More on eating disorders

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67firecracker

Cathlete
I just had a heartbreaking conversation with a friend today who has found out her daughter is struggling with bulemia/anorexia. The mom handled this all very well, not panicking or over-reacting but we commiserated on how any reaction is likely the wrong one. To say nothing at all is wrong, to comment will likely be wrong, to force her to eat will be wrong, to let her not eat would also be wrong. On the advice of a relative who is a therapist she weighed her dd so they had an accurate gauge of whether things were improving or getting worse. She's 5'2 and she weighs 88 lbs.

I know some of you have been through this - how do we help this young girl? The mom feels she's running out of time - her dd is in gr. 12 has only a couple more months where she's at home. Besides taking her to counselling is there anything we can do to help? Is there any 'right' thing to do?
 
I have a friend who completely handled her eating disorder using Dianetics -- you can get the book at any bookstore and read it and see what you think. The complete title of the book is Dianetics, Modern Science of Mental Health.
 
Hi - I have struggled with them myself and to be frank I still sometimes have to battle unhealthy thoughts.

I would say that ensure that you have a good doctor and a therapist who specialises in that area. My doctor was a bit flippant about my problems and when I weighed below 90lbs she laughed and asked how we Asian girls were so small.

The best way to start treating these diseases is to start early (instead of waiting for the physical side to get out of control). I would also urge the mother to ensure that her daughter has a sound support system around her. Apart from a professional therapist there are self help/ support groups where people can discuss their problems with other sufferers. Self help books are wonderful resources too. I personally benefitted a lot from books by Geneen Roth.

The best virtual support system is probably www.somethingfishy.org
Its also wise to work with a registered dietitician who specialises in eating disorders. Hope this helps and I sincerely hope that your friend's daughter will beat this.
 
Trish --

As many of us know, this is a very tricky situation and an extremely difficult problem for many women (pre-teen, teen, and adults). You are correct when you say it seems there isn't any "right" thing to do. You said "besides taking her to counselling" -- I hope that's not meant to imply that they aren't going to get her into therapy right away. Therapy is absolutely necessary, in my opinion. I think you said they had a relative who is a therapist, but that's not really a good idea. The daughter needs a neutral 3rd party and she needs a professional's help. The mother should also join in on some of the therapy sessions OR have separate sessions to discuss issues that come up.

In the end, there is nothing the mother can do to "fix" this problem. She can only help her daughter by getting her into a professional treatment program of some sort and by being supportive in a way that makes her daughter feel safe and loved. The daughter has to heal herself.

If the daughter is going off to college -- there are typically on-campus programs and counselling offered for eating disorders (and mental health in general) that are included in the tuition. Of course, who knows what the quality is like?!?

I would say both need to get into therapy. Mom needs to monitor the situation and be supportive. Daughter needs to WANT help. It's really similar to any other addiction -- you can't force the person into getting better -- they have to WANT it for themselves.

Anyway...that's my .01

Shonie
 
I battled this also when i was in high school. I'm only 23 now so it wasn't THAT long ago. My mom took me to every therapist she could find, basically because i was a stubborn teenager and said i didn't like any of them. But she didn't give up. I wasn't the type of anorexic to workout, (some workout constantly), so she started making em work out. Sounds like the wrong thing to do, but she said "if you want to be skinny you are going to do this the right way. You are going to eat and exercise" and she stuck to that. She made me do 30 mins of arobics each day. And since eating was a huge issue for me, she bought slim fast shakes, and made me drink one of those with each meal. Eventually i started liking exercise, and realized i needed to eat to do it, and the shakes definatly helped me gain some weight back.

So i still to this day thank my mom for teaching me that being healthy is way more important than being skinny. I would reccomend that approach. But of course, what worked for me may not work for her... One thing my mom was clear on was that she wasnt' giving up. She grounded me if i wouldn't eat. Its definately going to require some tough love, but tell your friend not to give up!

Good luck!
 
This is so heartbreaking. My daughter suffered from this in her late teens. I gave her a choice of staying at a clinic in a larger city nearby that handles teens with problems, or going to a therapist in our city. Again, it is so hard for the mother. You constantly want to ask, "did you eat enough today?" and you want to force them to eat, and you want to say the right things. It's so hard. Therapy was successful for my daughter's anorexia/bulemia. It took several months. I will pray for this child.

Margaret
 
It's such a difficult situation. I know from my own experience that, in a way, it's like the anorexic is temporarily a bit insane. When she looks in the mirror, she does not see reality.

One thing that might help is getting at the underlying issues. Bouts of anorexia usually occur during times of high stress, when the adolescent feels out of control of her life and emotions. Anticipating going off to college may be the thing that is stressing this girl. Maybe she needs to postpone college for awhile until she is better able to handle it, or maybe once she starts college she'll start to feel better. It all depends upon the individual. If I were the mother, I would be finding ways to help the girl feel more in control of her life, whatever it takes. For the time being, I would focus less on the eating, and more on the emotions.

Anorexia is like a last resort coping mechanism of people who feel hopelessly out of control. I wonder if an anti-anxiety medication such as Adivan would be helpful? They didn't have that stuff in the days when I was anorexic, but you would think that it would be useful as a temporary measure to get her out of danger.
 
I'm definitely with Nancy on this- focus on the emotions & issues instead of directly on the eating. The eating behaviors are a manifestation of what this girl is going through emotionally.

Unfortunately, the girl, who must be about 17 or 18, is at an age where she is becoming an adult. She's not going to want someone to tell her how to handle her problems. For the mother, this will be incredibly difficult, and I imagine she will feel helpless much of the time. It may not be a bad idea for whoever is closest to the girl to have a heart to heart with her. It could be a friend, relative, parent... anyone with whom she feels the most comfortable. It's important that she not feel judged or "in trouble" to get her to open up a bit.

The best thing you can do now is be there for both of them, which I am sure you already know. Perhaps buying the mom a book on the subject could help as well.

I hope this all turns out okay!
 
The mother should take her daughter to a doctor first to see if the girl is in any imminent danger and then to a therapist. If there are any serious physical problems these need to be addressed immediately and it is the mother's responsibility to take her daughter to a physician for an evaluation. The girl should then be taken to a therapist with experience in the area of eating disorders. The mother shouldn't ignore it, she needs to take an active role in her daughter's recovery.
 
Hi, had to comment as I am a therapist who specializes in eating disorders.

Everyone who said get her into treatment ASAP, I second you. This is not an issue the mother is going to be able to or should try to figure out on her own. Getting a professional involved who knows how to proceed is best. I can say that, based on the stats posted, she could very well be in physical danger, her weight should be around 105-110 for her height.

What is likely to happen if she's taken to a specialist is that the therapist will recommend that she see a physician to get bloodwork done for treatment planning purposes (you might go ahead and take her there). She is a candidate for outpatient therapy, especially if her bloodwork is normal (if not, inpatient might be recommended). A regular eating plan will be instituted and the therapist will help the mother know what to say, what not to say about food, weight, other things (it almost never works well for parents to control what their children eat unless the child is really young).

Then, therapy will begin, and will focus on all kinds of issues, primarily family issues, self-esteem, distorded thoughts etc. No medications have been shown to work for anorexia (is she is depressed or anxious, they may help alleviate those problems so treatment for the eating disorder can move forward more smoothly.

Sorry, too lengthy, but if you have any more questions, I'd be happy to answer them. This is SUCH a confusing, scary issue and it really is hard to know exactly what to do. My thoughts are with you and your friend.
 
>This is SUCH a confusing, scary issue and it really is hard to know >exactly what to do.

That is so true. This seems so strange and out of the blue. She is a bright, beautiful, athletic girl from an upper middle class family. Strangely enough it seems, from the outside looking in, like this year she got her life in order. She's worried her mom for a couple years with partying and having an older boyfriend. She decided last summer that that wasn't the way she wanted to spend her life, dropped the boyfriend and started making better choices. She went from being miserable and grumpy to being quite happy all the time...but obviously in the complicated mind of a teenager there are much deeper issues that need to be addressed.

I will pass your comments and recommendations on to the mom. This has been so helpful for me to be able to unload this on you as I can't really talk about this with anyone else around here. It's also been good to hear from those of you who have struggled with this condition and been successful.

I do have one question. The therapist that the mother talked to said that many girls will 'try it out' for a time period most commonly in Gr. 9 and Gr. 12 and these short forays into eating disorders are normal. Is that true? How does one distinguish between a 'short foray' and a more dangerous situation? I ask because now my dd in gr. 9 has me worried because she quite often "isn't hungry" or she won't eat breakfast or take a lunch. I'll pack food for her but it often comes home untouched. I'm having trouble knowing where the line of control is on a mother's part. Having not eaten all day (or so it seems) she'll often come home and make herself a smoothie and then isn't hungry when dinner rolls around. I've been making her sit with us anyway while we eat. How do you encourage correct eating without having food become a mother/daughter control issue? (OK I guess that was 3 questions!)

Trish
 
Trish,

Just my opinion, but I do think what you said is true about girls "trying it out." Many seem to think it is just another version of a diet like the Zone, Atkins, Weight Watchers, etc. While I wouldn't classify it as normal, I would say it's all too common.

It becomes dangerous when it continues for an extended period of time; when it becomes a habit. It also becomes dangerous when the initial reason for doing it (losing weight) becomes something else like a control or emotional issue.

As far as mothers, daughters, and food, that's a toughie. I think the best thing moms can do for their daughters regarding food is to be a role model of healthy example as often as possible and give them lots of healthy choices early on. When they become teens, the best you can do is to continue to encourage healthy behaviors and choices. You can also teach them that the scale isn't a good gauge and that it's better top focus on what your body can do than how many punds it weighs.

So much to consider these days!
 
I agree with FFD competely.

Parents do not always know how to help. Mine didn't. My father's rage aggravated matters for me and made me more determined not to eat than ever before.

I turn 40 in less than 2 weeks, but my eating disorder raged unattended from age 15 to 28, and even after then, I can still feel twinges of it. I may have damaged my body in ways I can never know. I certainly know that it screwed up my emotional health and my psyche and isolated me terrribly socially for years. An eating disorder is a waste of time and life: beciuase while you are busy not eating, life is what you are missing out on.

This girl's eating disorder is a cry for help. I can bet you a milion dollars that inside she is desperately unhappy, out of control, screaming for help and love. Only professional expertise can help her. I so wish my parents had been brave enough to face the social stigma they feared at the time and confront me with the truth. How much better years and years of my life could have been.

Help this girl to not waste her life. Get her into counselling and a professionally run treatment plan now. That and love are the best things anyone can give her right now.

Clare
 
In answer to your additional questions, which are great by the way, I do think many girls try dieting on for size, and statistics suggest this is happening at younger and younger ages (80% of 10 year olds have worried about their appearance and tried/want to diet). However, I don't think its as easy to try an eating disorder on for size. In my experience, there is usually much more going on than just worry about appearance when someone develops an eating disorder. Think about it, most women worry about appearance a lot, yet eating disorders are still fairly rare, particularly anorexia. So, usually there are other issues and control of food/weight/body shape is something that's easier to focus on than those other issues.

About your daughter, depending on how long you've noticed her eating habits being unusual, you should talk to her about it - Alone, one on one (at the dinner table in front of the family will only make her feel attacked and put her on the defensive). If it hasn't been going on too long, you might monitor for awhile - maybe her eating habits will return to normal and she's just experimenting. If its been longer than a couple of weeks, find a time alone with her and express your concerns about her. Tell her you are worried about her, concerned that she may be trying to starve herself based on what you've seen, and that you worry about her developing an eating disorder. This is an ENTIRELY DIFFERENT APPROACH than trying to control food, although both are driven by the same motivations. Expressing concern and worry, however, will help her be less defensive, and show her how much you love her and care about her.

Don't expect much in this first exchange. She is likely to deny anything, and keep in mind that you may be wrong in your conclusions. Be willing to listen to what she has to say, letting her know your concerns all along. Then keep monitoring quietly. If she continues to appear to not be eating, is losing weight, becomes more interested in food (i.e. collecting recipes, cooking or buying rich foods for others but not eating them herself, talking about food all the time), becomes irritable and more isolated, or you see any signs of bingeing/purging (she goes to the bathroom after eating anything,etc) talk to her again, and this time you will likely need to tell her you are taking her for an evaluation. She will likely argue with you again, but at this point you have much more evidence and in a loving way are saying that you, as her mother, are going to do what you think best.

Now, THAT was long!
 
I myself have struggled and still sometimes struggle with anoreia and binging then excercising too much. I have found that overeaters anonymous, a 12 step program that follows the steps of AA, has helped me focus on my recovery. Of course, dire situations where a young womans' health is in jeopardy calls for more intense therapy, etc. Just wanted to share. :)
 
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