Think teen daughter is developing eating disorder, what are next steps?

[Anonymous]

She is 5’6” and in the 10th percentile for her weight as of her last physical, but she continues to lose weight and is very rigid about what she eats. We have an appt with her pediatrician but is there anything we can do in the meantime? Thanks.

[Anonymous]

Have you tried to talk to her about her diet and body? I’d start there.

[Anonymous]

Anonymous wrote:Have you tried to talk to her about her diet and body? I’d start there.

No, that’s the wrong move.

OP, you have described an eating disorder exactly. F.E.A.S.T. is a great resource, and you can sign up (it’s free) for the first 30 days program.

This is an unregulated field. Your pediatrician likely has no training in this. You can get an eating disorder evaluation through CNMC - that is what I would recommend first.

[Anonymous]

Address it asap. The longer it goes on, the less likely a full recovery.

[Anonymous]

There are centers that treat this. Some are residential, depending on the assessment of your child.

Look for registered dietitians / therapists who specialize in this. They may be able to help directly or refer you somewhere.

I’m not sure a pediatrician can help beyond a referral.

[Anonymous]

Same thing here, and I talked to her therapist about it. She had me watching for specific signs, she also suggested we direct her towards health oriented activities rather than diet if possible. It’s hard bc you don’t want to push her away and cause her to go underground. My daughter has OCD so she’s prone to obsessive behavior, and in her case redirecting did work.

I suggest you search her phone - my daughter was in some unhealthy discord ED groups that were feeding her interest.

[Anonymous]

Yea, agree you need to see watch she’s watching and listening to on social media.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Have you tried to talk to her about her diet and body? I’d start there.

No, that’s the wrong move.

OP, you have described an eating disorder exactly. F.E.A.S.T. is a great resource, and you can sign up (it’s free) for the first 30 days program.

This is an unregulated field. Your pediatrician likely has no training in this. You can get an eating disorder evaluation through CNMC - that is what I would recommend first.

+1 for FEAST. You’ve got a steep learning curve and will be second-guessed every step of the way. There are a number of YouTube videos by Eva Musby that can also help.

If the pediatrician starts talking about her BMI, run the other way. It’s a clear sign that they don’t know much about this topic. Dieticians and psychologists are not very useful until phase 2, once weight has already been restored and their brains are less-hijacked by the ED. Psychiatrists can be helpful if you’ve got other symptoms (like depression or anxiety) holding her back.

The one thing that gives your daughter the best shot at a full recovery is to get the weight on .. plus extra to allow for further brain and body growth, as fast as possible. You start by taking control over all her meals - 3 main + 3 snacks - she needs to finish everything on her plate. Be careful for signs of over-exercising and/or purging/laxatives. If you can’t manage this or if she can’t/won’t cooperate enough to gain the weight, a clinic or residential facility may be in order.

EDs are terrifying & will turn your world upside down. Stay strong. I’m so sorry & hope your daughter recovers.

[Anonymous]

I went through this a year ago with my daughter. She grew two inches in a year but dropped ten pounds and was hiding food. I immediately took her to the pediatrician and they said her BMI was in a healthy range and basically told her to remember to eat and check back in two months. That didn’t sit well with me…so i took her to a therapist the next day. My pediatrician did not understand eating disorders or the necessity of early intervention for a successful recovery. My daughter was diagnosed as anorexic and had to be placed in intensive out patient therapy for 4 months (four hours daily - five times a week) to regain the weight and to battle her disordered thoughts about food. She had only been starving herself for about six weeks before we started the therapy and it took months to undo the damage. I’m not saying your daughter has an eating disorder…but don’t always trust your pediatrician. I would at least have her talk to a therapist that specializes in eating disorders…the earlier you start intervention the better result. My daughter has been in recovery for 14 months successfully….but i truly think the early intervention really helped her in battling this awful disease. Good luck!

[Anonymous]

I wanted to add, I went through this with both of my kids. My youngest has (had?) PANDAS disorder and went through this somewhat at age 8, it was horrible. Healing her from PANDAS fixed the eating issues. She also got sick with a high fever which oddly helped a lot.

My oldest was diagnosed OCD but didn’t have any of the pandas bloodwork signs and no known illness. She deep dived into EDs this year, which her ocd was driving. It was an obsessive thought. She got the flu this summer and had a fever for two days and after recovering, she completely lost interest and stopped her ED behaviors.

It was the most bizarre trajectory to watch with both of my kids and I wish I knew more about the science of what this means.

[Anonymous]

Anonymous wrote:She is 5’6” and in the 10th percentile for her weight as of her last physical, but she continues to lose weight and is very rigid about what she eats. We have an appt with her pediatrician but is there anything we can do in the meantime? Thanks.

I would have her drink a bottle of Ensure daily to start. https://ensure.com/nutrition-products/ensure-complete-shake/strawberry

Is she an anxious person? Check if anything is stressing her more than normal.

[Anonymous]

Anonymous wrote:Have you tried to talk to her about her diet and body? I’d start there.

As a former teen with an ED, please please please do not do this. If you are unsure what to do, see and ED specialist.

This is a life long battle that can be helped by understanding the root causes and not focusing on her diet and body.

Good luck, there are so many great resources out there that can help.

[Anonymous]

Anonymous wrote:

Anonymous wrote:She is 5’6” and in the 10th percentile for her weight as of her last physical, but she continues to lose weight and is very rigid about what she eats. We have an appt with her pediatrician but is there anything we can do in the meantime? Thanks.

I would have her drink a bottle of Ensure daily to start. https://ensure.com/nutrition-products/ensure-complete-shake/strawberry

Is she an anxious person? Check if anything is stressing her more than normal.

If I didn’t have an ED, being asked to drink Ensure would give me one PDQ.

[Anonymous]

Residential treatment immediately

[Anonymous]

OP, she needs to be seen by a treatment center. Are you in DC? My 17yo daughter is being treated by the Eating Disorder clinic at Children’s National Hospital. Direct number - [phone] (Friendship Heights). Get on the waiting list and in the meantime learn everything you can about the Maudsley Method. It’s what the majority of treatment centers use. They will benefit from having a copy of your daughters growth chart from your pediatrician. Unfortunately an appointment with our pediatrician did nothing. Go straight for a treatment center.

Tell her about the appointment. Gently. Frame it in a nonjudgmental way. You know your daughter and how to do it. Also don’t make a big deal about it. Phrase it in the form of a wellness/nutrition appointment if necessary.

Get the book - https://www.amazon.com/Help-Teenager-Eating-Disorder-Second/dp/146251748X/ref=mp_s_a_1_15?crid=297I6Z2M7ULPT&keywords=eating+disorder&qid=1661511644&sprefix=eating+disorder%2Caps%2C87&sr=8-15

You can do this. It’s a marathon not a race.