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Restrictive eating in teenager

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#1 me-n-b

Posted 12 November 2019 - 10:58 PM

Sorry, long post..
DD 13 has been progressively getting more restrictive with her eating, to the point now that she is eating a very small amount of chopped watermelon for lunch, minimal breakfast unless forced and a small serve of dinner. This has been brewing on and off for some time but it seems to have escaped me just how bad it is at the moment. She admitted to me tonight that she has forced herself to try to vomit a few times after eating which I didn't know about. She also regularly weighs herself and I notice her all the time looking at calories on food labels. She also manically exercises when she thinks she's eaten too much. Her reasoning for this behaviour is that she is afraid she will get fat, thinks she is overweight and wants to be skinnier.
She is tall and slim but doesn't look obviously underweight and isn't tired. She does group fitness classes at school twice a week and has the energy to get through them and walk 20 mins to and from school each day. I did her BMI a while ago to show her she wasn't overweight and she is slightly underweight on that. Also her period this year has been off more than on - I had assumed because of her exercise and it did come back after she had 5 weeks off for holidays.
She has always tended to be quite anxious and does tend to fixate on ideas but previously i have been able to talk her through. I'm concerned about this though and feel like I need to do something more than just talking to her myself but unsure what is the best way to proceed. I am cautious about making it into more of a thing if that makes sense? She has a funny personality that you need to approach things a certain way to get buy in and other approaches can make things worse. She has said she doesn't want to go to the doctor and just wants to talk to me about it. But I'm not winning. We had a big talk tonight and I've given her some strategies and a little time (as in a week) but she is struggling to see that this is a problem and I'm not convinced she'll follow through. I actually think we'll go and find that she has quite significant anxiety and maybe she can get some help for that too.
So what do you think? Doctor for advice and referrals? We don't actually have a good doctor and I am mildly worried about this being on her record for ever more. As in previous review for a feeling like she couldn't breath was put down to anxiety and not investigated because she was a tweenage girl I assumed - they might have been right but I think it was a post viral thing probably made worse by anxiety. Also, not sure if it's better to leave her in the waiting room while I talk to the  doctor first if she's really reluctant? Do I ask for referral to child mental health service? counsellor? Psychiatrist?

#2 DaLittleEd

Posted 12 November 2019 - 11:34 PM

Go and see a GP for a mental health plan and referrals. Ask around for a good GP in your area, and when you book the appointment tell the receptionist that it is for a mental health plan (you normally need a longer appt).

I would go by yourself first (a separate appt), to word up the gp, and discuss how they will handle it - basically interview the gp to see if they know what they are doing. Also ask the Dr what supports are available - some hospitals have dedicated eating disorder services for teens.

I don't want to scare you, but I was this teen, and you need to get onto this now. Don't wait. Make appointments tomorrow. Your DD is exhibiting signs of both anorexia and bulimia. I would also not be weighing and measuring her at home, in fact I would probably bin the scales.

#3 BusbyWilkes

Posted 12 November 2019 - 11:34 PM

That sounds hard OP. It seems like you're worried that drawing more attention to it may make it worse?

The butterfly foundation has some fact sheets and info that you might find useful. I would go to a GP (ask around to find a decent one). I think it would be best to make an apt just for you to talk about your concerns, and then bring your daughter to a later apt.

I understand your concern about having things documented, but getting your daughter help is the most important thing. Once the eating behaviours are entrenched, it is much more difficult to change.

#4 Expelliarmus

Posted 13 November 2019 - 01:08 AM

I think it's bigger than restrictive eating. I'd be looking into eating disorders asap. My DD does restrict her eating but it's more of a sensory thing not a weight obsession thing. It seems like you've got a potential emergency on your hands. A friend's DD was eating as you describe and it was quite serious for them so I would make an appointment tomorrow.

#5 Islander

Posted 13 November 2019 - 03:51 AM

I agree- you can’t turn it into a thing. It sounds like it’s already a thing. From your description she would qualify for a diagnosis of anorexia. A doctors appointment sounds very necessary.

My younger sister was diagnosed with anorexia at age 11. By the time we’d noticed that it was every meal and every day, she already had significant cardiac issues (despite no symptoms being obvious to us, just fatigue). I’d take your daughter for an appointment as a high priority.

Good luck. Take care of all of you- it’s such a hard path.

#6 ytt

Posted 13 November 2019 - 04:53 AM

GP ASAP, as pp said go by yourself at first.
My DD has eating disorder NOS and was just like your DD. She didn't/doesn't exercise and the purging did come but after she gained weight due to medication.

DD's eating was the last straw that saw her admitted to a mental health ward.

ED's very serious and start arming yourself with terminology and support. I strongly suggest you join Eating Disorders Families Australia on facebook. There are lovely people who will help you start to get help and encourage you all along your journey.

DD has 6 mental health diagnosis and her psychologist told DD that the ED diagnosis is the one most likely to kill her. She was being frank and trying to make her realise how serious it is. My DD was 14 or 15 at the time, she17 now and her ED has evolved into restrictive, compulsive eating, purging and some binging - so a little of everything.

I had no idea how bad she got because she was always a slim person and covered up in loose clothes.

Good luck PM me if you need to

#7 Bigbaubles

Posted 13 November 2019 - 05:20 AM

Get help asap.

This isn't restrictive eating, this is an eating disorder. ED are so incredibly difficult to 'beat', i've seen some of my students struggle with it for years and years.
See GP, get referrals for someone who can help her with her mental health issues.
I'd even talk to the school to keep a discreet eye on her as well.

#8 IamzFeralz

Posted 13 November 2019 - 05:24 AM

I would just calmly go to the GP and make an appointment for her as soon as you are able so that you can get access to expert and specialist care.  

Eating disorders are life threatening and your DD sounds like she is doing all the behaviours of the people I know in real life who have been diagnosed with those conditions.

Good luck.  It is very hard as a parent trying to work out the right thing to do but it sounds like your gut is telling you it isn’t normal.

#9 MarciaB

Posted 13 November 2019 - 06:21 AM

Hi OP - find a good GP and make an appointment for yourself first to run through your concerns before your dd goes in.

Take your dd and tell her it is to get her iron levels checked out (to help with irregular periods and feeling out of breath).

Let the GP do the rest.  

It is hard finding a good GP - if you can't ask around and get a referral - to be honest I would look for a young female GP.  I often find that the young doctors are very thorough.

#10 JBH

Posted 13 November 2019 - 06:39 AM

You could contact The Butterfly Foundation for advice. They have a helpline and live chat.

#11 me-n-b

Posted 13 November 2019 - 04:54 PM

Thank you all so much for your lovely and very helpful responses. I will book a doctor's appointment. I think I have been in a bit of denial but writing this down last night made me realise how much worse it's gotten. We've had a close family member pass recently so I wonder if this has contributed. The talk we had yesterday send to have helped a bit, she did eat her lunch at school today but has since made some comments about dinner so I'm not kidding myself that she's fixed but at least she's trying. I hadn't realised how not eating reduces your appetite, she has always said she's not hungry and feels sick when I make her eat so that may be why. I have been recommended a doctor nearby but if anyone can recommend someone to be referred to in Brisbane I would appreciate a pm please. Thanks you guys

#12 Ruf~Feral~es

Posted 13 November 2019 - 05:51 PM

I was this girl too, OP, and still have disordered eating patterns at nearly 50.

I hid it from my parents until I was hospitalised.  I think kids were often skinnier back in the 80s, so I didn't look much different from many of my friends, and the trend of big jumpers etc made it easier too.  

I wish I'd had more help and support back then.  You are honestly doing the right thing - regardless of having it documented.  It will follow her anyway, if it gets worse.

There are great suggestions here.  Is there a school psych you can get in touch with as well?  they may be able to provide recommendations to a good eating disorder psych in your area?

Remember too that this is much less to do with 'food', and more to do with her control - or lack of - in all areas of her life.  It is much much deeper than just being skinny.  During the times I've been bulimic, I've been at a much higher BMI and more 'normal size', which enabled me to continue doing 'what I needed to do' - eat dinner with my parents watching, etc.  And then purge it later.

Make sure you get yourself some support too.  It is not your fault, and most likely nothing that you or your family have 'done to her'.  My mother still beats herself up about it, but it really wasn't her.  It was me.

All the best OP.  You are doing the right thing.

#13 FuzzyChocolateToes

Posted 13 November 2019 - 06:08 PM

I agree with pps - you need to see a professional now. This is too big for you to handle alone. The Butterfly Foundation has lots of resources including education and links to specialists. There should  also be support groups.

Be prepared for her to resist intervention. You may have to be firm. Your GP is the right place to start.
Ideally she should see a dietitian, a psychologist and a psychiatrist, plus the GP to manage her physical health. You may be able to access these specialties in the public sector, depending on where you live.

If her menstrual cycle was established and has now been effected by her restriction, that is evidence that she is underweight.

#14 CallMeFeral

Posted 13 November 2019 - 06:59 PM

View PostDaLittleEd, on 12 November 2019 - 11:34 PM, said:

I would also not be weighing and measuring her at home, in fact I would probably bin the scales.

I agree with all of the PP's post above but am unsure about this bit, please check with a specialist in the area about this. I think there are positive aspects of someone being unable to focus on their weight, but as far as I know this particular condition also makes it very important to be aware of how much weight she is losing. And there is the potential for them to just fixate on some other symbol of weight loss instead.

View Postytt, on 13 November 2019 - 04:53 AM, said:

DD has 6 mental health diagnosis and her psychologist told DD that the ED diagnosis is the one most likely to kill her. She was being frank and trying to make her realise how serious it is.

This. It has one of the highest mortalities of any disorder. And once a certain amount of food deprivation kicks in, it causes issues in cognition (i.e. their thinking becomes really warped and irrational) because of malnutrition and that makes it ten times harder to come out of. Get it early.

#15 ytt

Posted 13 November 2019 - 07:14 PM

Glad you are getting help, I know the feeling of realising it's something bigger than you thought.

We do not have scales in our house, we did before we realised and apparently DD used them everyday. In the bin it went. DD's psychiatrist weighs her.

At DD's Monday appointment she has lost weight, psychiatrist was happy. I'm worried even though she is weight restored ++ she hates that weight and wants it gone but she is still solid so I'm not going to fuss..... yet

#16 CallMeFeral

Posted 13 November 2019 - 08:19 PM

Oh and one option to try is Headspace. They specialise in younger people and may have a psychiatrist onsite.

#17 DaLittleEd

Posted 13 November 2019 - 11:05 PM

View PostCallMeFeral, on 13 November 2019 - 06:59 PM, said:

I agree with all of the PP's post above but am unsure about this bit, please check with a specialist in the area about this. I think there are positive aspects of someone being unable to focus on their weight, but as far as I know this particular condition also makes it very important to be aware of how much weight she is losing. And there is the potential for them to just fixate on some other symbol of weight loss instead.

My treatment was a long time ago, and things might have changed. But it was no scales at home, only being weighed by my treating team.

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