Anorexic-Is my Daughter?

[skelly]

I need help.  My 13 year old daughter is never hungry.  By genetics our family is on the thin side, but my daughter who is 5'4, is skin over bones, weighing in at 83lbs.  More times than not, she  is never hungry and always has an excuse for why she doesn't like something: hot dogs make her sick to her stomach, chicken gives her a headache, etc.  Yet I can  contradict that with days  when she seems to be eating with very little problem, however, her food intake is quite small  When she went to the Dr. for a check up last April he found blood, protein and keytones in her urine.  He suspected she was not eating enough and her body was burning its own muscle.  We returned in December with a gain of 1-lb and a large amount of blood along with keytones and protein.  He sent her on for a kidney ultra sound everything checked out ok.  We suspect she is having some kind of period unbeknownst to her.  She is an extremely organized very mature gifted student.  I don't know if its possible, but I am wondering if she can be anorexic without her really knowing it.  We made a concentrated effort to put on weight between x-mas and the end of January and upon our return to the Dr. she put on 3-lbs.  Since that visit she seems to have slacked off a bit.  The Dr. told her "good job if you keep that up you will 100lbs when you get into 8th grade".  Her only comment upon leaving was " I don't want to be 100lbs, I like the way I am.  She has never said anymore about her weight at all and never every says anything about being fat.  She is extremely attached to my husband and I (we have one other daughter - they are best friends) and is very intense.  How do I know if I have a problem or a very pickey eater.  I too was very tall and thin as a child, but not as thin as this.  I don't want to wake up two years from now wishing  that I saw the signs, please help!!

[Kevin Kennedy, Ph.D.]

Dear Skelly,

Your daughter's weight in and of itself doesn't indicate she is anorexic. She is actually approximately at the 20% for children her age, so her weight is not dramatically low. In any weight distribution there are going to be children at the low end of the spectrum, some at the high end of the spectrum, with most children falling somewhere in the broad middle range.

Anorexia is characterized by an intense fear of gaining weight or becoming fat, an intense drive for thinness, along with severe food restriction in order to lose weight. People who display anorexia (and approx. 95% of anorexics are female) display a distorted view of their bodies, often regarding themselves as overweight when, in fact, they are not. Anorexics often deny that they have a problem.

Based on these criteria, it is probable that your daughter does not meet the requirements for a diagnosis of anorexia, but she may be at risk for eating disorder and it is worthwhile to keep this in mind. It will be important to refrain from engaging in struggles with her around eating, weight, etc. Your approach in having her pediatrician guide her toward some weight gain on a gradual basis is sound. Just be careful not to over-invest in her weight or eating habits.

If you choose to have her evaluated by a mental health professional, be sure it is someone who is a specialist in eating disorders. This is a sub-specialty of mental health practice.

[evelyn]

My brother with through a long process with his daughter when she battled anorexia.  If you would like to talk further, please e-mail me at ***@****.