difficult child's and anorexia/bulimia

[hearts and roses]

Okay, I know I will sound jaded but here goes...

difficult child discussed with her counselor, and then me tonight, that she thinks she has anorexia. She claims that she's lost some weight - 10 lbs - which I have noticed she's thinned out, but I honestly just thought it was the age. I've noticed a lot of girls lose the adolescent pudginess around 17+ so I wasn't really concerned. As far as I know, she's been eating lunch, etc. Now she says she's been lying about eating lunch. I see her gobble up the brocolli cheese soup at Panera bread and I see her eat my dinners. She also snacks on what I have in the house such as fruits, salads, macncheese and makes herself nachos. She said that last night she forced herself to eat the fettucine alfredo that she ordered and then threw it up. Tonight, she claims that she threw up the dinner that I sat next to her and watched her eat (chicken with potatoes - her fave - and gravy and green beans. I do not recall her going to the bathroom after dinner, so really, I do not see how I could have missed her puking. I could wake up a tribe of narcoleptics when I puke, so my feeling is that it'd be hard to hide puking in our tiny house if she did.

Yesterday, the counselor was all cryptic when I went in at the end of the session and suggested that difficult child see a nutritionist. I know from my own teen years that seeing a nutritionist, if one is truly anorexic, will not do too much to help. If a person is h.e.l.l bent on skipping meals, she will whether she knows the right foods to eat or not.

Okay, so I am having trouble distinguishing this as either an attention grabbing thing (difficult child's M.O.) or a true case of eating disorder...or a very common period in which one loses their appetite. I recall when easy child was 17, she stopped eating for a while - she simply lost her appetite and I had to talk her into eating. After forcing herself for a couple of weeks, she regained her appetite and all was well. This is how I've advised difficult child - create a goal to eat at least half her lunch and work her way up to a whole meal.

I have lots of healthy foods in the house, I'm not neurotic about my weight and dieting, etc., and difficult child is neither underweight nor overweight - we just try to eat healthy foods.

She's 5'1" and weighs in at approximately 120lbs...she's curvy and buxom. She's got a perfect little figure and I KNOW she's been complimented on it. She takes a multi-vitamin each evening and as far as I can see, when she's home, she's eating okay. I have never suspected her of puking on purpose. She's always been a pretty good eater and usually chooses healthy foods like fruits to snack on, though she's also always been a carb-hound and loves pastas and rice.

So, am I underreacting by not rushing her to see a specialist? Should I make an appointment with someone ASAP? Should I wait a bit and see how this plays out? Should I deliberatly NOT make a big deal out it?

In the past I've learned that when I jump through hoops, difficult child seems to feed off of that. I've learned NOT to jump through hoops and kind of let her see that she needs to work stuff out on her own.

I am kind of annoyed with her counselor for telling difficult child that she agrees she has anorexia based on what?? And also for not telling me but difficult child said the counselor promised not to tell me. Instead, the counselor shoved a card for a nutritionist at me but said it was because difficult child was afraid of gaining wait when she quits smoking. I was confused and wondered why the counselor was going along with that train of thought. I'm thinking it might be a good idea also to find a new counselor. I just thought that was very strange.

Thoughts much appreciated!

 

[Big Bad Kitty]

Basset Hound was NOTORIOUS for doing things for attention. Not only that, she had a SW that was wrapped around her finger for quite some time...it took a few years to undo some of the damage she did. She had this kid believeing that she was a poor victim of everything.
At any rate, given your daughter's age, and given your testimony of seeing your child eat, it does not sound like she is bulemic. She is certainly not anorexic. Now, she may THINK she looks "fat". Most girls her age do. Her feelings should not be discounted if that is the case. But this sounds like a cry for attention. I personally would not rush to a specialist. I would, however, keep an eye on her. I would not make a huge deal out of it, but I would let her know that you care about her well being.

 

[tryingteacher]

in order to have a diagnosis of anorexia you have to fall blow a 14% bmi. I would check and see if she is visiting in pro-ana sites and watch to see when she goes to the bathroom after eating. If she doesn't go within a half hour of eating I doubt she is throwing anything up. I played that dangerous game and after passing out in the bathroom and getting some really nasty bruises and threats of a feeding tube I straightened out. I didn't have an eating disorder just body issues. maybe you could get her to join a gym or something. hope this helped.

 

[klmno]

Maybe the counselor is just trying to be her "person on her side" by believing everything she says, I don't know. But, I would definitely keep an eye out on it. I am about 5'-1 1/2" and was pudgy around 13 yo, then as an older teen, was so stressed out that I went down to about 90 lbs or less- not bulimic but could not eat or when I ate, was so stressed that I couldn't keep it down, unintentionally. I don't know the circumstances, but it seems there is a small chance that she knows something isn't right with her eating and keeping it down and she's assuming it is anorexia or bulimia. If she starts losing weight suddenly, I'd get her to someone. But try to keep in mind, in my humble opinion, it's not necessarily that she's anorexic like "I think I need to lose weight"- it can sometimes be that the person loses all apetite or when they eat, they can't keep it down due to other stresses. If she starts losing weight suddenly, it's not just for attention. If she doesn't lose weight or is acting sick, then it does sound like a cry for attention for something else.

 

[smallworld]

Jo, I always operate under the assumption that it's real until proven otherwise. In your shoes, I would not discount what difficult child is saying, but I would do detective work to see if you can figure out what's really going on. It definitely sounds as if there's something rather than nothing. But I happen to be particularly sensitive about eating issues because my easy child had such a bad time last summer when she stopped eating after developing a choking phobia.

Here's hoping you can figure everything out.

 

[flutterbee]

I would keep an eye on it, too. These things can get out of hand quickly. I maybe wouldn't jump into full force battle of the ED, but just keep a watchful eye on her diet and bathroom habits and go from there. I would, however, have serious concerns about any therapist keeping a possible eating disorder from the parents. in my humble opinion, that falls into the harming of self category that necessitates the therapist telling the parent. Maybe the therapist didn't really buy it and was seeing how it played out?

Food for thought: I was mildly anorexic as a teenager and into my early twenties. My lowest weight was 95 pounds at 5'4" and it took me 6 months to gain 2 pounds. I did have body image issues, but the real cause for me was that it was the only way to put a physical face on the emotional pain. There wasn't a broken arm or a tumor...nothing that could be seen or touched. And there were no words to articulate just how incredibly miserable I was. But I needed it to be seen. I needed someone to know how bad I felt. It wasn't a conscious thought at the time. It's just the way it manifested.

 

[kris]

<span style='font-size: 14pt'> <span style='font-family: Georgia'> <span style="color: #663366"> therapist cannot reveal what is discussed in therapy. your daughter has a right to confidentiality & medical consent is usually 14. i think she did what she could under the circumstances.

since daughter has confided in you ask if she will grant therpist consent to speak to you....even if only on this topic.

kris </span> </span> </span>

 

[timer lady]

Six of one, half a dozen of the other. If difficult child knows the symptoms/patterns of an eating disorder & has a proven track of anxiety issues - I'd definitely keep an eye on it.

And there are criteria on which to base a diagnosis.

As we have a budding eating disorder with kt, we watch food intake very closely; the rule is 2 glasses of water before a meal & no bathroom visit for a half hour after a meal. This has become routine around here with little protest from kt.

Attention grabbing or not, an eating disorder can quickly get out of hand.

 

[jbrain]

Hi JoG,
I guess I agree with the others about just trying to keep an eye on her and figure out if anything is going on. I am like you--if this had been my difficult child 1 I would be pretty jaded in my response as well. While she was in rehab she started throwing up after eating--it was sort of a "fad" there for awhile since they had a bulimic girl. She also was a cutter for awhile--got lots of attention from her middle school friends for that. I guess it just seemed that none of these things were really "real" if you know what I mean. They seemed to be ways to shock people or get sympathy from her friends, etc.

Good luck, always something...

Jane

 

[hearts and roses]

If difficult child knows the symptoms/patterns of an eating disorder & has a proven track of anxiety issues - I'd definitely keep an eye on it. And there are criteria on which to base a diagnosis.

Attention grabbing or not, an eating disorder can quickly get out of hand.

This about sums it up for me. Despite my reservations, I've always taken everything going on with difficult child very seriously - I just cannot allow her to see just how alarmed or concerned I am. If she sees that I'm 'very worried' or 'freaking out' she eats it up and overplays every little move and thus, makes the situation much worse than it has to be.

My plan is to do as everyone has suggested: Keep my eye on it, be sure to time visits to the bathroom after a meal, be sure she's staying hydrated, etc. Last night we talked some more and created her first goal: Eat only half a meal at a time, rather than forcing herself to eat it all (her bff told her to force herself to eat all her food and then when difficult child was feeling too full, she puked it up). So, she ate 1/2 a bagel this morning with a cup of coffee. I gave her lunch money and she is supposed to eat 1/2 of everything and bring the rest home with her. She also voluntarily took a piece of some coconut pound cake I made last night so hopefully she will include that in 1/2 her lunch meal plan. Or, maybe she will do what she says she's been doing and give it all away!

I have a call into the counselor - she's been pretty cool with me in that she DOES tell me things, just not in front of difficult child. She will wait for me to call her and then we have a brief discussion. Someone mentioned that maybe the counselor wants to be the 'good guy/friend on difficult child's side' in all this and I tend to agree. She's played that role in the past and then we discuss it privately. difficult child has had on a very long face since sharing this with me and I am getting the impression that she feels like I'm not reacting enough....as if she expected me to bawl and be all upset and freak out (not usually the case - I usually do that in private). I usually try to remain calm so my kids will keep talking. My mother was a freaker outer and as soon as she'd get hysterical, we'd back away so I have always tried to remain calm and supportive while we work through the details.

I was considering getting a book or some material on anorexia/bulimia. I am familiar with it as when I was difficult child's age, I was anorexic and my DR threatened me with hospitalization if I didn't 'knock it off'. I got down to about 95lbs at 5'5" (I was 18/19) and one day I just got my appetite back. My easy child went through a period where she lost her appetite and when her hair began falling out in whisps, I pointed out to her that it is probably related to her diet and she started eating again. And that was that.

difficult child told me she doesn't like her belly and legs. I suggested a walk around the block in the afternoons rather than her usual nap. She grimaced. I am not averse to having difficult child join a gym, in fact, we've done it all - a gym, dance class, Tai-Bo, Karate, gymnastics, etc. The thing is that she will sign up and then not go and then I've wasted hundreds of dollars. This kid has made an art out of sleeping. If she were getting paid for it, she'd be a millionaire! She smokes, sleeps, works PT, goes to school, and watches hockey and Law & Order. That is the extent of her activities. I've tried to coax her into going hiking with me, biking, etc. I've tried to get her to read a book, or get back into her drawing artwork and music, but she just gives me a blank stare.

I've watched her try new ways of getting a rise out of us and behaving risque or dangerously over the past few years. She tried cutting for a while, she tried to tattoo herself, she had risque discussions with strangers on line and wound up being kidnapped and assaulted. Now this. I know that she's bored and lonely. I know that she feels like all her peers from school are out having a blast and no one calls her to join them. on the other hand, when they do call, she declines the invite.

She was recently being "courted" (ugh, I'm so old, but that's what it was) by this nice kid at her school, but she chose a loser over him. Now this loser never calls her during the day on a Sat/Sun, but only maybe once or twice during the week for about an hour he will come over, flop down and watch TV with her and then leave. It's like he's killing time and in between difficult child sits around mooning over him (God, I am SO old!).

Thanks for all the feedback.

 

[hearts and roses]

They seemed to be ways to shock people or get sympathy from her friends, etc. Good luck, always something...

Yes!! That's it!!

 

[neednewtechnique]

I had an eating disorder when I was in high school. Luckily for me, it only lasted about 2 years. There is a disorder, or rather, I like to call it a complex, called BDD. This is where one is gone WAY past the point of the typical "IM FAT" assumption that most girls her age are going through. This goes on to the point that when she looks in the mirror, she doesn't even SEE herself as she is and thinks she's fat, she may actually look in the mirror and see a double chin (that isn't really there) or a fat roll in her belly (that isn't really there either) or a behind that is much to large for her liking even if it really is perfect the way it is.

The fact that she is still eating at times and she is already recognizing that she is "anorexic" makes me think that maybe she is toying with the idea of trying it out to see if it will help her feel better about herself to NOT eat. But in the end, her willpower gives out and she gets hungry and decides to go ahead and eat. That being said, I don't know your daughter and I really can't say if this is what is really going on or not, but in my opinion that is what it sounds like. And if she really IS still in the beginning stages and simply toying with the idea, let me give you a tidbit of info that you can pass along to her.

No matter how much weight I lost, I never felt better about myself. Then on top of that, I was always crankier because I was hungry when I chose not to eat...and when I finally decided that anorexia wasn't the answer because I was simply too interested in eating, I thought bulemia was a better choice for me. It caused me many health problems, I was constantly sick from eating too much and then making myself sick, my stomach was always in knots from "purging" and from the diarhea associated with abusing laxatives. And it has SERIOUS LONG TERM CONSEQUENCES. Now at age 23, I have serious dental problems because frequent vomitting leaves acidic residue that gets up under your gums where you simply CANNOT reach with a toothbrush and decalcify's your teeth to the point they turn soft and flake off in tiny pieces until there are huge holes in your teeth right inside the gumline, which is PAINFUL to have and EVEN MORE PAINFUL TO TREAT because in order to correct this problem, they have to separate your gums from your teeth...etc. Also, I am no longer physically capable of vomitting when I genuinely AM sick, which generally like with the flu, as unpleasant as it is to vomit, usually afterwards there is a short period of releif of the nausea...but if you simply CANNOT throw up, there is NO break from the nausea and it seems to get worse becuase all that grossness is stuck inside and has no way to get out...

Not trying to scare her, but maybe sharing someone's personal experience will help her understand that if she really wants to ensure that she isn't "fat" her best bet is a good diet and excercise. You mentioned that she IS taking vitamins, which is a GREAT thing, and you must continue to be sure she takes them, just in case, because this will help supplement the nutrients she will be missing if she isn't eating, or if she is purging all her food too quickly after eating for any of it to soak in.

Also, if you fear that she is vomitting up her meals...when I was in treatment, and even after I got home from treatment, I was required to SING anytime I went to the bathroom so that it was evident that I was not making myself sick. You simply cannot puke and sing at the same time, so it is a good way to know for sure. :smile:

Good luck, eating disorders are serious, and they are scary. No matter what, I would rather assume it is serious and find out it wasnt than to write it off as a ploy for attention and find out later that it is much worse than you thought.

I will be thinking of you!!!!