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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Rasm1

My daughter is 14 and severely underweight..after visiting the doctor we have been told today her BMI is below 15. She knows how thin she is and hates it, she doesn't make herself sick or anything but never appears to be hungry therefore only eats 1 meal per day..the doctor now thinks she's anorexic. Has anyone heard of this form of anorexia before?

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sk8r31
Rasm1 welcome to the forum, though sorry you have a need to be here.  One doesn't need to wish to be thin to have AN.  And not being hungry, certainly at this stage when so ill, is not uncommon.  

It is a steep learning curve after diagnosis, and there is a lot of great info on the main FEAST website.  I'd encourage you to start with the FEAST Family Guides.  What is the doc suggesting as a way forward?  Are you wanting to try FBT, or is a higher level of care needed to jumpstart recovery?  What other professional support to you have access to?

You can get nutritional rehabilitation going right away, beginning with 3 meals and 3 snacks.  If your d is only eating 1 meal a day that is not nearly enough, and the goal is to be eating every 2-3 hours.  You can try Life Stops Until You Eat (LSUYE) or Life Begins After You Eat (LBAYE), whichever might work best for your d.  In other words, no school until breakfast is eaten, etc.  And truly, this is a serious illness that trumps school if necessary.  Or you can try something like 'you can visit your friends/go to a movie etc after your meal/snack'.

Ask as many questions as you have; there is lots of great peer support here on the forum.  Sending warm support to you.  
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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Rasm1
Thankyou, getting lots of blood tests done tomorrow and encouraged to eat 2/3 meals a day for the next week so she can be weighed again. The doctor is then going to take next steps when results come back from lab. On a positive note, she’s not making herself sick or thinks she’s overweight, she does however hate how thin she is..
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scaredmom

Hello and welcome!

So sorry you needed to find us here. What you write is common with anorexia and her weight has to go up. Three meals and three snacks are a great way to do that. Once you start feeding her more, she may refuse and fight the food. That is where you need to take control and use incentives like school etc to eat. Like sk8r31 says above LSUYE or LBAYE! Eating comes first as it is her health and that is the priority.
Please note that there is no specific labs test or result that will give you a diagnosis of AN (anorexia Nervosa) The blood work will likely be normal unless she is purging and there are electrolyte abnormalities. 
We all wish to help you, please let us know what you need in terms of support.
All the best,


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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Rasm1
I think the blood tests are to make sure there is no other heath problems underlying..she has been very dizzy, tired and having small blackouts but again probably linked to not eating. She’s a very fussy eater which prob started all this and in time she has just ate less and less. 
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CED123
It sounds like your doctor is being proactive but it might be useful to know that in the UK you can ask to be referred to an eating disorder service - you don't have to wait for the Dr to decide that. The Beat website is quite useful on this point. And then I think they have to see you within 4 weeks, but as the lovely sk8r31 and scaredmom have said, you can start feeding straight away.  I would assume that the dizzy, tired and blackouts are linked to the not eating.

everyone here is so helpful with questions etc, do use them for help.
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sandie
Hi there,
this must all be very worrying for you. 

As CEd has said, the dizziness and blackouts may be directly related to her not eating and are really important to get checked out urgently. 
Poor nutrition can affect the heart. It is important that your D has her pulse rate and blood pressure checked lying and standing. This is really important part of assessment as some young people need to be admitted to hospital if their pulse is too low or if  there is a big difference in pulse or blood pressure lying or standing. If your gp has not done this, I think you need to have this done as soon as possible and from what you have said your D will need an ecg as well. 

Knowing what I know now, I suggest you bring your D to A and E tomorrow/ ask your gp for urgent referral to COmmunity eating disorder service. 





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Rasm1
Thankfully our doctor is great and said she will refer asap..She has also given an appointment for a weeks time to weigh her again and is going to continue with that weekly until someone from the eating disorder team can see her..everyone on here has been great, just wish I’d taken her to the doctor sooner. We are all slim so I guess I was just putting it down to her having same genes. I guess when you live with someone it’s harder to see what’s in front of you 
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Rasm1
Yes the doctor checked her heart today and had her pulse and blood pressure checked when she was sitting and then again as she stood up. 
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sandie
I hope that didn’t sound too scary RASM1. 
I know it is a lot to take in. 
A big hug to you. 
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Rasm1
Thankyou, everything on here has been very helpful and also reassuring that the doctor has already checked anything yous have mentioned. I was just shocked today when I realised her BMI was so low and I always believed anorexia was only those who thought they were heavier and made themselves sick so it had never even entered my mind before ...
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Mamaroo
Rasm1 wrote:
Thankyou, getting lots of blood tests done tomorrow and encouraged to eat 2/3 meals a day for the next week so she can be weighed again. .
Welcome from me as well. You already got some great advice. I would add that instead of encouraging her to eat, you REQUIRE her to eat. She needs to get into a routine of eating 3 main meals and 3 snacks every single day. You need to choose what she eats and how much. You can start with safe foods and top it up with supplements. It will be hard getting into the routine and it took us 7 weeks before all meals and snacks were taken (and then only as Ensures), but perservere and present each meal and snack with the expectation it will be eaten. This is a marathon, not a sprint and it takes time to gain the weight and a further 6 - 12 months after weight restoration (WR) before brain healing starts, so take care of yourself and give yourself daily breaks from ED. Sending you lots of hugs!!!!!!!!!
D became obsessed with exercise at age 9 and 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. View my recipes on my YouTube channel: https://www.youtube.com/channel/UCKLW6A6sDO3ZDq8npNm8_ww
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deenl
Hi Rasm1,

This is exactly the sort of restricting eating disorder that my son had/has. He never had very strong hunger cues and a difficult time in school meant he lost what little appetite that he did have and ate less and less. That, combined with a growth spurt that was not properly fueled lead to negative energy balance and was enough to flip the switch in his brain over to severe restricting.

My son never wanted to be thin or muscley, he did not have a fat phobia, nor did he have body dysmorphia. He was simply petrified to eat. I think in some ways this made it worse. He had the full knowledge and terror of dying, combined with the terror of eating. No wonder he was emotionally in a total mess and frozen in fear, unable to do anything.

When your teen has an Eating Disorder by Lauren Muhlheim is an excellent crash course in how to help get you child eating again and nutritionally rehabilitated. Eva Musby's resouces are really helpful. Check out this video, for example, and her website.

The greatest tool that we, as parents, have in helping our kids is knowledge. With the benefit of hindsight, I would suggest you try to read as much as possible, starting with the resources suggest in this thread. 

Just a quick word of warning on the basis that forewarned is forearmed. The terror our kids feel at eating can, at times, lead to extreme emotional reactions, especially as parents start insisting on 3 meals and 3 snacks a day. Most kids are actually relieved to have their parents take over the whole aspect of food (asking them what they would like just increases the anxiety and confusion so just serve what you are serving everyone else) but there can be an initial period of meltdowns, screaming, crying and even violence and selfharm. I don't want to scare you but as I say better to know it is normal than to be faced with it out of the blue.

It can feel that we are making everything worse but books Lauren Muhlheim's help us make plans and contingencies and to realise what we have to do and that WE are the best resource in helping our kids back to health. Please feel free to come back to us with any and all questions and for support or a simply to let it all out in a safe environment. It is a very difficult situation to be in and it feels terrible and unfair that our young kids are dealing with such a serious illness but yournger kids often have a strong recovery because they live in the supportive environment of home for longer.

Wishing you strength and courage,

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, food variety, begin socialising. Sept 2017, back to school FT first time in 2 years. [thumb] 2018 growing so fast hard to keep pace with weight
  • 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.
  • We cannot control the wind but we can direct the sail.
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Rasm1
Thanks for all the great advice on here. Back to doctors this morning for blood tests and they carried out an ecg aswel. Referral has now also been made to camhs aswel
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sandie
Great. It is so much to take in. When my D diagnosed last year, took a while to get my head around what to do. We had to stop all exercise including shopping trips to help her put weight on. It was so important to keep her out of kitchen when preparing food and serve her food on a plate. We had to change from all family helping themselves to plating  up for everyone. I learn not to discuss ingredients- just to say it is what you need. I had to forget preconceived notions about “healthy” food and cut down drastically on fruit and veg which just fill you up but don’t give the calories needed and I had to add oil, butter, double cream, grated almonds/nuts to food. Lots of people have found home- made milk shakes are valuable way to add energy. 
Xx
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