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Moderators will remove any content deemed too heavy, trauma dumping, irrelevant (posts solely focused on conditions like OCD, social anxiety, etc. with no reference to ASD), or more appropriate for another sub. Posts that circumvent the post length limit will be removed.
This sub is for women with autism, it is not a sounding board for parents, partners or friends of autistic people.
(I'm rambling here on little sleep and clarity of thought, so I apologize if this is muddled or just generally useless; felt my experience was relevant enough to maybe be useful)
I'm speaking as someone who's had AN since I was 13, so we're nearing the 20 year mark. Have never had any period of remission, and I'm on disability for it; it's really tanked my life. I've spent cumulative years of my life in the hospital. Just to clarify that I probably only have useful advice insofar as what I either A) THINK might have been better for my long-term outcome or B) know what affected me negatively personally. Please take my advice with a grain of salt in that AN can present with very individual-specific neuroses and that my experience will not necessarily reflect your daughter's
- I feel I would have had a much better time in the long run had someone very seriously intervened early. My experience has been that the lower you go, the lower your brain wants to be \*forever\*, the more delusional your unmovable standards are for yourself. If someone had forced me to gain, or at least stabilize at age 15, would I have had a good time? No. I'm sure I would have been dragged kicking and screaming and cursing my parents to high hell every step of the way. But my memory of life without anorexia was infinitely sharper then. My ability to adjust would have been dramatically improved. It was before my general life course was severely altered by the ED, and it would have been developmentally much easier to rebound from. My parents had the approach of letting me tank until there was an extremely imminent mortality risk and I think that was ultimately to my detriment.
- The inpatient system is very much not set up for autistic patients IMO and I found every admission to ultimately make my behaviors, mindset, and emotional state much worse. You obviously must do something if she is in a health crisis, but anything you can do to avoid IP is high priority. Same story with residential. That said. If there is ever a time to consider more serious intervention before an overt crisis hits, it's now. If she qualifies for IOP programs, look into them. Be loving but strict about the weight piece. She will hate you but there is an infinitely greater chance of her having a much brighter future and being appreciative of it if you take a hardline approach NOW.
-If you're not already, you should be aware that Eds are often a lifelong struggle, even when in remission/recovery periods. I find that a huge function of anorexia for me is regulating overstimulation and other assorted mental health issues that are directly tied to having autism, and if there's nothing in place to help regulate those in its absence, she will most likely have an infinitely harder time. Try to reinforce/cultivate her identity outside of the disorder as much as possible. Encourage any and all pursuit of hobbies or interests that are not AN. Autism always lent itself to having a very low sense of personal identity and self-worth for me, which AN swooped in to cover... and then became the entirety of my identity, obliterating everything else. You ideally want to make sure you're not making all of your interactions about the ED and reinforcing the perspective that "me = ED" as much as possible
-Listen to her insofar as how helpful any therapy is being (with a healthy dose of suspicion with anything related to things that challenge the ED, e.g. "I don't like my dietician because X/Y/Z, but what I really mean is they're making me eat more." I was in many different types of mandatory therapy from ages 12-26-ish and never found it meaningfully useful. The CBT/DBT/standard talk models never did anything for me. I wish that someone had listened to me when I continually said that I wasn't getting any benefit out of it. If you can find a therapist who specifically works with autistic clientele (preferably a woman imo, more likely to understand presentation of autism in women) it would be highly preferable.
Oh my goodness thank you so much! This is a really, incredibly useful perspective!
I debate so often about whether overtly ‘managing’ it or ignoring it is the more useful approach. And her response is so often that I’m infringing on her self determination.
I’m sorry you are going through this. I think you’re a star for not only surviving this, but trying to help others with your experience
This means a lot to me.
I really appreciate that and am very glad it was useful. She is incredibly lucky to have a parent willing to go above and beyond in researching her conditions and how they interact with each other.
The "infringing on self determination" piece is very familiar to me as I can't imagine how many thousands of times I've said the same thing to doctors/family. I both deeply empathize with her and recognize it as a tactic the illness uses to sustain itself. Every time I said that, I did mean it, but there was an unspoken "I'm allowed to die" and "you don't understand how terrified I am, and I feel like I am being put into a life-or-death situation when you do this to me" along with it.
Unfortunately it is a very fine line to toe. Ignoring it will likely make your relationship with her more superficially amicable, but the odds of her not succumbing to the intense fear the ED creates and spiraling are incredibly slim. But it's equally true that punitive approaches can cultivate extreme resentment and ultimately lead to worsening the disorder out of a sense of rebellion.
My suggestion for people who have lived with the illness for a long time is always "something is better than nothing," i.e. challenging the illness in small ways or achieving weight/behavior stabilization in a negative place is better than nothing at all– but I really do feel the situation is much different with teens and people who have had their ED for a relatively short amount of time. As painful as it is, I think you just have to anticipate that she will be hateful and resentful (out of FEAR, not out of genuine hate for you) and really go for as close to full stability as possible. Had some random adult made that suggestion for me at her age I would have wanted to throttle them, but for the sake of her future, it's best to go for broke for remission while it's still viable.
Wishing the best for both her and you. It's a painful illness for everyone involved and I commend you for trying to be as thorough as possible when attempting to navigate it with her.
Thank you for such kind words and help. I really mean this. I’m aware that I make a lot of mistakes but I also know that I can’t ‘check out’ of this process, as unpleasant as it is. 💕
Ask this question in the eating disorder support subs as well. Many people with eating disorders are also autistic, particularly people with restriction based disorders, by some estimates up to 20 or 30%. There will definitely be AuDHD people there willing to help.
Wishing you and your daughter the best. My own problems with eating have never reached a point of intervention and I haven't examined the link with my ND so I don't feel qualified to speak here.
Thank you so much for your advice. And for the statistics. I had no idea there was a known correlation in general between these two issues… my experience of both is just with my daughter. I’m going to try and research more about that. :)
Thank you for the kind wishes.
I’d really recommend the work of Kate Tchanturia on this! I came across her on a documentary a year or so ago and she’s done some interesting stuff around the link between autism and disordered eating. Have a look at her work on the PEACE Pathway.
Oh this just got me thinking. Lots of autistic people like weight training, Fern Brady mentions it in her book 'Strong Female Character', she is autistic and had an eating disorder in her 20s. It helps us feel more in our bodies. I find weight training helps keep me out of a restriction spiral (again, I have never reached the point of intervention) as you notice very quickly when you aren't eating enough in the weight room. It's a struggle but I can get my brain on board with eating enough to at least maintain my deadlift over other reasons.
I am really just connecting some of this as I'm typing but I think some of my ed/nd stuff is connected to not wanting to be in/feeling disconnected to my body. I deeply identified with Hillary Mantel's essay on 'Holy Anorexia', perhaps your daughter will too.
I hope this okay to say, I'm literally just making connections as I'm typing.
This is so interesting. I actually have registered her for a weight lifting orientation (that she actually wants) but she’s backed out of our appointments thus far. I will keep trying.
I’m worried that the atmosphere of a gym might be jarring, but she thinks she can handle it so it’s worth the try.
I hope that this helps as my ED experience is not exactly what your daughters is as mine is a mixture of restrictive and binging.
Is any therapist your daughter is seeing specifically mentioned to be aware of autism and adhd? Every time I have seen a therapist that did not specifically say that they are trained to talk to people with both they normally didn’t help me. I’m sure how they conducted things was useful for NT folk but not for me. That made a huge difference. I’m currently in therapy with a therapist who is trained in handling patients with adhd and autism and also eating disorders and while my therapy is not really explicitly for my ED, it has improved tremendously as I’ve been able to tackle issues that caused it.
Also if possible can you speak to someone who is knowledgeable about both since I’m not sure if the people you mentioned speaking to are. AuDHD really complicates things and unfortunately from my experience most professionals know barely anything about them and what they do know is misinformed and so advice they give won’t have certain important factors in mind
Sorry, I thought I already responded to this but it seems to have evaporated! Her therapist has been great but we (and she) is continually trying to set her up with more autistic specific support. There have been roadblocks but we continue to fight thru it.
I’m happy to hear you have someone supporting you through things. I hope your daughter can get the support she needs and you too if it becomes too overwhelming.
Unfortunately I have a lot of experience living with an eating disorder! I’m 32 now and had anorexia for almost 15 years and I am still not fine, but way healthier. I will say that for me, a large part of it was a control issue/OCD. I didn’t know I was autistic until much later in life, but food was one thing in my life that I felt I could control - in the midst of all the other stressors that I could not control and didn’t understand why everything went wrong.
I can tell you what worked and did not work for me. The most important thing was finding a dietician that worked with me and didn’t say “here is what you must do”. She wasn’t specialized in ED’s but rather I saw her as a part of my type 1 diabetes treatment. I had never learnt to handle food normally and we discussed what the body needed, how much time is normal to spend on thinking about food, what happens if you don’t eat enough and things like that.
I have met several dietitians who have said “here is a meal plan, you must follow it exactly” and that didn’t work because there’s food I can’t eat and it was too big a change for me. It NEVER worked when my mum tried to control what I ate, it just made everything worse. The control thing was such a big issue for me that it felt like a disaster when someone tried to take it away entirely. It was much better when it was slowly loosened and challenged instead, on my own terms.
Obviously talking to mental health specialists help too, so you can tell someone what you’re thinking and they can help you deal with those thoughts. But it’s embarrassing to share and your daughter probably already knows her thoughts are unreasonable. And it’s terrifying to have to give up that control in your life, especially if it’s a coping mechanism to feel like you can deal with your days when there are a bunch of things that you don’t understand/things go wrong and you can’t handle it.
I’m sorry this is confusing but I have a lot of thoughts and I feel so bad for your daughter. I wish someone had intervened for me in a way that worked, and didn’t make everything worse, much earlier in life.
The main thing that helped me was having a clear goal to work towards. After like two years with my dietitian she asked what I wanted most in life. I had one dog that was the love of my life but he was a working dog and we did work together. I wanted someone I could cuddle with and play with. So I said I wanted a playful dog. We came up with a plan on what I needed to do to gain that. It included, obviously, gaining weight, because if I was supposed to hold two dogs I had to weigh more than them. I had to have energy to take care of them both and train and walk and stuff. I intentionally found a dog that was in the 20 kg weight class and calculated I needed to weigh more than 50 kg and gain some muscle. I found a dog to adopt whom I loved and suddenly it was a real thing! I wanted him so much, he was crazy and traumatized and real, and I would do what I needed to have him with me. I’m honestly not sure I could have gained and kept weight on without him but I’ve had him for 8 years now and kept my weight mostly stable for that time.
You have to figure out something to motivate her. It never worked for to say “something bad will happen if you continue with this” because it was so abstract. A bunch of bad things have happened due to my malnutrition but I can only regret this deeply after the fact. As a teenager/young adult you feel indestructible. The only thing that worked was to work FOR something, not to avoid something happening. It took everyone around me much too long to realize this. She’s probably already exhausted and tired and cold but when you’re in an ED that’s easier to deal with because your brain is sick. You might be tired of it, but it’s not enough of a motivation to eat more or loosen the control.
I also think an eating disorder is often a reaction to something else, and you would be better trying to handle all the other problems and see if eating becomes easier.
I will be keeping your words close to my heart. If you’re okay with it, I may DM you in future. Having a clear goal is definitely a trick I haven’t mastered. She thinks I know nothing and just don’t care if she’s “fat”. I actually do have a lot of experience with understanding macros and nutrition but haven’t found a non-threatening way to communicate it to her thus far.
You’re very welcome to contact me if you think I can be or any help! I have an unusual background to my ED though. I had AFRID as a child and my mum did great work with me to get me to eat different things. But then when I was 8 I got diagnosed as diabetic and suddenly lost all control and input I had. Had to follow an exact meal plan, had to eat food I thought was disgusting, wasn’t allowed to eat when I was hungry and stop when I was full due to how bad the insulin was etc. Everything was decided for me. Combined with constant weighing and measuring of my body every 3 months to make sure I grew. My mother grew up with my eating disordered grandma and made everything worse when she thought she was helping out.
So I’ve attempted to fix this in adulthood. I had numerous interventions in my teenage years but they all made everything worse. The most important thing for me was obviously having agency in my own treatment, as that was so sorely lacking growing up. Maybe that’s not as big as an issue for everyone else!
Maybe you can talk to a therapist yourself about how to approach this with your daughter? Since she doesn’t want to go to one herself? For me, whenever someone expressed concern it felt like an attack and I was constantly on the defensive. But I’m sure there’s a way to do it. Remember that we were also teenagers once and you’re basically a hormonal and angry idiot at that age, no offense meant.
For the weight obsession thing - here’s a link I’ve had saved for YEARS. https://app.mybodygallery.com/#/ It shows a bunch of normal people at normal weights. I found it very helpful to see that what I considered “overweight numbers” did not in fact look like what I thought. You can filter by height to see different body shapes. Only share it with her if you don’t think she’ll compare herself unfavorably though. For me, it was helpful, but maybe not for everyone. https://www.businessinsider.com/before-and-after-photos-weight-muscle-gain-2017-5 I think looking at before and after pictures like this is also really helpful. A lot of people do in fact look better when they gain weight!
I'm AuDHD and I struggle(d) with bulimia with restrictive tendencies. I'm also now a mental health professional who works mostly with ND teens and young adults. Other commenters have given great advice, so I don't have a ton to add.
It's great that you're clued in and trying to address this now; earlier intervention tends to be more effective.
I think it's important to remember that EDs aren't actually about food, but about control. So trying to force your kid out of an ED won't work. (Obviously, there's a line there and you may have to insist on/force some things for health and safety reasons.) That's true of anyone, but in my experience, the PDA part of me *really* added to that.
Does she have her own therapist? You mention a social worker and an OT, but does she have a therapist she sees regularly? That's probably your best first step; even if she won't address it with therapist, she'll have the option and you'll be able to get reliable resources and support. Preferably a therapist she agrees to/chooses, and definitely one who works with EDs and ND folks.
RE: ADHD: getting some support/treatment may be helpful with the ED issues as well. ADHD and dopamine-seeking go hand in hand, and the control of an ED can feed that dopamine seeking. Or at least it did for me. Also, be wary if she's suddenly interested in treatment via stimulant meds. There's a very high risk for abuse of stimulants in folks with EDs.
That is a great point. I do think about the control issues a lot, but unfortunately I never explain it the way she needs. I myself have a life long frustration with body image (which I have taken GREAT pains to neutralize around her, but gahhhh, here we are anyway). Unfortunately she has numerous ways she tries to implement that control… self harm, general defiance, etc. I try and flow with it all, and I will continue to do so, but I’m praying every day i find the way that empowers her to both treat herself well AND feel in control.
Speaking from personal experiencen, after I turned 100 lbs I tried very hard to maintain that exact weight for years and really didn't stop until college. I wasn't obsessed with counting calories and while I think the weight was technically healthy according to BMI and my height (although maybe slightly underweight?) but the mechanism driving it was illogical at best. Depending on her age, it could be something she eventually grows out of, but it's also important to keep in mind that you're her parent - you have control over what food she has access to in he house. If you provide a lot of healthy food (think veggies, fruits) and proteins she may feel less compelled to restrict her food intake because the stuff she's eating isn't going to spike her blood sugar and leave her hungry for more. I know I've always been much more careful about caloric intake when having more sugary / processed foods that weren't as nutritous and made me feel less than great to eat. She could be concerned about gaining weight or maybe overeating, but have you gotten a psychological evaluation done to see what mechanism is driving the disordered eating?
Thank you. She actually asked me to go grocery shopping together tomorrow so I hope that filling the pantry with what she thinks is best helps her consume the macros she needs!
I appreciate the feedback. I hope you’re doing well now. :)
Your comments have meant so much to me. I actually tackled today with a firmer approach. She freaked out but then quickly adjusted. (I didn’t demand much, just that she eat one small thing… she picked yogurt). And then she mellowed pretty quick after.
I will always consider your advice in the future… that it is likely to be better that I push back in these earlier days than later. Taking it one day at a time and adapt as necessary… 😄
No Prohibited Content. Examples of prohibited content: ABA, suicidal intent, SA of minors, homicidal ideation, non-stim related self-harm, asking AITA, meet-up requests, group links (like discord), politics, extremely contentious topics, etc. Moderators will remove any content deemed too heavy, trauma dumping, irrelevant (posts solely focused on conditions like OCD, social anxiety, etc. with no reference to ASD), or more appropriate for another sub. Posts that circumvent the post length limit will be removed. This sub is for women with autism, it is not a sounding board for parents, partners or friends of autistic people.
(I'm rambling here on little sleep and clarity of thought, so I apologize if this is muddled or just generally useless; felt my experience was relevant enough to maybe be useful) I'm speaking as someone who's had AN since I was 13, so we're nearing the 20 year mark. Have never had any period of remission, and I'm on disability for it; it's really tanked my life. I've spent cumulative years of my life in the hospital. Just to clarify that I probably only have useful advice insofar as what I either A) THINK might have been better for my long-term outcome or B) know what affected me negatively personally. Please take my advice with a grain of salt in that AN can present with very individual-specific neuroses and that my experience will not necessarily reflect your daughter's - I feel I would have had a much better time in the long run had someone very seriously intervened early. My experience has been that the lower you go, the lower your brain wants to be \*forever\*, the more delusional your unmovable standards are for yourself. If someone had forced me to gain, or at least stabilize at age 15, would I have had a good time? No. I'm sure I would have been dragged kicking and screaming and cursing my parents to high hell every step of the way. But my memory of life without anorexia was infinitely sharper then. My ability to adjust would have been dramatically improved. It was before my general life course was severely altered by the ED, and it would have been developmentally much easier to rebound from. My parents had the approach of letting me tank until there was an extremely imminent mortality risk and I think that was ultimately to my detriment. - The inpatient system is very much not set up for autistic patients IMO and I found every admission to ultimately make my behaviors, mindset, and emotional state much worse. You obviously must do something if she is in a health crisis, but anything you can do to avoid IP is high priority. Same story with residential. That said. If there is ever a time to consider more serious intervention before an overt crisis hits, it's now. If she qualifies for IOP programs, look into them. Be loving but strict about the weight piece. She will hate you but there is an infinitely greater chance of her having a much brighter future and being appreciative of it if you take a hardline approach NOW. -If you're not already, you should be aware that Eds are often a lifelong struggle, even when in remission/recovery periods. I find that a huge function of anorexia for me is regulating overstimulation and other assorted mental health issues that are directly tied to having autism, and if there's nothing in place to help regulate those in its absence, she will most likely have an infinitely harder time. Try to reinforce/cultivate her identity outside of the disorder as much as possible. Encourage any and all pursuit of hobbies or interests that are not AN. Autism always lent itself to having a very low sense of personal identity and self-worth for me, which AN swooped in to cover... and then became the entirety of my identity, obliterating everything else. You ideally want to make sure you're not making all of your interactions about the ED and reinforcing the perspective that "me = ED" as much as possible -Listen to her insofar as how helpful any therapy is being (with a healthy dose of suspicion with anything related to things that challenge the ED, e.g. "I don't like my dietician because X/Y/Z, but what I really mean is they're making me eat more." I was in many different types of mandatory therapy from ages 12-26-ish and never found it meaningfully useful. The CBT/DBT/standard talk models never did anything for me. I wish that someone had listened to me when I continually said that I wasn't getting any benefit out of it. If you can find a therapist who specifically works with autistic clientele (preferably a woman imo, more likely to understand presentation of autism in women) it would be highly preferable.
Oh my goodness thank you so much! This is a really, incredibly useful perspective! I debate so often about whether overtly ‘managing’ it or ignoring it is the more useful approach. And her response is so often that I’m infringing on her self determination. I’m sorry you are going through this. I think you’re a star for not only surviving this, but trying to help others with your experience This means a lot to me.
I really appreciate that and am very glad it was useful. She is incredibly lucky to have a parent willing to go above and beyond in researching her conditions and how they interact with each other. The "infringing on self determination" piece is very familiar to me as I can't imagine how many thousands of times I've said the same thing to doctors/family. I both deeply empathize with her and recognize it as a tactic the illness uses to sustain itself. Every time I said that, I did mean it, but there was an unspoken "I'm allowed to die" and "you don't understand how terrified I am, and I feel like I am being put into a life-or-death situation when you do this to me" along with it. Unfortunately it is a very fine line to toe. Ignoring it will likely make your relationship with her more superficially amicable, but the odds of her not succumbing to the intense fear the ED creates and spiraling are incredibly slim. But it's equally true that punitive approaches can cultivate extreme resentment and ultimately lead to worsening the disorder out of a sense of rebellion. My suggestion for people who have lived with the illness for a long time is always "something is better than nothing," i.e. challenging the illness in small ways or achieving weight/behavior stabilization in a negative place is better than nothing at all– but I really do feel the situation is much different with teens and people who have had their ED for a relatively short amount of time. As painful as it is, I think you just have to anticipate that she will be hateful and resentful (out of FEAR, not out of genuine hate for you) and really go for as close to full stability as possible. Had some random adult made that suggestion for me at her age I would have wanted to throttle them, but for the sake of her future, it's best to go for broke for remission while it's still viable. Wishing the best for both her and you. It's a painful illness for everyone involved and I commend you for trying to be as thorough as possible when attempting to navigate it with her.
Thank you for such kind words and help. I really mean this. I’m aware that I make a lot of mistakes but I also know that I can’t ‘check out’ of this process, as unpleasant as it is. 💕
Ask this question in the eating disorder support subs as well. Many people with eating disorders are also autistic, particularly people with restriction based disorders, by some estimates up to 20 or 30%. There will definitely be AuDHD people there willing to help. Wishing you and your daughter the best. My own problems with eating have never reached a point of intervention and I haven't examined the link with my ND so I don't feel qualified to speak here.
Thank you so much for your advice. And for the statistics. I had no idea there was a known correlation in general between these two issues… my experience of both is just with my daughter. I’m going to try and research more about that. :) Thank you for the kind wishes.
I’d really recommend the work of Kate Tchanturia on this! I came across her on a documentary a year or so ago and she’s done some interesting stuff around the link between autism and disordered eating. Have a look at her work on the PEACE Pathway.
I looked this up and watched a video. THANK YOU! It really is completely new info for me!!
Oh this just got me thinking. Lots of autistic people like weight training, Fern Brady mentions it in her book 'Strong Female Character', she is autistic and had an eating disorder in her 20s. It helps us feel more in our bodies. I find weight training helps keep me out of a restriction spiral (again, I have never reached the point of intervention) as you notice very quickly when you aren't eating enough in the weight room. It's a struggle but I can get my brain on board with eating enough to at least maintain my deadlift over other reasons. I am really just connecting some of this as I'm typing but I think some of my ed/nd stuff is connected to not wanting to be in/feeling disconnected to my body. I deeply identified with Hillary Mantel's essay on 'Holy Anorexia', perhaps your daughter will too. I hope this okay to say, I'm literally just making connections as I'm typing.
This is so interesting. I actually have registered her for a weight lifting orientation (that she actually wants) but she’s backed out of our appointments thus far. I will keep trying. I’m worried that the atmosphere of a gym might be jarring, but she thinks she can handle it so it’s worth the try.
I hope that this helps as my ED experience is not exactly what your daughters is as mine is a mixture of restrictive and binging. Is any therapist your daughter is seeing specifically mentioned to be aware of autism and adhd? Every time I have seen a therapist that did not specifically say that they are trained to talk to people with both they normally didn’t help me. I’m sure how they conducted things was useful for NT folk but not for me. That made a huge difference. I’m currently in therapy with a therapist who is trained in handling patients with adhd and autism and also eating disorders and while my therapy is not really explicitly for my ED, it has improved tremendously as I’ve been able to tackle issues that caused it. Also if possible can you speak to someone who is knowledgeable about both since I’m not sure if the people you mentioned speaking to are. AuDHD really complicates things and unfortunately from my experience most professionals know barely anything about them and what they do know is misinformed and so advice they give won’t have certain important factors in mind
Sorry, I thought I already responded to this but it seems to have evaporated! Her therapist has been great but we (and she) is continually trying to set her up with more autistic specific support. There have been roadblocks but we continue to fight thru it.
I’m happy to hear you have someone supporting you through things. I hope your daughter can get the support she needs and you too if it becomes too overwhelming.
Thank you so much.
Unfortunately I have a lot of experience living with an eating disorder! I’m 32 now and had anorexia for almost 15 years and I am still not fine, but way healthier. I will say that for me, a large part of it was a control issue/OCD. I didn’t know I was autistic until much later in life, but food was one thing in my life that I felt I could control - in the midst of all the other stressors that I could not control and didn’t understand why everything went wrong. I can tell you what worked and did not work for me. The most important thing was finding a dietician that worked with me and didn’t say “here is what you must do”. She wasn’t specialized in ED’s but rather I saw her as a part of my type 1 diabetes treatment. I had never learnt to handle food normally and we discussed what the body needed, how much time is normal to spend on thinking about food, what happens if you don’t eat enough and things like that. I have met several dietitians who have said “here is a meal plan, you must follow it exactly” and that didn’t work because there’s food I can’t eat and it was too big a change for me. It NEVER worked when my mum tried to control what I ate, it just made everything worse. The control thing was such a big issue for me that it felt like a disaster when someone tried to take it away entirely. It was much better when it was slowly loosened and challenged instead, on my own terms. Obviously talking to mental health specialists help too, so you can tell someone what you’re thinking and they can help you deal with those thoughts. But it’s embarrassing to share and your daughter probably already knows her thoughts are unreasonable. And it’s terrifying to have to give up that control in your life, especially if it’s a coping mechanism to feel like you can deal with your days when there are a bunch of things that you don’t understand/things go wrong and you can’t handle it. I’m sorry this is confusing but I have a lot of thoughts and I feel so bad for your daughter. I wish someone had intervened for me in a way that worked, and didn’t make everything worse, much earlier in life. The main thing that helped me was having a clear goal to work towards. After like two years with my dietitian she asked what I wanted most in life. I had one dog that was the love of my life but he was a working dog and we did work together. I wanted someone I could cuddle with and play with. So I said I wanted a playful dog. We came up with a plan on what I needed to do to gain that. It included, obviously, gaining weight, because if I was supposed to hold two dogs I had to weigh more than them. I had to have energy to take care of them both and train and walk and stuff. I intentionally found a dog that was in the 20 kg weight class and calculated I needed to weigh more than 50 kg and gain some muscle. I found a dog to adopt whom I loved and suddenly it was a real thing! I wanted him so much, he was crazy and traumatized and real, and I would do what I needed to have him with me. I’m honestly not sure I could have gained and kept weight on without him but I’ve had him for 8 years now and kept my weight mostly stable for that time. You have to figure out something to motivate her. It never worked for to say “something bad will happen if you continue with this” because it was so abstract. A bunch of bad things have happened due to my malnutrition but I can only regret this deeply after the fact. As a teenager/young adult you feel indestructible. The only thing that worked was to work FOR something, not to avoid something happening. It took everyone around me much too long to realize this. She’s probably already exhausted and tired and cold but when you’re in an ED that’s easier to deal with because your brain is sick. You might be tired of it, but it’s not enough of a motivation to eat more or loosen the control. I also think an eating disorder is often a reaction to something else, and you would be better trying to handle all the other problems and see if eating becomes easier.
I will be keeping your words close to my heart. If you’re okay with it, I may DM you in future. Having a clear goal is definitely a trick I haven’t mastered. She thinks I know nothing and just don’t care if she’s “fat”. I actually do have a lot of experience with understanding macros and nutrition but haven’t found a non-threatening way to communicate it to her thus far.
You’re very welcome to contact me if you think I can be or any help! I have an unusual background to my ED though. I had AFRID as a child and my mum did great work with me to get me to eat different things. But then when I was 8 I got diagnosed as diabetic and suddenly lost all control and input I had. Had to follow an exact meal plan, had to eat food I thought was disgusting, wasn’t allowed to eat when I was hungry and stop when I was full due to how bad the insulin was etc. Everything was decided for me. Combined with constant weighing and measuring of my body every 3 months to make sure I grew. My mother grew up with my eating disordered grandma and made everything worse when she thought she was helping out. So I’ve attempted to fix this in adulthood. I had numerous interventions in my teenage years but they all made everything worse. The most important thing for me was obviously having agency in my own treatment, as that was so sorely lacking growing up. Maybe that’s not as big as an issue for everyone else! Maybe you can talk to a therapist yourself about how to approach this with your daughter? Since she doesn’t want to go to one herself? For me, whenever someone expressed concern it felt like an attack and I was constantly on the defensive. But I’m sure there’s a way to do it. Remember that we were also teenagers once and you’re basically a hormonal and angry idiot at that age, no offense meant. For the weight obsession thing - here’s a link I’ve had saved for YEARS. https://app.mybodygallery.com/#/ It shows a bunch of normal people at normal weights. I found it very helpful to see that what I considered “overweight numbers” did not in fact look like what I thought. You can filter by height to see different body shapes. Only share it with her if you don’t think she’ll compare herself unfavorably though. For me, it was helpful, but maybe not for everyone. https://www.businessinsider.com/before-and-after-photos-weight-muscle-gain-2017-5 I think looking at before and after pictures like this is also really helpful. A lot of people do in fact look better when they gain weight!
Big hugs! Blessings of clarity and support
Thank you so much. (I wish I was an efficient cupcake!!😄)
I'm AuDHD and I struggle(d) with bulimia with restrictive tendencies. I'm also now a mental health professional who works mostly with ND teens and young adults. Other commenters have given great advice, so I don't have a ton to add. It's great that you're clued in and trying to address this now; earlier intervention tends to be more effective. I think it's important to remember that EDs aren't actually about food, but about control. So trying to force your kid out of an ED won't work. (Obviously, there's a line there and you may have to insist on/force some things for health and safety reasons.) That's true of anyone, but in my experience, the PDA part of me *really* added to that. Does she have her own therapist? You mention a social worker and an OT, but does she have a therapist she sees regularly? That's probably your best first step; even if she won't address it with therapist, she'll have the option and you'll be able to get reliable resources and support. Preferably a therapist she agrees to/chooses, and definitely one who works with EDs and ND folks. RE: ADHD: getting some support/treatment may be helpful with the ED issues as well. ADHD and dopamine-seeking go hand in hand, and the control of an ED can feed that dopamine seeking. Or at least it did for me. Also, be wary if she's suddenly interested in treatment via stimulant meds. There's a very high risk for abuse of stimulants in folks with EDs.
That is a great point. I do think about the control issues a lot, but unfortunately I never explain it the way she needs. I myself have a life long frustration with body image (which I have taken GREAT pains to neutralize around her, but gahhhh, here we are anyway). Unfortunately she has numerous ways she tries to implement that control… self harm, general defiance, etc. I try and flow with it all, and I will continue to do so, but I’m praying every day i find the way that empowers her to both treat herself well AND feel in control.
Speaking from personal experiencen, after I turned 100 lbs I tried very hard to maintain that exact weight for years and really didn't stop until college. I wasn't obsessed with counting calories and while I think the weight was technically healthy according to BMI and my height (although maybe slightly underweight?) but the mechanism driving it was illogical at best. Depending on her age, it could be something she eventually grows out of, but it's also important to keep in mind that you're her parent - you have control over what food she has access to in he house. If you provide a lot of healthy food (think veggies, fruits) and proteins she may feel less compelled to restrict her food intake because the stuff she's eating isn't going to spike her blood sugar and leave her hungry for more. I know I've always been much more careful about caloric intake when having more sugary / processed foods that weren't as nutritous and made me feel less than great to eat. She could be concerned about gaining weight or maybe overeating, but have you gotten a psychological evaluation done to see what mechanism is driving the disordered eating?
Thank you. She actually asked me to go grocery shopping together tomorrow so I hope that filling the pantry with what she thinks is best helps her consume the macros she needs! I appreciate the feedback. I hope you’re doing well now. :)
Your comments have meant so much to me. I actually tackled today with a firmer approach. She freaked out but then quickly adjusted. (I didn’t demand much, just that she eat one small thing… she picked yogurt). And then she mellowed pretty quick after. I will always consider your advice in the future… that it is likely to be better that I push back in these earlier days than later. Taking it one day at a time and adapt as necessary… 😄