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My 16 year old daughter has just been to the doctor. She gained 6''
but no pounds during puberty. She is 5'10'' and 105 lbs - ~35 pounds
less than a normal/light teenager of that height. Her father and I
were both ''sticks'' until puberty and she has always been a very
thin child so I have not worried about it, but it seems she intends
to remain stick-like.
Her doctor and I do not believe anorexia/bulimia is the problem. She
rarely exercises, does not count calories, and can wolf down plates
of food when she wants to. She seems completely uninterested in food
unless it is handed to her on a platter. And believe me, I have
busted my tail trying to serve her with a platter. For instance, I
used to make her school lunch. No matter how hard I tried or what
variety I brought to the lunch box, she was giving it away. She will
not make her own lunch. Now she goes from breakfast to dinner on one
bowl of cereal and there's nothing I can do about it. She is very
picky, doesn't like to cook or prepare food, won't eat at mealtime
if she is not hungry but may want to eat 2 hours later, and gets
tired/bored of eating in mid-meal.
Her doctor has recommended she see a nutritionist and a
psychologist. She believes my daughter is malnourished in that she
is expending more calories than she is taking in.
I've got a few major concerns:
1) I don't want her eating issues to become her identity and worry
that sending her to specialists will help solidify that. The label
of eating disorder has potential to become her new life theme if she
chooses to adopt it
2) Believe me - this is said with great amounts of Mom-guilt - I
resent the dollars and time and energy this may take. I may have to
turn my life upside down offering her multiple food options and meal
times just to get her to gain a few pounds. My younger daughter can
make breakfast and lunch and eats when we eat so it's frustrating to
me to continually cater to the older.
3) I worry how she is going to get by on her own when she goes to
college, given that she is not interested in changing and will
probably not live with a short-order cook. If we throw dollars,
time, and money at this will it not just be for naught if she moves
So - I need to hear from anyone who has dealt with this. Is the
doctor over-reacting, under-reacting, should my daughter start in
with a psychologist or nutritionist, am I a crummy mother? Help!
As a parent of a teen with a serious eating disorder I encourage you
to follow your daughter's doctor's advice and work with both a
nutritionist and a therapist who specializes in working with teens
with eating disorders. I understand your frustration and concern over
the time, effort, money, and possible stigma involved with treatment,
and your fears about the future. But starting now, with a team that
understands the complexity of eating issues could prevent your
daughter from developing an eating disorder and also give her the
skills and support she needs to manage her eating in a healthy way
both now and in the future. Michelle Vivas (510 595-9474) is an
excellent nutritionist, very experienced in working with people with
all kinds of eating behaviors, and an excellent resource for
experienced therapists. Please feel free to email me if you would like
to speak privately.
If your doctor has followed up on all possible tests for everything
besides an eating disorder, and you have ruled out all diseases or
conditions that might be causing under-eating, then it is certainly
appropriate to consider an eating disorder. Not all eating disorders
appear at first to fit into a one of the major diagnostic category.
That's why eating disorders are often diagnosed as NOS, or Eating
Disorder Not Otherwise Specified. With therapy and nutrition
counseling and working closely with her doctor, your daughter may
indeed end up with a diagnosis of anorexia or bulimia, but right now
she needs to get some calories and to deal with the fact that her
health is seriously compromised.
Some doctors don't have enough experience with under-weight issues to
realize when it becomes critical. There are lots of physical
consequences from under-nourishment, including permanent loss of bone
density and the potential for heart attack. 105 lbs at your daughter's
height is pretty low. My best advice is to act AS IF your daughter has
some kind of eating disorder and start working with a therapist and a
nutritionist and a physician with experience.
Mother who has been there
You definitely should see a nutritionist for your daughter-I
recommend Michele Vivas. She is not covered by insurance, but she is
worth the money. My daughter lost a bunch of weight, did not
technically have an eating disorder, but Michele helped her
tremendously-she gained 20 pounds in 3 months. Your daughter's
weight is frighteningly low, this is not something to mess around
with. Your pediatrician should also be checking her heart rate, and
is she getting her period? Malnutrition is very serious, whatever
the reason, and she needs to find a way to eat more. If anyone can
do it, Michele can. Please call her ASAP.
speak from experience
As a parent of a child who has suffered an eating disorder (and
someone who had one herself), I can understand the fears you have
about taking this seriously and getting your daughter outside help.
It is expensive to pay for therapy, and you can feel like you're on an
emotional rollercoaster when you really try to resolve a problem of
this sort. But believe me - it will be the best money you ever spent.
And the sooner you get your daughter help, the better off you and she
will be (not to mention the rest of the family, as these problems will
impact younger siblings too).
Eating disorders only get worse over time, and the weight/food issues
that you are describing sound quite severe.
Also, from what you've written, I certainly wouldn't rule out
aneorexia. People who try to control their food intake will sometimes
eat large meals when they're feeling emotionally good, or may have
good days and bad days. When they're young, they may not pay
attention to calories, and may in fact eat high-fat and high-sugar
foods occasionally without qualms. Eating disorders present
differently in each case. But any young person who regularly gives up
lunch and is purposely taking in less calories than she expends is
facing a real problem.
We saw Deborah Waterhouse (a nutritionist) and felt like she was very
helpful. She has an office in Orinda.
An experienced nutritionist urgently needed for severely underweight
and anxious, ADD young teen with very low appetite. Failure to thrive
complex issues, including depression. Ideally in Penninsula area but
will consider others in Bay Area. Am open to Weston Price philosophy
or other ideas.
Desperate mom of super picky eater
Alta Bates Summit Med. Center at Herrick Campus in Berkeley has an
excellent in-patient eating disorders program for teens and separate
one for adults.
There is a new excellent program for teens with eating disorders at the
Lafayette Women's Center which is affiliated with Alta Bates Medical Center.
They have a nutritionist on staff and work also very closely with the Herrick
Campus of Alta Bates. Apparently, people are flying in from out of state to have
consultations here. Best of luck.
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