Anonymous wrote:Get treatment soon. However, remember that YOU can't stop anorexia in its tracks. It is your DD's struggle. It is great you are being so supportive, but do realize you can't stop this for her. You sound like a super parent in recognizing behaviors. Your job is to provide tools for her to help herself.

This is actually completely outdated and dangerously inaccurate thinking. Maudsley or family-based therapy is really the gold standard in treatment for eating disorders in children and teens. Eating disorders are brain disorders; a person in the throes of an ED have very limited ability to help themselves. Therefore, the first and most important treatment is weight restoration. Parents must step in and ensure that weight is restored. Then control can slowly be shifted to the patient, and therapeutic work on mental health issues, family relations, etc. can begin.

https://en.wikipedia.org/wiki/Maudsley_family_therapy

Anonymous wrote: I also know lots of girls 12-14 are really struggling with self-esteem, self-confidence, hormonal changes, social pressures, etc. All of a sudden, her behavior has taken a turn for the worse. Dad isn't concerned but I'm ready to send her to therapy before this kind of thinking and behavior gets engrained. ANY good recs for appropriate therapist/doctor/etc. in downtown metro DC area[u] would be greatly appreciated. Other parenting advice also appreciated. I have no idea how to handle/respond.

This is the treatment for anorexia and you don't actually need a therapist to do it, although they might be able to help you get her to eat.

Feed her. Make sure she eats. 3 meals and 3 snacks per day. WATCH HER. Cancel ALL exercise and sports until she is eating normally again and has gained back any lost weight or is back where she should be on her growth curve.

It doesn't matter that she loves her sport and it is her whole life -- sports are for healthy people and she isn't healthy until she can eat enough to fuel her growth and activities.

The treatment is intensive and exhausting and you have to put your life on hold for a while but the alternative is devastating, and treatment by the family has the highest rate of success. Anorexia has the highest death rate of any mental illness. The earlier you can intervene the easier the treatment and the better your child's chance of recovery.

Anonymous wrote:Get treatment soon. However, remember that YOU can't stop anorexia in its tracks. It is your DD's struggle. It is great you are being so supportive, but do realize you can't stop this for her. You sound like a super parent in recognizing behaviors. Your job is to provide tools for her to help herself.

Actually, no, that is an out of date way of thinking about this illness.

If your child is under 18 you can stop this for him or her, and a child's agreement that he or she is ill, and desire to get better, is not required for treatment to begin.

The same way that a child with diabetes or cancer doesn't need to have tools to help herself heal -- she needs medicine to get better.

With anorexia, the medicine is nutrition, and that is what heals the brain. If the illness makes it impossible for a child to eat, he or she can and should receive the nutrition through tube feeding as a hospitalized patient, until he or she is able to take the medicine through eating.

Anonymous wrote:
This website has a lot of good information:

http://www.feast-ed.org/

And this is the related discussion forum, which I found both terrifying and helpful:

https://www.aroundthedinnertable.org/?forum=136439#gsc.tab=0

Both of the above are very useful resources.

Intervene sooner rather than later. The earlier you can address this the easier it is to fix.

I agree with what someone earlier posted -- do NOT go for convenience over effective. This illness can kill and it can tear a family apart. Treat it early.

Get treatment soon. However, remember that YOU can't stop anorexia in its tracks. It is your DD's struggle. It is great you are being so supportive, but do realize you can't stop this for her. You sound like a super parent in recognizing behaviors. Your job is to provide tools for her to help herself.

My ED started at 12 and I was very, very good at hiding it and lying my way out of the severity of it being fully uncovered for years. Definitely get into treatment sooner rather than later.

Mom,

When you say her behavior has taken a turn for the worse what exactly do you mean? I suffered from anorexia in high school and would love to be of any help possible to you, I'm just unclear as to exactly what you are dealing with. Are you certain that the problem is an ED, or is it more behaviorial? I know that for me, it wasn't at all about "stupid ideas"...it was just the first time I had ever dieted (I was 16) and it quickly spiraled out of my control.

Could you possibly give any more info so that I could actually be more helpful? I'm so sorry that you are all dealing with this. Please be gentle with your child and remember that she is likely terrified and ashamed and is NOT doing this "at" you. I look back with so much sorrow about all of the pain that I caused my parents, but at the time I was also acutely aware that this was like a freight train that I could not stop, even though I deeply wad to.

I followed the advice of more experienced parents on the aroundthedinnertable site regarding two snacks/three meals a day. We stopped it in its tracks, but it took a year of refeeding to get back to normal. This was 6 years ago. No relapses regarding the disordered eating.

DD does have ongoing mental health issues, and I believe this was the first symptom of it. But we are out of the woods regarding the eating issues, FWIW.

Anonymous wrote:

Anonymous wrote:There have been some early flashes of behavior that concerned me, but I knew that DD loved to eat and always hoped that healthy desire to consume delicious foods would counter balance any stupid ideas she got in her head for a few days. I also know lots of girls 12-14 are really struggling with self-esteem, self-confidence, hormonal changes, social pressures, etc. All of a sudden, her behavior has taken a turn for the worse. Dad isn't concerned but I'm ready to send her to therapy before this kind of thinking and behavior gets engrained. ANY good recs for appropriate therapist/doctor/etc. in downtown metro DC area[u] would be greatly appreciated. Other parenting advice also appreciated. I have no idea how to handle/respond.

I say this as a father with experience, do not mess around with this. DD had better wake up. there is one in the immediate DC area called Renfro i believe. Other than that Shepard Pratt in MD is considered excellent and Reflections in Falls Church. Do not go for convenient and close over quality.

Eating disorders are not about social pressure per se, they are very complicated and become almost like drug addiction very quickly.

x1000 Run, don't walk, to the best program you can get into quickly. Honestly, if you have to take a week off of work to make calls and get appointments lined up then you should do it. Best wishes to you, your daughter and your family.

Lisa Himmelfarb was a great help to my child, and with her help, we were able to "stop" anorexia in its tracks. My DS was severely calorie-restricting and limiting the types of food eaten and generally becoming very food anxious. Though weight was still within "normal" range, DS had fallen off the historic weight trend (though his height had increased significantly), was teetering on the edge of underweight, and was experiencing fatigue, lack of energy, and general anxiety. I had noticed that he was acting strangely about food but didn't really become alarmed until he confided that something was wrong. Then I was alarmed. DS began to see Lisa weekly, and she referred us to a nutritionist, Elizabeth Davenport, who was also extremely helpful.

http://www.lisahimmelfarb.com/

https://www.pinneydavenport.com/

Unfortunately, neither of them take insurance.

I think you should have your DD evaluated if you are worried about this. My sense is that things are likely to be worse than you think, not better. Start with your pediatrician, because any specialist or therapist will want your DD's height & weight trends and a medical evaluation. Our pediatrician was helpful and supportive, but eager to hand us off to a specialist I think. This is really not their area of expertise.

This website has a lot of good information:

http://www.feast-ed.org/

And this is the related discussion forum, which I found both terrifying and helpful:

https://www.aroundthedinnertable.org/?forum=136439#gsc.tab=0

My son made huge progress both weight-wise and mental-health-wise over a period of several months. He's gained 25 pounds over the past year. FWIW, he does continue to suffer occasionally from some mild anxiety. He is managing well with self-help techniques (no medication), but it's something we continue to keep an eye on.

Good luck.

Anonymous wrote:There have been some early flashes of behavior that concerned me, but I knew that DD loved to eat and always hoped that healthy desire to consume delicious foods would counter balance any stupid ideas she got in her head for a few days. I also know lots of girls 12-14 are really struggling with self-esteem, self-confidence, hormonal changes, social pressures, etc. All of a sudden, her behavior has taken a turn for the worse. Dad isn't concerned but I'm ready to send her to therapy before this kind of thinking and behavior gets engrained. ANY good recs for appropriate therapist/doctor/etc. in downtown metro DC area[u] would be greatly appreciated. Other parenting advice also appreciated. I have no idea how to handle/respond.

I say this as a father with experience, do not mess around with this. DD had better wake up. there is one in the immediate DC area called Renfro i believe. Other than that Shepard Pratt in MD is considered excellent and Reflections in Falls Church. Do not go for convenient and close over quality.

Eating disorders are not about social pressure per se, they are very complicated and become almost like drug addiction very quickly.

Potomac Behavioral Solutions

OP, sorry the therapist DD used is in Bethesda, so she is not helpful to you. I hope you find someone who is helpful to your DD.

My only comment (please take as constructive): educate yourself about eating disorders and disordered eating - they are not about the food, the disordered eating is a symptom of another type of struggle.

Wishing the best to your family and DD.

What behaviors is she exhibiting? How long?

There have been some early flashes of behavior that concerned me, but I knew that DD loved to eat and always hoped that healthy desire to consume delicious foods would counter balance any stupid ideas she got in her head for a few days. I also know lots of girls 12-14 are really struggling with self-esteem, self-confidence, hormonal changes, social pressures, etc. All of a sudden, her behavior has taken a turn for the worse. Dad isn't concerned but I'm ready to send her to therapy before this kind of thinking and behavior gets engrained. ANY good recs for appropriate therapist/doctor/etc. in downtown metro DC area[u] would be greatly appreciated. Other parenting advice also appreciated. I have no idea how to handle/respond.