Op, thanks for the update! For those of us dealing with similar, would you mind sharing what the medical condition was? Celiac?

Just wanted to come back and update. I did take DD to the pediatrician, and there turned out to be a medical reason for the loss of appetite and overall resistance to eating. Because DD gets grouchy when hungry, there was some unpleasant behavior that went along with the hunger, but the behavior was a symptom and not the cause. We’re still working on exactly what’s causing the issues, and how to treat them, but making some progress.

Thanks to everyone who shared suggestions and resources. And huge hugs to the parents dealing with disordered eating, which seems so much harder, for both kids and parents.

The problem isn't what she is or isn't eating, the problem is that she is using eating or not eating to reward or punish you. That's some deep stuff. She knows that your happiness rests on her food intake. I'd get a family therapist and totally back off the food.

Yes to the above. Treat the physical side first, then the mental/emotional aspects. You won’t get very far the other way round.

Anonymous wrote:When food becomes about control, you step away. Don't acknowledge her eating habits in any way. If she becomes underweight then, yes, you'll need to intervene and take her to therapy.

Are you basing this advice on CURRENT eating disorder research or your own gut feelings?

Actual studies show this is false. Taking full control of eating is how you treat anorexia (FYI the good residential programs do this, too).

People can and do die of anorexia before they become underweight. Malnutrition can cause an electrolyte imbalance and then a heart attack.

This is an eating disorder and you need to get on it right away! go to:
https://www.allianceforeatingdisorders.com/
https://www.nationaleatingdisorders.org/
https://www.feast-ed.org/

It’s very hard and please get her help quickly. I have recently learned that there are a lot of websites out there that kids use to teach each other anorexia and bulimia tips. I would look at her online history and her phone and see what material she has been accessing. I would look for an inpatient eating disorder program and call them and ask for advice, contact, therapist recommendations, support group information, etc. And keep track of what she does eat without her noticing. Make milkshakes for the whole family just for fun. Pack the calories in as much as you can. You really need professional help here quickly and the fact that she ties eating to her mood in her mind is a red flag.

Anonymous wrote:Does she say why she’s not eating? Would she prefer something else or is she saying she’s just not hungry. Yes, definitely speak to the ped. Eating disorders are much, much easier to address early than late.

The "why" is very important and you definitely need the pediatrician to help you with all of this.

Anonymous wrote:

I don't know, if it is indeed about control for her, this sounds like it could backfire big time. In fact, it is kind of using food as an emotional control. Food is tricky because we need it and good nutrition is important, but we have to manage it ourselves. If you make it "non-negotiable" you're kind of setting yourself up for a battle. What are you going to do if she doesn't want breakfast? Hold her at the table staring at it for hours? Tie her down and make her choke it down? You can't do that. I think an overall day by day normal total is fine, but that could be in the form of snacks, no breakfast and a big lunch, etc. Forcing 3 squares sounds kind of outdated and setting yourself up to make food a point of contention. Plenty of healthy people don't eat that way and don't have eating issues. I think the advice to back off and just quietly track what she goes for sounds a lot better for now.

Yes, PP, you exactly hit on the reason why treating anorexia is so incredibly difficult. In the ideal situation, the human body desires food, and just goes about eating what we need. When kids have anorexia, there is something in their minds that interferes with this process. Kids sometimes actually describe a voice telling them that they are "bad" if they eat food, even if they are very very hungry in reality. Some kids, especially the younger ones, are fearful to eat certain foods all of a sudden; they get horribly anxious thinking about eating and feel a sense of relief only if they do not eat.

The treatment for anorexia is indeed to require kids to eat. For some kids it can be easier than others. If you catch it early enough, it might be enough just to insist of three meals and three snacks a day, and no phone or other devices or other treats until everything has been eaten. For others the recovery process is much much harder, and might involve a feeding tube for a time, until the kdis are able to eat again on their own.

Anonymous wrote:

Anonymous wrote:
I don’t know how to manage it because I don’t want to do anything to contribute to disordered eating, and while I can force her to sit at a table with food in front of her, I can’t force feed her. I feel like she’s basically making herself miserable for no reason. I’m sure her growth is slowing, so her appetite might be decreasing naturally, but she is and has always been very thin, and I don’t want this to impact her health.

Trust your Mama Bear or Papa Bear instincts. An 11 year old girl is usually going through her peak growing years around age 10-12.

For most girls, puberty occurs between 8 and 13 years old and the growth spurt occurs between 10 and 14 years old.

https://www.healthline.com/health/when-do-girls-stop-growing#:~:text=For%20most%20girls%2C%20puberty%20occurs,by%20age%2014%20or%2015.


Do you have some reason to believe her growth is slowing right now? (Did she go through a very large growth spurt and already hut puberty?) If not -- she should be growing a LOT right now so she should be eating a LOT.

You have a sense of what normal food intake is for your child. Can you look at what she is eating, and guesstimate her daily caloric intake? Trust your instincts. You know how to feed your child. If she isn't eating normally for a week, ok fine. But if this has been going on a while... be alert and pay attention. It is NOT normal for kids to just not eat.

+1

Many different factors contribute to eating disorders. Look into it, OP. I wish you well. This happened to a good friend of mine's family - it was a long road, but you can do this.

Anonymous wrote: “It’s a control issue” is what we were all taught, but it is not grounded in current eating disorder research.

OP, eating disorders can happen in children as young as 7.

FYI, Maudsley/Family Based Treatment (which is the only evidence-based treatment for children and adolescents with anorexia) absolutely involves forcing your child to eat. Just like if a toddler refuses the car seat and reasoning, bribing, etc, doesn’t work, at some point you have to forcefully buckle up your kid.

Pediatricians do not receive specialized training in eating disorders. I’d take my child to a Maudsley certified psychologist, bring in growth charts, have her weighed and evaluated.

Malnutrition can lead to heart problems and bone density issues much sooner than you’d think, even if your daughter doesn’t look skeletal. Your instincts are telling you something for a reason - get on this now.

Yes, yes, yes.

- parent of a girl who developed anorexia at age 11, and was hospitalized for low heart rate less than three weeks after she was formally diagnosed. If you have an excellent pediatrician, that's good. If yours doesn't believe this is the onset of an eating disorder, find a new doctor. Get a weight and height and heart rate baseline now.

This site was a godsend for me when we struggled with DD's anorexia: https://www.feast-ed.org

(My DD is now 16 and thriving, but the first year was terribly difficult and I was just grateful we caught it as early as we did.)

Wishing you all the best.

Anonymous wrote:When food becomes about control, you step away. Don't acknowledge her eating habits in any way. If she becomes underweight then, yes, you'll need to intervene and take her to therapy.

Terrible advice to step away. This kid is eating a small lunch and small dinner, already. Abt half her former food intake. It’s not just about not eating when she’s mad at someone.

When food becomes about control, you step away. Don't acknowledge her eating habits in any way. If she becomes underweight then, yes, you'll need to intervene and take her to therapy.

If she’s having trouble controlling her anger towards you in a productive way, then maybe she could use therapy in general. Find a good therapist and see if that helps.

Drop the rope.

This is not an eating disorder. This is food being used to get back at you and dad because she knows it will press your buttons.

If she refuses to eat because you have punished or disciplined her, your attitude should be "Fine, that's your decision. Punishment stands."