My 10 Year Old Daughter Has Recently Been Diagnosed with Anorexia.

Get a new dietician first. And you need many more people on her care team. Going from 500 to 3300 calories for someone with anorexia is so unrealistic it’s laughable. She needs INTENSE work with a mental health care professional with an eating disorder specialty, they will usually start by identifying “safe” foods, and work up from there. Good luck!

My daughter has been through two eating disorder programs (with doctors, nutritionists, psychologists - the team approach). Her issue was not anorexia, but rather a learned aversion to food due to medical problems, but many of the same principles apply.

One of the most important things we learned was that the family had to participate. If, for example, mom has just a diet soda and a meal replacement bar for lunch, it's going to be difficult. Or if another family member is doing a Keto diet and another family member is preparing Weight Watchers frozen meals at meal times, it's going to be difficult.

During our initial sessions it was just us (her parents) and our daughter, but as things progressed we were instructed to bring her older brother to sessions so that he could learn about what his sister was experiencing. It was also helpful for him to realize that she had a true medical problem and wasn't just a "picky eater" or being stubborn out of spite.

We learned tactics for dealing with mealtime meltdowns (not reacting emotionally but staying calm, for example). We brought food that we typically ate to the psychologist's office and shared a meal while our daughter played and talked with the therapist.

I think that a family with a child with any type of eating disorder needs more than a dietitian - I think that an eating disorder program is most helpful. Many hospitals have them. My daughter didn't do an inpatient thing, but an age-appropriate eating disorder treatment program that involved tasting foods, sampling unusual foods, trying to identify foods by taste or sight alone, coming up with a plan for accountability with the eating program therapist, etc. She attended sessions twice a week for several months.

Best wishes for a good recovery for your daughter!

What does the therapist or psychiatrist treating her for this disorder say? If she doesn't have one, she needs one immediately. Anorexia isn't about food, it is about a way to control emotional problems or about equating skinniness with self-worth.

You can't make someone eat and the person/doctor/place that diagnosed her should have referred both her and your family on to a mental health professional for follow up and continuing services. If this wasn't done, then you should be seeking a new professional to diagnose her properly and provide you with the appropriate supports.

Good luck.

I am no expert but my understanding of eating disorders is they are all about control. She feels she has no control of her life except what she eats. So ... how much control does she have in her life? Even simple things like who picks out her clothes, shoes, etc. Is she allowed to make any decisions about her own life?

I know she is only 10 but she has to be allowed some control in her life. If she wants long or short hair let her have it. If she wants to paint her room an outlandish color let her. If she prefers all pink or blue (insert any color) clothes okay. When she sees she has more control in her life she will make better decisions about food.

If you remember Karen Carpenter, she died 1982, heart failure from Anorexia. Even though she was a widely successful musician she had little control in her life. Her brother Richard and their record producer choose all of the songs she would sing, clothes etc. She was extremely shy and stayed behind the drums on stage in the beginning of her career. Richard and the producer forced her to come out center stage to perform, she was uncomfortable and hated it. She basically stopped eating and by the time anyone noticed she was in deep trouble.

Let your daughter have some control and decision making in her life. If you want her to eat more let her choose the food, hamburger or chicken - carrots or green beans - ice cream vanilla or chocolate .... I think you get the idea.

My friend went through this with her daughter. Her daughter is fine now, 20 and in college, studying to be a nurse. She's doing great. I have another friend whose daughter wasn't eating, not due to anorexia, but due to Celiac and a food motility problem that had her feeling really ill all the time. She's also doing well. Therapy was key, and I also worked with her to teach her to prepare gluten-free foods she liked so she could take control of her own eating. That's stopped the fighting between mom and daughter. She was 15, turning 16, when I worked with her. So your daughter might not be quite as adept in the kitchen yet, but perhaps you can consider a version of this, helping her to prepare basic foods (or having some neutral person do it) with no expectation that she must eat.

The psychological part was the big hurdle. So hearing that you have a great team is wonderful. Do work on the therapy more than you worry about the calories. I know that's impossible in many ways, but I think it may be the way you have to focus.

You can also sneak a lot of nutrition into foods. I work a lot with protein-rich, nutrient-balanced powder which can be put into yogurt, smoothies, milk, water, and even sprinkled on a lettuce leaf or a quarter of a turkey sandwich - whatever the kid will eat. Rapid absorption at the cellular level helps people get the most from the nutrition, even in small amounts. So you could try something that is highly absorbable but not thick. I'd stay away from things like Boost and Ensure - those are chock full of emulsifiers which makes them hard to digest. They fill the person up too, which makes them less willing to try other foods because they just don't have room or they feel kind of nauseated. I've gone to a lot of nutritional and food science trainings, and there are a lot of people with anorexia/bulimia success stories. So there is hope!

My advice, based on the experiences of friends as well as the lectures I've attended, is to stay focused on the long term and not today's calorie intake. Therapy can help your daughter figure out how she can have more control in her life without restricting food (if that's the issue) or redefining her body image (if that's the issue). Also work with the therapist yourself. She won't just one day start eating again. It will be gradual. You will have some successful days, and some setbacks. As hard as it is for you to back off, you really have to. But this is all new to you and you will see that a good therapy program will work with the family and not just the child. Don't be afraid to ask for help, and don't feel that this is up to you to solve.

Part of the process, and maybe I am just repeating what members of your support team have already said, will be changing the system and not just your daughter's place in the system. This will mean getting all the family members on board, looking at what you can work on to create an environment that will promote her healing. This was the trickiest part with my own daughter - seeing my role as a mother and getting my husband to explore his role too and make positive changes. Anorexia is so dangerous, I'm glad you're getting professional support. Just make sure the support is there for all of you and not to "fix" your daughter. It is so scary to watch and not be able to help right away, but you can do this. Slow and steady, effect positive, lasting change and don't get discouraged if it ends up being two steps forward, then one step back.

Updated

Part of the process, and maybe I am just repeating what members of your support team have already said, will be changing the system and not just your daughter's place in the system. This will mean getting all the family members on board, looking at what you can work on to create an environment that will promote her healing. This was the trickiest part with my own daughter - seeing my role as a mother and getting my husband to explore his role too and make positive changes. Anorexia is so dangerous, I'm glad you're getting professional support. Just make sure the support is there for all of you and not to "fix" your daughter. It is so scary to watch and not be able to help right away, but you can do this. Slow and steady, effect positive, lasting change and don't get discouraged if it ends up being two steps forward, then one step back.

When my best friend and I hit puberty, she told me how her older sister was on this crash diet. So we tried it out We drank diet sodas and ate next to nothing for a month. We lost a ton of weight. Crash dieting at a young age messes you up - distorts your body image.

Some girls become anorexic for psychological reasons, but some try dieting (peer pressure, fad, etc.) and find it hard to eat normal proportions again for fear of gaining it all back. They aren't mature enough to understand what is healthy. Most women don't get it - so of course kids can't.

My sister clued in to what was going on, had my mom take me to the doctor. Thankfully, my dieting lasted a month. My friend struggled with eating issues for years.

I would say going from ###-###-#### is unrealistic. Baby steps. It's very scary to a kid who is not eating to think she has to put all the weight back on.

That's just going to cause her anxiety to go through the roof the poor girl (think you said she was anxious). Right now, you just want her to stabilize so she doesn't lose any more. I think you need to find a new health team - and a therapist for her. Have them work together.

She needs encouragement and support. I would try to figure out if it's a diet that has gone terribly wrong, or if it's a deeper psychological issue - either way counseling will be helpful, but if something hurtful has happened, she'll need help for that.

My suggestion to start - those high energy drinks like Boost - she won't feel anxious and can sip away. It's not like eating and have calories but nutrition. Taste good (like chocolate).

anorexia can be controlled, but its shadow will probably be a lifelong thing. i'm glad to see that the dietitian isn't expecting that sort of increase any time soon. that's really really unreasonable. i don't think expecting anyone to eat 3300 calories every day, especially an anorectic girl, is reasonable.

i'm sure you're aware that anorexia is all about control, not about food. it's not a simple equation. expect some backsliding even if all goes well. if she's purging she's in danger already so that has to be watched. but you don't want her to feel micromanaged or controlled, so it's a tough tightrope to walk.

she won't just one day start eating again. it's a long process that involves the whole family. dig in and expect a long haul. but there are many good outcomes these days.

good luck!
khairete
S.

The fact that you are coming to a public forum to get these answers indicates to me that you are not receiving enough support from professionals.

A diagnosis of Anorexia Nervousa is a medical emergency that requires experienced and certified specialists of many different disciplines to treat because of its complexities.

You have been reporting this behavior for over a month now. TODAY, I would be researching specialized treatment facilities to get her to TOMORROW. The specialists will also advise you where/how to start family treatment so that you may start understand the family dynamics that play into the illness and understand the concept of a life long recovery plan.

This is not a ‘wait and see’ parenting issue. Move on this now!

You can't specify who/how people respond on a public forum.
Anecdotal stories aren't going to help you nor will they have any bearing on your specific situation.
I hope your whole family is working with a eating disorder specialist.
This dietitian has some unrealistic goals and no clear path with how to get there.
She is not going to just start eating - so don't expect it.
She might very well end up in the hospital on a feeding tube.
I really hope she gets better - but you need a professional that deals with these things.

My friend Laura Collins Lyster-Mensch wrote these books and another. I suggest you read both. If you’d like to speak with her directly, please let me know and I’ll pass along her info.
https://www.amazon.com/Throwing-Starfish-Across-Sea-pocke...

https://www.amazon.com/Eating-Your-Anorexic-Mothers-Memoi...

She worked with her daughter through anorexia and got her out the other side.

I don't have specific advice, but I noticed no one mentioned getting her school on board. Is there someone at school that can help to make sure she eats something at lunchtime? That would be the easiest meal for her to skip since you are not around, so it would help if one of the lunch monitors could keep an eye on her without singling her out and making a big deal of it in front of her friends. Maybe your psychologist can offer some tips on how to help her at school without causing her any embarrassment. Also, make sure the lunches you pack for her are things she is more likely to eat in the first place.

I'm not experienced with anorexia, but our son has ARFID, which is basically a fear of most foods. He was extremely underweight at one point and in eating disorder treatment. Did the eating disorder team give you suggestions on how to get her to eat? With our son, they first threatened him with a feeding tube if he didn't eat enough (which scared him so much he started to eat). He had ongoing meetings with the eating disorder therapist, where he determined which foods he was willing to eat. From there, we made him eat those foods, reminding him of the feeding tube if he didn't and setting specific quantities of food he had to eat, which were recorded in a log.

The eating disorder nutritionist stressed to us to stop focusing on nutrition and make it all about fat and calories. Getting our son to eat high-fat ice cream, for instance, was considered a good thing. We looked for the fattiest versions of his "safe" foods to help him put on the pounds.

If the eating disorder team isn't giving you tips like that, you need to go back to them and ask. They need to be guiding you. Also, check out this message board to connect with other parents going through the same thing. It's moderated by an eating disorder doctor who diagnosed our son (or at least was at the time I was on there 5 years ago). https://www.aroundthedinnertable.org/?forum=136439#gsc.tab=0

And on a positive note, our son gained a ton of weight in his eating disorder program. Five years later, he's at a healthy weight. At one point a year ago he was slightly overweight and it was such a monumental thing because I didn't have the constant worry of getting him to a point where his ribs weren't sticking out.

Good luck!

I have zero experience with this but just wanted to say I'm sending you a hug! This would be so hard and it sounds like you are dealing with it head on! You have some good responses and support below. I hope you are on another forum with parents in similar positions so you can talk freely. I know that when you're dealing with something really heavy like this it is truly comforting to hear from other people in the same position.

The thing is, a nutritionist who doesn't work specifically with anorexic kids shouldn't be working with your daughter. He or she isn't trained to work with this disorder.

Make sure that she doesn't have unfettered internet access. There are sites that glorify anorexia along with pictures that you don't want her looking at.

I'm so sorry you are all going through this. Please make sure that you are getting help as a family so that you know how to deal with her.