therapy or other guidance re: stopping anorexia in its tracks

[Anonymous]

You are doing the right thing. Try to get her to a therapist as soon as possible and a on a separate track, can you get someone -- anyone -- help you get through to DH?

[Anonymous]

OP, I'm the previous PP who said that your DD sounds like she has a full blown eating disorder.

You sound like a terrific person and a good mom. Please know that the theory that EDs are caused by over-controlling mothers has been pretty well debunked. And also know that the ED treatment that has been shown in studies to be most effective is family-based/maudsley therapy, which involves removing food decisions from the child--that is, becoming MORE controlling. If control is the issue, it doesn't make sense that becoming even more controlling is a cure.

In fact, your DD is CRYING OUT for someone to take charge here. One thing I realized with my kid is how absolutely EXHAUSTING having an ED is. He was thinking about food and calories and exercise all. day. long. It is incredibly stressful. At some level, my son was so relieved when the decisions were taken out of his hands. Like your DD, he knew he had a problem but didn't know how to make it go away.

I strongly encourage you to join the forum at aroundthedinnertable. Parents there have dealt with all kinds of difficult situations and I know someone will have some ideas for how to navigate the situation as a step-mother and how to get your DH on board.

Hang in there. You are doing great.

[Anonymous]

EDPS on Facebook. Great parent support. Go GO GO!

She can't help it and you can't reason with her. Get some phosphorous in her?

Food is her medicine. Don't listen to her mouth.

[Anonymous]

Anonymous wrote:

And now I feel with every bone in my body that she's in trouble again. And no one is listening. And I am desperately scared for her. But Dad googles "how to tell if your child is anorexic" and sees things like "is she dramatically underweight?" and "has she missed more than 3 periods in a row" and feels satisfied that his beautiful, straight A daughter is a-ok b/c the answer to those particular things (right now) is no.

The period thing is outdated and doesn't even apply to young kids who haven't gotten their period yet (has your 12 year old stepdaughter??) Make sure he is getting reputable, up to date information. And get ahold of her historic weight percentiles. If she started off 75th%ile and is now down to 30th%ile within a year.... where does he think she's going to be in another 3 months? Look up how many calories a 12 year old girl of her weight needs per day, and add in the calories needed to sustain her athletic activities. It's at least 2200 per day, not counting what she needs to gain back her weight she's lost. Ask your husband -- how many calories do you think your daughter is eating each day? Ms. Bag o Peanuts for lunch... is she even getting 800 a day? Is this sustainable??

It's fair to call me controlling if I want to do everything I can do/need to do to help her be the best person she can be. I love her madly. I don't care one iota what that person looks like. Or does. Or likes to do. I just care that she's healthy and happy. And she's neither. AND SHE'S ONLY TWELVE. I'm terrified. So part of me really really wants to tell whoever wrote that to FUCK OFF.

EXCELLENT mamabear attitude!

Because, you know what? Of course I'm part of the problem. OF COURSE I AM. This kid is stuck in a weird family dynamic. And I'm a part of that everyday. How I respond to all of that weirdness. How I respond to her. What I say. What I do. And if I'm being honest, I would admit that ... since I frequently feel like I'm the only one who notices what's going on with this child that I have become hyper vigilant, which isn't fair to her.

Actually, this is her best chance of surviving and healing from anorexia. An expert in eating disorders said that she worries less of kids of helicopter parents, because helicopter parents have what it takes to help kids recover.

She and I have very open honest conversations (usually) and she has told me on multiple occasions that I "see everything" in her. And that there is a really great side to that. I know when she needs new pants or a hug or a new rule or surprise cupcake or whatever. And she has told me for years how great it feels to have someone pay close attention. How loved and safe it makes her feel. But last year, she told me that it's a little too intense that I notice everything. That maybe sometimes I notice TOO much. That I can tell when she's lying about having a good day and I don't let it go. And I love that she has said that to me.

This is very likely when her eating disorder started... and you started noticing and commenting on it. You made her uncomfortable because you were noticing her ED.

And I have tried to do what good parents of preteens probably all struggle with--trying to back off as you watch someone who just barely learned how to wipe their butt properly to someone who is probably about to start having pressure to have sex. Try to give space. Try to give room for mistakes and bad judgement. Or just space for whatever. For being in a bad mood. For being rude. For being a bad friend. For getting yelled at by the coach for having a bad attitude. I've been working on just hugging her when she needs it and not controlling outcomes. And she basically had an entire summer out of my orbit. And it seems to me that she's fallen to pieces. And she is telling me she is unhappy and knows what she is doing is a problem and is asking me for help. So my immediate gut reaction is to get even MORE controlling. To force her to eat. To tell her that I will come to her school and watch her eat. And that if I see any more weight loss, she will be weighed every day and there will be negative consequences in her life and she will lose the things she loves (phone, tv, sports, access to friends, etc) if she keeps losing. Because I didn't know what else to do.

That is EXACTLY how you heal anorexia. You are very clueful. After the child has recovered and is in a good space, and can feed herself again, then it is time to work on any other issues like anxiety or being able to be independent. Food needs to come first, though. Yes it is hard.

And that's exactly why I posted. Because I have absolutely no clue whether this is just like when she was 7 and she needed someone to step in and give her structure and some rules to keep her safe and happy. Or if she needs something else entirely.

This is so scary people. So scary. If I were religious, I would say that I pray that this isn't something you ever have to try to deal with. No parent should have to hear a beautiful amazing 12 year old tell them that they spend EVERY DAY thinking that they are the most hideous, worthless piece of shit in the world. I will do anything to help her. If that's controlling her, I will. I will do it without hesitation for as long as it takes or as long as I am legally able to do so. But I will also take hard long looks at what I do to contribute to her anxiety or depression or ED or whatever it all is. Thanks for the reminder that I'm part of the problem. It's something I need to keep in mind as I hunt for the solutions for her and for our family. And you're right that me saying I am looking for a solution is controlling. But she's too important to the world for me not to try to control the outcome. I haven't seen her in 2 days. Last night, she texted me if I knew anyone who had ever killed themselves. Well, I do. My brother. And I will not lose her. Not now. And not to THIS.

OP THIS IS VERY ALARMING.

Please get her to an eating disorder clinic ASAP and mention she is asking about people who killed themselves.

[Anonymous]

OP, you are a great parent. I wish I had a supportive mom like your stepdaughter does.

You seem to be looking for a doctor who can help you, so I'm also going to recommend Potomac Behavioural Solutions. Contact them ASAP. My DD has been participating in group therapy revolving around nutrition and EDs. It has been super helpful. I would call them and see if you can get an appointment with you and your stepdaughter and a therapist. That would be the first step. They will be able to point you in the right direction. Tell them exactly what you told us here, with just asich detail. I wish you the best of luck. If you need any more information please let me know. Sending you hugs, OP.

[Anonymous]

Anonymous wrote:Usually the parents, a controlling Mother, that contribute to the onset and worsening of the disorder. So take a look in the mirror and at your post trying to "control" the outcome. Great place to start, your own behavior towards your daughter.

This was obviously written by someone whose knowledge about eating disorders stops in the 20th century.

[Anonymous]

Anonymous wrote:You are doing the right thing. Try to get her to a therapist as soon as possible and a on a separate track, can you get someone -- anyone -- help you get through to D?

Agree with this PP. I would tfind a treatment provider who follows up-to-date treatment protocols for adolescents (ie Family Based Therapy vs the "they need to want it for themselves" method -- the people at Around the Dinner Table can provide with things to look for when searching for a provider & a list of important questions to ask potential providers) & do your best to convince your DH to go with you to meet with him or her. If he sees that an expert believes that your stepdaughter's symptoms merit concern, he may be more likely to believe that there actually is a problem.

[Anonymous]

OP, it's taken me a few days to chime in here, because my experience is very outdated. My sister had bulimia which she transitioned to anorexia after in-patient treatment, and I also had anorexia. For us, having our mom, who really was the source of many problems that ultimately manifested in EDs, was not a cure for our EDs. Because the wounds of her behavior, and in my case neglect, were deep and couldn't be disentangled from other issues.

Your situation is not the same. You are the person your step-DD trusts, and you can help her in a way few others can. I had that from an aunt who let me stay with her one summer for a while. What I remember most vividly about that time was the sheer relief of not having to think about anything, least of all taking care of myself. I even remember eating a few bites of cake for the first time in years at my cousin's birthday during that time. In college, I had a dear friend from HS (who went to a different college) who, when she knew I was going through rough times, used to call me at mealtimes to make sure I ate. These aren't the only things...but they are very important things. Giving her a safe place not to have to think about everything is a great relief, and you sound like you can provide it.

[Anonymous]

Anonymous wrote:

Dad concerned in the moment of when she would say/do these things but just thinks saying things like "you look great. eat your food" is enough. And privately he tells me I'm way overreacting and that this is all "normal for her age." We returned from vacation and went to her pediatrician who basically rolled her eyes at me. Because she's still in the range of "normal" height/weight. Which is true. She was always in the high range and is now in the very low range, but sure. The chart says she's normal. But she WON'T be normal with another few months of this behavior. And more importantly all this negative self-image and terrible eating habits seems like it should be addressed. Dr. did the same thing Dad does. "Hey, kid. You need to eat good, healthy meals. You're not fat. OK?" And gives her a pat on the head. It's like... they want to wait until her skin turns sallow and her bones are protruding and she's too weak to do anything before anyone gets concerned??? But maybe I AM an alarmist. It hurts me to hear her say these terrible things to herself. I keep telling her that she would never let someone else say those kinds of things to a friend so why does she do that to herself? DD has agreed that she'd like to "talk to someone" and that the decisions she is making for herself are "bad." So I'd at least like to do that. But since neither mom nor dad will be really supporting this, and she's so young, I'd like to find a place near her school that she could get herself to instead of just heading home to do homework.

What do you mean she was always at the "high end"? Because the high end on the chart is basically overweight for almost all kids unless the kid is short and you said she was not. You now say she is at the low end of normal. What does that mean? 1%, 10%, 20%? Is it possible that since her mom was with her all the time that her mom did realize her child was at the high end of the weight range and possibly was told by the doctor her child was overweight?

I will have to agree that it's normal for eating patterns to change in the middle school years. I recall that I stopped eating lunch in those years and did try several diet plans because I was truly chubby. Lasted about 6 months each stint and I was very serious. I never did go back to eating lunch even in high school though. I think it was because lunch was so early in the day sometimes - 10am - and I just wasn't hungry at that time.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Dad concerned in the moment of when she would say/do these things but just thinks saying things like "you look great. eat your food" is enough. And privately he tells me I'm way overreacting and that this is all "normal for her age." We returned from vacation and went to her pediatrician who basically rolled her eyes at me. Because she's still in the range of "normal" height/weight. Which is true. She was always in the high range and is now in the very low range, but sure. The chart says she's normal. But she WON'T be normal with another few months of this behavior. And more importantly all this negative self-image and terrible eating habits seems like it should be addressed. Dr. did the same thing Dad does. "Hey, kid. You need to eat good, healthy meals. You're not fat. OK?" And gives her a pat on the head. It's like... they want to wait until her skin turns sallow and her bones are protruding and she's too weak to do anything before anyone gets concerned??? But maybe I AM an alarmist. It hurts me to hear her say these terrible things to herself. I keep telling her that she would never let someone else say those kinds of things to a friend so why does she do that to herself? DD has agreed that she'd like to "talk to someone" and that the decisions she is making for herself are "bad." So I'd at least like to do that. But since neither mom nor dad will be really supporting this, and she's so young, I'd like to find a place near her school that she could get herself to instead of just heading home to do homework.

What do you mean she was always at the "high end"? Because the high end on the chart is basically overweight for almost all kids unless the kid is short and you said she was not. You now say she is at the low end of normal. What does that mean? 1%, 10%, 20%? Is it possible that since her mom was with her all the time that her mom did realize her child was at the high end of the weight range and possibly was told by the doctor her child was overweight?

I will have to agree that it's normal for eating patterns to change in the middle school years. I recall that I stopped eating lunch in those years and did try several diet plans because I was truly chubby. Lasted about 6 months each stint and I was very serious. I never did go back to eating lunch even in high school though. I think it was because lunch was so early in the day sometimes - 10am - and I just wasn't hungry at that time.

NP here- are you even reading this thread?! Your experience and this girls is not apples to apples. STFU

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Dad concerned in the moment of when she would say/do these things but just thinks saying things like "you look great. eat your food" is enough. And privately he tells me I'm way overreacting and that this is all "normal for her age." We returned from vacation and went to her pediatrician who basically rolled her eyes at me. Because she's still in the range of "normal" height/weight. Which is true. She was always in the high range and is now in the very low range, but sure. The chart says she's normal. But she WON'T be normal with another few months of this behavior. And more importantly all this negative self-image and terrible eating habits seems like it should be addressed. Dr. did the same thing Dad does. "Hey, kid. You need to eat good, healthy meals. You're not fat. OK?" And gives her a pat on the head. It's like... they want to wait until her skin turns sallow and her bones are protruding and she's too weak to do anything before anyone gets concerned??? But maybe I AM an alarmist. It hurts me to hear her say these terrible things to herself. I keep telling her that she would never let someone else say those kinds of things to a friend so why does she do that to herself? DD has agreed that she'd like to "talk to someone" and that the decisions she is making for herself are "bad." So I'd at least like to do that. But since neither mom nor dad will be really supporting this, and she's so young, I'd like to find a place near her school that she could get herself to instead of just heading home to do homework.

What do you mean she was always at the "high end"? Because the high end on the chart is basically overweight for almost all kids unless the kid is short and you said she was not. You now say she is at the low end of normal. What does that mean? 1%, 10%, 20%? Is it possible that since her mom was with her all the time that her mom did realize her child was at the high end of the weight range and possibly was told by the doctor her child was overweight?

I will have to agree that it's normal for eating patterns to change in the middle school years. I recall that I stopped eating lunch in those years and did try several diet plans because I was truly chubby. Lasted about 6 months each stint and I was very serious. I never did go back to eating lunch even in high school though. I think it was because lunch was so early in the day sometimes - 10am - and I just wasn't hungry at that time.

NP here- are you even reading this thread?! Your experience and this girls is not apples to apples. STFU

Yes I am reading the thread. I am reading from a stepmom who doesn't actually have children of her own, who sees the child on occasion and has never been willing to ask her DH to step up and parent.

[Anonymous]

As someone who is in a similar situation (stepmom of a kid with anorexia and bulimia) I totally identify. Before she got sick with bulimia (around age 16) she exhibited real issues (still throwing tantrums at age 15 etc). I talked a lot with my husband about changing the way they parent and getting her help, but nothing happened until she got bulimia.

Anyway, my advice for you is to avoid Renfrew - in our experience it made our kid worse. She spent three months is residential there and came out worse. Maybe it works for some kids but for our kid it made her more competitive with losing weight and she developed some really toxic friendships with other kids there.

If at all possible keep her home and keep her in very intense therapy and like others said, food is healing - make sure she eats at least three meals a day and monitor her bathroom use so you know she isn't vomiting.

I'm worried that our kid has gone too far down the road....it's hard to be hopeful most days. This is a really horrible experience for all the families who go through it. I hope you have a good outcome.

[Anonymous]

Anonymous wrote:
What do you mean she was always at the "high end"? Because the high end on the chart is basically overweight for almost all kids unless the kid is short and you said she was not. You now say she is at the low end of normal. What does that mean? 1%, 10%, 20%? Is it possible that since her mom was with her all the time that her mom did realize her child was at the high end of the weight range and possibly was told by the doctor her child was overweight?

I think you got that backwards. The high end on the weight percentile chart is NOT overweight, unless the kid is short.

If the kid is 90th%ile for height, it totally makes sense for her to be 90th%ile or even higher for weight.

And OP said her stepdaughter was perfectly normal most of her life, not chubby or overweight.

Finally, just for information, even kids who are overweight can develop anorexia, and it is these kids that are actually at most risk of not being diagnosed early (and having a bad outcome). If a child who has always been tall and skinny, say 5th%ile on the weight chart, develops anorexia and stops eating -- he will sink rapidly to 1st or 2nd%ile and the case will be taken seriously by the pediatrician. The child is more likely to get help quickly.

But if the child is short and 80th%ile for weight, and says "I'm eating healthy and exercising!" and starts losing weight (growing kids BTW should never lose weight, just maybe gain less as they grow in height) -- he might be praised to losing weight. Meanwhile the child is losing 20% of her body weight, and the anorexia behaviors are becoming entrenched of a matter of 6-12 months. She finally reaches 5th%ile for weight and the parents get concerned but the Dr says, "That's still normal weight, no problem". These are the kids who end up with heart failure in the ER due to malnutrition.

I will have to agree that it's normal for eating patterns to change in the middle school years. I recall that I stopped eating lunch in those years and did try several diet plans because I was truly chubby. Lasted about 6 months each stint and I was very serious. I never did go back to eating lunch even in high school though. I think it was because lunch was so early in the day sometimes - 10am - and I just wasn't hungry at that time.

Yes, it is normal for tweens to change eating patterns, but they still need to ingest calories. And if they are athletes or compulsively exercising, they need to eat even MORE calories than they used to.

[Anonymous]

From what you have described and based on my daughter's own experience with anorexia, I would agree with others, that your stepdaughter most likely has a full blown ED already and the best course of action is intervention now. I would also reiterate that having her go to a therapist after school by herself is not going to be enough.

You are in a really tough spot, and for this to be successful all family members will need to be on board. That is truly the only way this will work. Maybe start with bringing her to either a nutritionist, one of the ones mentioned above, or a full service out -patient center that specialized in ED's and have nutritionist, psychiatrist and therapists on staff that can all work together and help you get the rest of the family members to understand what is happening.

I also found the book Help Your Teen Beat an Eating Disorder by Lock and LeGrange to be extremely helpful in framing the problem and finding a good course of action. It might help your husband and others understand if they to a look as well.

Good luck to you.

[Anonymous]

Here's a good video

https://www.youtube.com/watch?v=WykMa4A-U5Y