-about-friend#worried-about-someone

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DR
Thank you everyone.  Really appreciate your advice!
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jcutch

Even though his “weight was fine” at his recent physical, you pointed out that he had lost over 25% of his weight. I think that is significant. Many Health care providers may not recognize the eating disorder in him because it does not fit with that stereotypical model that they were taught. But, eating disorders can present at any weight and the symptoms you describe with your son certainly sound concerning. It may be harder because he is a young adult already but hopefully you can convince him to be evaluated. Do you know the internist? Maybe you can talk to the doctor before the appointment or maybe your son would allow you to go with him. Regardless, you and your wife know your son best and you may need to seek out other help if your local medical provider Isn’t able to help. 

 

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mommiful

Hi, DR,

 

As a parent of an adult child with anorexia, I would recommend some of the many resources by Tabitha Farrar. Tabitha recovered after living with anorexia for a decade, and she has a lot of materials that seem to really connect with adults with eating disorders. In her podcast episode Recovering when you’re a no-nonsense guy who totally doesn’t have anorexia but has some sort of a problem, she interviews a young man who had recently gone through the process of realizing that he has a problem, and that it’s an ED, and deciding to recover. A lot of her short YouTube videos also address adults who are wondering if they have an eating disorder or on the fence about whether to recover. You might want to take a look at some of these to see if there’s anything your son might relate to and try sharing/watching together. Tabitha also has a blog post for parents of adults with eating disorders that touches on how to get them to accept help. (One caveat on Tabitha's resources: She recovered without professional support and considers that for some people recovering on their own can be the best option--but only if they actually do it. This is a pretty controversial stance in the treatment community, since people can use this as an excuse not to engage in treatment. Anyway, Tabitha doesn't exactly advocate for recovering on ones own, but she does sometimes mention it as a possibility.)

When you do broach the subject, you may be surprised and find that your son is actually partly relieved that you have brought it up. Although many people with anorexia are not able to recognize that they are sick, that experience is far from universal. For some people it's more like a difficulty in admitting just how sick they are, and others see that they are sick and are too terrified to admit it to anyone. By raising your concerns with him, you are being brave for him and giving him the chance to share his fear with you. That might come out in the form of lashing out; try to remember that it comes from fear.

It might also help to consider what you want to ask of him for starters. Maybe to make an appointment with a physician who is familiar with the AED medical guidelines LaraB linked to and to, at the very least, inform the doctor that he has lost that much weight and his family and friends are concerned about an eating disorder? Maybe to sign a release for the doctor to speak with you? Maybe to take a look at some materials you have selected? 

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MKR
Hi,

Very good advice above.

I may just add (though this applies to start of treatment, rather than broaching the subject) "less is more". We were told by our therapist to treat it like a hostage situation, keep the dialogue simple.

And don't forget compassion! I see you have buckets of love to draw from ❤.

You are very caring parents, he is lucky to have you on his side.

All the best,
Mum's Kitchen

14-y-o "healthy living" led to AN in 2017 and WR at 16. Current muscle dysmorphia.
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DR
Mommiful - this is great advice.  I really appreciate your sharing this.  Many thanks!
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Torie
I just want to add that a dentist can sometimes play a role in cases involving purging, which is very damaging to teeth.  If you can get him to visit a dentist, you may want to tip off the dentist about your concerns re. purging before your son's appointment.  Although the dentist is legally prohibited from sharing medical information about your son with you, the reverse is NOT true, and the medical professionals are free to listen to whatever input you may wish to provide.

In general, ED sufferers are bafflingly, maddeningly indifferent to adverse health effects of ED.  There are a few exceptions, and teeth may be in that category - he may really care about the possibility of losing his teeth.

He also needs to have his potassium level tested if possible.  I'm not sure if the dentist might be willing to order that or not.

Please let us know how you and your son are doing.  Best of luck xx

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