AbigailNatenshon.com - Letters to Abbie

Letters From Parents & Loved Ones
With Responses By
Abigail H. Natenshon, MA, LCSW, GCFP

Dear Abbie,

My daughter developed her eating disorder while a freshman in college. As soon as we were aware of it being a problem we began treatment. She had a therapist she met with the summer of her freshman year. She did go back to school in the fall and we arranged weekly meetings with the dr, therapist and nutritionist on staff at the college she was attending. She began getting worse during the semester and she did not go back this past semester. We entered her , willingly, into a partial hospitalization problem in our area --8 weeks and she was out due to insurance --her therapists felt she needed more time in there and we are fighting with the insurance company--she was then scheduled twice a week meetings with a therapist affiliated with the program. She has made strides BUT at this time, I am having a problem with her therapist. Hopefully you can give me some insight into this problem. My daughter constantly watches what I eat.

She is now on approximately 3,200 calories per day. My question: the therapist told me yesterday that I have to eat as much as my daughter as it bothers my daughter when she needs to eat more than me. I took exception with that, stating that I am a 55 year old woman with different nutritional needs than my 19 year old daughter and that there is no way I can eat that many calories and that I shouldn't be expected to. She made me feel like it was now my problem that my daughter wouldn't eat more. I try to make meals that fulfill her requirements (she is on a point system) and we do eat the same foods, but I do not eat as much as she needs to eat at times.
I also eat anything and everything and she still has "forbidden" foods.

Am I keeping my daughter from getting well? After reading your book and many others, I was finally able to push away some of the guilt I felt about this disease and now I find myself feeling very guilty and not a responsible mother. If I need to do this for her, I will try but it seems unrealistic ... Am I wrong in my feelings. I have read many books on this disease and nowhere did I see that parents need to eat calorie for calorie like their daughter. Her therapists in her partial-hospitalization
program did not mention this to us. Any insight you can give me would be appreciated. It's such a scary disease, we want to do what is right for our daughter.

Susan

Abbie's Response:
This therapist is really off base, particularly because it sounds as though you are a healthy eater and a good person to model after in any case.

If you did what she said, you'd be working against all of your goals, as you'd surely become overweight, which is precisely what is most frightening to your daughter.

If your daughter needed insulin for diabetes treatment, does that mean you'd need to take it as well? Trust your instincts.

Best,
Abbie

Hi Abbie,

I know you are so busy so I will try to make this as brief as possible. I have a 3 1/2 year old daughter who was born loving everything that is pink and feminine. (Her older sister, age 6 is just the opposite. We embrace them both in their differences.) She insists on wearing some old pink, ballet leotards EVERYDAY that are in our dress-up box. This morning as I was doing her hair, out of the blue, she looks down at her stomach and pushes it in and out. (Keep in mind, she does have a little tummy, but all of my children did until they began growing taller.) She turns to me and says, "I want my tummy to stay in. I look fat with my tummy out like this." My heart sank. Then later that morning, she said (looking at her tummy again), "I have too much food in my tummy. It sticks out." I am so worried, but maybe I am over-reacting. I think that wearing all the leotards has probably made her more aware of her body. I also know that she is around when people talk about how skinny I am after having four kids. I wish I wasn't quite so thin, but it's in the genes. (My dad only weights 135 pounds.)

We don't talk about weight in our home. We don't over emphasize exercise or working out. I only walk a few mornings a week with a friend. We don't expect perfection from our children, only emphasize always doing our individual best. I am confused as to why she even notices things like that. A friend gave her a ballerina Barbie for Christmas. She is a very intelligent little girl. Could she already be comparing herself to how the Barbie looks? Should I "lose" the leotards and the Barbie? I don't want her thinking that only "thin" is beautiful. She is a very confident child. These were just two comments that she made "out of the blue." Maybe she just simply has tendencies that could lead to an eating disorder, but if I am aware and prepared, we can avoid any problems in the future. Or maybe her comments are nothing to worry about. What would you do if she were your child?

Thanks for your time,
S

Abbie's Response:
I would simply invite her to speak more openly about her concerns so you can explain them away. Why is she concerned? How did she happen to think of these things? How is she planning to lose weight, if she is planning to lose weight?

I believe my book, When Your Child Has an Eating Disorder will be very helpful to you. I do not think she has an eating disorder, however. No need to worry. You've got time to relax her mind and avoid a problem in the making.

Best,
Abigail Natenshon

Hi Abbie,

My daughter is 23 years old and has been fighting bulimea for years. She has been in therapy for years and now is in somewhat control of the problem. I use the work somewhat because every so often I get "the phone call" where she is emotionally distraught for "no aparent reason she claims.

I worry about her mental health and worry that someday in desperation she might take her own life.
All my wife and I can do presently is listen.

But the thought that this might lead to suicide pervades my thoughts constantly.

Are there warning signs that I might look out for?

Thank You,
A Parent in Cleveland, Ohio

Abbie's Response:
I believe it might be very helpful for you to get hold of a copy of my book, When Your Child Has an Eating Disorder, which deals with these difficult situations concerning children/adult children who are resistant to eating disorder recovery and who remain depressed.

The odds are that she has at least one other diagnosis as well (mood disorder perhaps?) that she needs constant treatment for, and perhaps medication. I would be sure that her therapist is someone you can trust implicitly, so that you know she is in responsible hands.

As parents, keep talking... I would request family sessions and state my fears openly and clearly. I would also discuss with your daughter what signs she thinks might be a tip off. ...reality can be a great source of control and healing.

Good luck.

Best,
Abigail Natenshon

Hi Abbie,

My three year old son has been a "picky eater" since approximately age two. He is getting pickier and pickier by the day. He refuses to try any new foods and is growing tired of his old stand-bys. I feel he is afraid to try anything new that he thinks I want him to eat. I know part of his issue is pickiness, but a larger part is stubborness. We eat as a family almost every night, but he refuses to eat our food and often refuses his old favorites. What can I do? We've tried not giving him attention on this matter and we've tried both positive and negative reinforcement. Now, we're at a loss! Help! He needs nutrition!

Abbie's Response:
This is a tough problem. I would start with a medical doctor, and then look carefully at his eating habits...what food is he taking in on a daily basis and if not from meals, where is he getting it? He should not be given food to eat except at mealtimes and except for nutritious food.

You might also want to look at your own eating habits to see if there is any tension around food that he is picking up and note if food is his only problem area. Does he fight for control in other areas? Therapy/consultation may be in order for you as parents in how to respond to him.

You may also want to investigate Feeding Disorders on the internet, and the hospitals or health professionals who treat them. This problem may fall into that category.

Good luck.

Best,
Abigail Natenshon

Hi Abbie,

Our daughter, 17, started dieting and lost about 30 lbs over 7 months. She then started gaining it back and began vomiting. I started her with the local "anorexia specialist" right before she started vomiting. From Sept-June she saw a therapist once a week, a dietician 3 times and the pediatrician every other week. She is a cheerleader and was ready to start intensive conditioning the first week of June when we decided that we needed to get her more intense help before she was 18 and could do as she pleased. Also, I was tired. I had tried to get a treatment team going here and no one is committed to this kind of problem (as I see it-and they don't have the experience).

We had her admitted to inpatient treatment 9 hours away by car . We have flown down three times-to admit her and for family visits. We are exhausted. My daughter is angry that "we took away her last summer before high school graduation." She is homesick and cuts us off when we call.

My family is sad and I'm not sure what to do. I took my younger old daughter to a counselor. We will go every 2 weeks to the family session. My husband and I are just kind of zombies. My husband and I are celebrating our wedding anniversary, but It's hard to be happy. Should we all go on medication?

Any thoughts? Is there any information about what happens to the family while a member is in treatment? Telling people is hard too. I would have blamed the parent too, based on previous knowledge. Our town is medium size, but we all know alot of people. I'm not sure how to handle this--telling people and what do I tell them? I sent emails to our family. I don't really want to talk to them even. I don't like telling the story and answering the questions and wondering what they are thinking.

Thanks. Your website is very helpful.
An exhausted and loving mother

Abbie's Response:
Your letter was heart wrenching. This recovery happens to the family as a whole...every person is affected in ways that are so profound. I only hope that the family work that is being done is adequate to support the process and keep your spirits up. It is a long process, but the outcomes are worth fighting for. I would ask for a phone consultation for you and your husband with a professional at the hospital just to coach, mentor, guide and support you. I would be available for consultation if they will not provide it.

I wouldn't worry about what others think or what to say. As long as you understand and accept the process, that's all that matters. The problem is, plain and simple, a genetically based one. It is not your fault. In fact, your work to repair it has been valiant and invaluable. You can be proud of that.

Good luck.

Best,
Abigail Natenshon

Hi Again Abbie,

Thanks for your kind reply and your offer to be available for consultation. I don't know what anyone could say that would be better. It's just a hard process that you have to go through. Maybe we don't understand the process. And the outcomes are unsure.

We got through our anniversary and my husband's birthday. Thursday our other daughter turns 15. We are planning a surprise party for her. She is on the same cheerleading squad as our daughter in treatment. I am telling the coach this week that for sure our older daughter will not be going to camp and will not be cheering this fall. In order to see an experienced eating disorder counselor, we will be traveling about 70 miles to see one, when she gets home. One thing that came out this week is that she feels responsible for her eating disorder and that it has caused the family pain. Her counselor is working on that.

Thanks again, just reading your reply has been helpful.

Hello,
We are in our first month of recovery for our 14-year old's eating disorder. I took action to get an internal specialist, psychologist and dietitian, as our family physician saw no problem. The road to recovery is so hard for everyone. My question is...when the pressures build up and I can tell Jessica is experiencing extreme conflict and the tears start to form, what else, besides hug and pray, can I do if she doesn't understand why she feels the way she is feeling?

Thank you,
Trying in Oklahoma...

Abbie's Response:
You sound as though you are doing a great job for your daughter. Keep doing what you are doing. I believe that my book, When Your Child Has an Eating Disorder will be an invaluable resource for you in dealing with the complex process of recovery. It is not easy for parents to deal with, and the book will guide you on how to be as supportive as you can be for your daughter.

Good luck.

Best,
Abigail Natenshon

Hi Again Abbie,

Thank you. It means a lot to hear you offer your support. You're book has become my daily "bible" along with the real Bible. Thank you, Abbie

"Parents...this letter from a 17 year old girl says it all. I thought you might find both her letter, as well as my response, instructive. Perhaps my response to this young woman could be a helpful guide to you in conversing about the illness with your own daughter or son. Good luck."
Abbie

I'm a 17-year-old female. I'm 5'5, and 100 pounds. I know that isn't that bad, but I know that I'm starting to get really anorexic cause I'm always blacking out when I exercise and all my friends are telling me how skinny and pale I look. April of this year I weighed around 120 pounds, and then I decided I wanted to lose a little weight, and after one week of not eating breakfast or lunch, it became very simple... not eating equals being skinny. But it's not about being skinny for guys or anything like that, it's just that I'm an A student. I'm number 3 in my Junior Class and everything I have ever tried, I have been close to perfection. It's just when I look in the mirror, I feel so fat... even now after losing more than 20 pounds in less that 3 months. I just hate eating. My mom found out that I haven't been eating that much, and I told her I could control it after she threatened me that she'd take me into a doctor or something. It's just I'm scared, not that I'll get hurt or damage my health. I'm just scared that I'll get fat if my mom makes me eat. I have thrown up a lot of the food she has made me eat, although she doesn't know. What I'm trying to say is, please tell me that having anorexia is ok... Because I don't want to be "cured" of it. I love it!!! the only thing I don't like it not having any energy, and being cold all the time. But other than that, I love this. I love feeling like I can control my weight, by myself without my parents trying to make me the "perfect child". I can EAT when I want and what I want. So please, just tell me that it's ok for someone like me to have Anorexia.. or do I even have it?? I don't know. All I know is, is that I'm very confused and scared of food... Thanks for the web site.. I like most of it.. but Anorexia is not a problem to me. it's just my parents and friends are MAKING it a problem but I'm JUST FINE..

Peace and Love.

Abbie's Response:
I am so glad that you wrote. I appreciate your being so honest with me. Great girl!

Several things I want to say to you....
1.Yes, this is anorexia in full bloom. Your disease is what is responsible for making you feel that you are not sick, and that the way you are is empowereing, not debilitating.
2. You are damaging your body now and for the future. Once you are fainting, you know that you are soing significant damage.
3. The damage is FIXABLE as long as you get help now.
4. Do confide in your parents and see your doctor. It will be an investment in the rest of your life.
5. I appreciate your wanting to be thin and fit. However, restricting food is the WORST way to accomplish this as you are damaging your metabolism more with each passing day. You don't realize that you have an increased chance of becoming a fat adult if you keep doing this to yourself as a young person.
6. The best way to become and to stay thin is through just eating well, and not through dieting, though you probably don't believe it. It's true.

Let me know what you decide to do and how things turn out for you.

By the way, both you and your parents might benefit tremendously from reading my book, When Your Child Has an Eating Disorder. Good luck!

Best,
Abigail Natenshon

Dear Abigail,
My 18 year old daughter has had anorexia for over two years. Lately, she has got over many of the effects such as depression, anger towards parents, showing food eaten etc. However, she still obsesses about when and where to eat and thinks a lot of the time about what to eat. Is she on the road to recovery or does she need more therapy?

Abbie's Response:
Yes, she is certainly on the road to recovery, but her obsessive preoccupation with food shows signs that she still has a ways yet to go. She will need more therapy. Remember that the average recovery time for an anorexic who has been hospitalized is 7 seven years. So don't be impatient.

You will find a complete, informative, and reassuring description of what to expect from anorexia recovery in Chapter 6 of my book, When Your Child Has an Eating Disorder. The chapter, entitled " Understanding the Recovery Process, " will give you an idea of what this unique and convoluted process looks like, and will tell you all you need to know to be the best parent you can be to your daughter while she goes this last mile.

Good luck to you both.

Best Regards,
Abbie Natenshon

Dear Abigail,
Does your book deal with what to do if you know your child (in this case 21 yr old daughter) has an eating disorder (binge eating) but denies it when you try to discuss it? I am 99% certain that my daughter struggles with this, have tried to be supportive, have tried to discuss it but she acts insulted that I would even think this of her. I have used the strategy that many college-aged kids struggle with this and that she is not alone. How do you get to the point of getting them to acknowledge it so that you can move on with a solution? If your book gives suggestions for this, I would like to know. Thank you.
A Concerned Parent

Abbie's Response:
Dear Concerned,

When Your Child Has an Eating Disorder very specifically deals with confronting your child and handling the denial and resistance that you may encounter. Remember that if your child had diabetes or cancer, you would not let yourself be intimidated by her reluctance to admit that she is sick, nor would you back down from taking a firm stand on finding the very best professional care. An eating disorder is a disease, and a lethal one at that. It needs to be confronted, recognized and dealt with in a timely and effective manner. You as the parent are in the best position to do so, and to help your daughter bring about change and healing.

Chapter Three, entitled "Beginning the Dialogue with Your Child" will guide you through the process of confronting your child so she will learn to understand and know herself better. There is a sample "script" contained in that chapter as well, which will help you anticipate and prepare for this exchange with your daughter.

Good luck.

Best Regards,
Abbie Natenshon

Dear Abigail,
My daughter now 40 has been bulimic for about 20 years. Usually denies it, occasional to a sister admits doing it; only on occasion. I have seen her as skinny as a 12 year old. The younger sister has had the same problem and is seeking help. The middle sister does not have the problem. I am average maybe 20 pounds overweight and have never made an issue of weight. We lived in an affluent area when they were growing up and thin and rich were the thing to be. Is there hope for the 40 year old when she only admits to occasionally throwing up? What would be her health problems in the next coming years? Her teeth look good and her hair looks nice. I have seen her eat like an animal in public! I have heard her say things I can't believe! Her husband looks pretty confused with all this, I am sure he has no idea what is going on. I am one confused mother!

Abbie's Response:
Though your daughter is 40 years old, she is still your child. Please get hold of my book, WhenYour Child Has an Eating Disorder, as I think you will find that all of the information in that book is fully as pertinent to a forty year old as it is to a fourteen year old. You are still and always her mother, and not only have a right to speak your mind and heart, but the obligation to do so. As her mother, though you can't put your head on her shoulders and expect her to take care of herself in the way you might take care of her if she were still a young child, you can and should expect her to hear you out and consider what you say. You would be surprised at how much relief she will probably feel at the notion that someone knows about her pain, cares enough to step forward, and can assure her that there is a way out. Recovery is very much within her reach, even after all these years.

These diseases in adults carry their own special set of problems that interfere with professional and personal lives on all levels...all this aside from the gastro-intestinal, cardiac, osteoporatic, and social and emotional problems that accompany eating disorders.

I would suggest that you first educate yourself with the section called "Learning All You Can" and then focus your attention on "Beginning the Dialogue with your Child." If you are still meeting with her resistance, you may want to read the chapter called "Recognizing and Overcoming Recovery Setbacks."

Best Regards,
Abbie Natenshon

Dear Abigail,

I'm writing to you because my husband and I are in a state of confusion as to what to do (if anything) about our previously anorexic daughter. Our daughter, who will be 14 in a few weeks was diagnosed with anorexia about a year ago. She was not considered to be in a severe enough physical state for hospitalization so we proceeded with therapy on an outpatient basis. She was put on Prozac initially, but after about 10 weeks, discontinued it due to sudden hair loss, which the doctors attributed to the medication, not the anorexia. By the end of the following summer, she had regained her weight and things seemed to be going well emotionally. She has completed her therapy and nutritional counseling, and is now on a 6 month physical exam schedule. Things seemed to be going great.

However, over the past 3 months, we have noticed a marked change in her disposition and personality. She is very mean-spirited and disrespectful. She doesn't even seem like the same person. Although her grades at school are still okay, she is also starting to display disrespect there as well. Over the past year, she has gone from virtually no social life to having lots of friends. (This I thought, was a good thing) Towards the end of her therapy, we voiced our concerns to the therapist, but she had no possible explanations other than we might want to go to family therapy. At this point, we are considering more therapy, but she is very against it. I expected changes in her all along during therapy and did see them, however, the changes I'm seeing now do not seem normal to me and go beyond what I would consider to be normal teenage mood swings. What should I do? Did she really recover from her eating disorder or is what we're seeing issues that are still unresolved?

Your book was literally a life-saver for all of us during this difficult time and we thank you. It seems as though there is so much inaccurate information out there and admidst all of it, your book was a guiding force.

Thank you for your consideration,

Sincerely and with thanks,
J

Brooklyn, N.Y.

Abbie's Response:
Hi J,

A couple of things to keep in mind when thinking about your daughter's recovery...remember that weight restoration by itself is not necessarily an indication of a total recovery from anorexia. The other thing to keep in mind is that when a child DOES make a recovery from an eating disorder, that child has newly gained access to her feelings and needs. This could possibly open a whole new "kettle of worms." It is important that family members be prepared and equipped to listen to the new feelings, messages, needs, and concerns of the recovered child. Family therapy can be a great way to go.

If you feel you are seeing mood swings, there is a chance that your child may be exhibiting symtoms of bi-polar disorder, a disorder which typically tends to surface during the teen years. My suggestion to you is that you have her evaluated by a psychiatrist for a possible new diagnosis and certainly for medication... particularly in cases where she may be exhibiting impulsive or self-destructive behaviors. Where additional problems have surfaced, you will need to engage in family therapy with a skilled practitioner to resolve interpersonal issues and concerns that may arise as a result.

So in answer to her question, the issue is not necessarily one of "either/or." She may have fully recovered from the eating disorder and there may still be issues that are unresolved... some that if not tended to, could possibly lead to relapse.

Please read Chapter 7: Recognizing and Overcoming Recovery Setbacks in my book, When Your Child Has an Eating Disorder. There you will find tips and strategies on trouble-shooting, and guidance on how to proceed with your child and your child's professionals.

Good luck.
Abbie Natenshon

Dear Abigail,
My daughter is 10 years old, at the weekend I was cleaning her room and found that one of the draws of her chest was absolutely full of uneaten school lunches. I was very distressed by this and asked her what it was all about - she told me that she doesnt feel hungry at lunch times and so she hadnt eaten the food. This is the first time I have been aware that this had been going one. I have 2 older daughters of 16 and 14 who have never had a problem like this and I dont know what to do.

My youngest is very small for her age and is a very faddy eater and doesn't eat enough at the dinner table either. We do all eat together and I have always thought that she should eat more but she gets upset if she is made to eat more.

Please help me I dont know what to do.

Thanking you in anticiption
A Reader From United Kingdom

Abbie's Response:
I think you would do well to get a copy of my book, When Your Child Has an Eating Disorder, as I believe it will be a great help to you...particularly the third chapter about how to confront you child.

Once you have read the book and have become educated enough about the situation to become her educator, this is the time when you need to have a heart-to-heart discussion with your daughter about what you see, what your concerns are, and what such eating patterns could lead to.

She also needs to understand that whatever she is struggling with will cause her increasing unhappiness if she does not attend to it, and that it is totally fixable if the two of you begin to deal with these concerns NOW. She needs to know too, that the best way to be, and to stay, thin is to eat lots of nutritious foods in the form of healthy, balanced meals at least three times a day. The child who diets or restricts food in the early years is setting herself up to become an overweight adult.

Best Regards,
Abbie Natenshon

Dear Abigail,
Congratulations on your wonderful book. I am an American but live in Australia and there is nothing of the same quality here. I have read very little that is at all helpful in the 8 years during which my daughter has been anorexic.

One of the most difficult problems for carers of anorexic children is the feeling of continually losing one's bearings. Your book gives a clear and sympathetic MAPPING. Thank you so very much.

I have only one question: how does one deal with a child (over 21) in treatment who has not chosen recovery?

My daughter has been stable (though very, very underweight) for a number of years. For the last few years she has been going to an excellent counselor and according to your check list has advanced significantly in her emotional strength but struggles daily (each meal) with food. I shared excerpts from your recovery chapter with her and we discussed her fears,. She says she has not chosen recovery yet. Do I respect her need to move at her own pace or try again in a little while to suggest to her her life quality is being greatly impaired? Of course I fight constantly with feelings of concern and panic for her.

Once again, bravo on your writing and insights.

I am telling organizations and interested people here in Australia aboutyour book.
All the best,

A Reader From Australia

Abbie's Response:
Thank you so much for your kind letter. I do so appreciate knowing that people like you and your daughter are able to benefit from my efforts on behalf of this book. It has been a consuming passion for me and I am elated and gratified to know that it has been helpful to you.

Regarding your daughter, this is a tough problem. I like how you have invited her to read along with you and to dialogue together about her problem with the book as a reference or jumping-off point. I would definitiely speak with her about my concerns in a "significant" conversation.....perhaps together with her father, doctor and/or therapist present. I would entertain the thought of putting all caring heads together to brainstorm about find some alternative to help move her off of her current stuck point. Perhaps family therapy would be a poignant addition to the treatment "cocktail" at this juncture, even if for a session or two....perhaps, involving siblings, best friend, boyfriend, etc. in an effort to seek out another direction or find a new motivational pathway. Hopefully, a nutritionist could be of help to her, even at this late date. Possibly some body work could be helpful, too, such as Yoga, dance, Feldenkrais (see www.empoweredparents.com under Treatment, perhaps sometime later this weekend once the Feldenkrais and Eating Disorders article will be posted.)

Sometimes revisiting the issue with your child through conversation is enough to bring it to a new level of awareness which, in itself, can stimulate change. Remember that change can be infinitisimal and still be meaningful.. What is significant about eating disorder changes is their direction. Eating disorders are never stagnant...you can count on the fact that they are either getting better or they are getting worse. Her body is taking a beating, inside, as well as out. Her organs are losing weight and her systems are increasingly imbalanced. Remind her about the realities of the mortakity rates of these diseases.

Suggest that she contact me if she has any particular question or concern that I could help her with. Best to you. Good luck.

Best Regards,
Abbie Natenshon

Hi Abbie,
My children, currently, do not have an eating disorder. At least in the text book sense. They are a bit overweight, which makes them very self conscience of their bodies. However, they are good eaters, and only seem worried about their weight when emotions are involved.

My question is would your book help me on this? I have considered taking them to a nutritionist, however, as a family I think we should all start to focus on a healthier lifestyle. My kids tend to listen to outside influences better, and I really want to help them and myself. Please let me know. I don’t want their obsession with how they look now, to turn into something more dramatic later. (They are 10 and 13).

Thank you.

Abbie's Response:
I think a nutritionist would be a good solution for you all. My book might be helpful to you in knowing clearly what, if anything, you are looking at now and in the near future, in your children's behaviors in light of their body image concerns.

The important thing is to make sure that they continue to eat healthfully and regularly and to stay active; in addition, they need to learn to love and accept themselves. It sounds as though they have good parenting and that is an important element for success. Good luck!

Dear Abbie.
I am the grandmother of a 14 year old granddaughter who is an anorexic. I feel so frustrated not being able to help. I don't understand what is really going on with her. I tried to see if there was a support group in this area for families of anorexics but there are none. My granddaughter lived with me along with my daughter, her mother for a few years so she and I bonded and I feel almost as if she's my child. It has been a tough two years with her living so far away and now this.

What is the prognosis for this child? The Dr's put her in the juvenille unit where she eats but as soon as she comes home she slows down again. She has been hospitalized 4 times over the last few months. Now they are wanting to sent her to a place that specializes in this disease. It breaks my heart to think of her so far away from all of us at this point. I suppose I just want to know if that is the best thing for her. If you can please shed some light on this problem for me it would be greatly appreciated. Thank you.

Abbie's Response:
Hi. It sounds to me as though it may be possible to keep this child home, in outpatient therapy, if you could find a good outpatient therapist who specializes in treating eating disorders. In actual fact, even the best inpatient programs are good only if she can get good follow up care upon finishing with them and returning home.

It is so important for you and your daughter to learn how to understand this problem and how to help this child to recover and stay recovered when she is living her normal life at home. Good luck!

Dear Abbie.
I'm so pleased with your articles and website. But I have a problem. How do I motivate MYSELF enough to motivate my son. He is nine and over 100 pounds. I'm 33 and close to 300. I see all the programs and pretty much know what to do. But getting started and finding something that we can both stick to is getting so frustrating. We would read and talk about just walking the next morning before school, but if we oversleep or get distracted, then our program is over. I'm afraid for our lives now. Is there a book we should get or a interesting program we can do together? We've been to the doctor and all that was offered was a diet sheet and a goodbye! Any advice would be so much welcomed.
Thank you for your time..

Abbie's Response:
Hi. Great observations about yourself ; just know that you are not alone. I believe that my book, When Your Child Has an Eating Disorder will be as helpful to you as it would be if you were to read it for your child. There are so many ideas there that will shepherd you along in finding some additional insights about yourself and some strategies. The more help you can be to yourself, the better mother you can be to your child.

Remember to think of change in terms of small steps. That is so important. Don't plan to go for a walk that you will tend to avoid. As an alternative, you might want to use the stairs instead of the elevator once a day at work, or spend 8 minutes a day walking around your block. Start slow. Remember the hare and the tortoise.

My best to you,
Abbie

Dear Abbie.
My daughter has an eating disorder and is going therapy. The doctor has given me a few books to read and suggestions on how to handle my daughters problem, but there is one thing that I cannot answer. How my new husband should treat this problem. He is constantly watching her every move, checking up on her after she goes to the bathroom, looking in all of the trash cans and questioning her every move. It is really driving me crazy. I know he means well but I don't feel it is healthy for our daughter's recovery. Please advise me with any suggestions or literature on this matter.
Thank You.

Abbie's Response:
Hello. I believe you will find all the answers to your questions in my book, When Your Child Has an Eating Disorder. It is so hard for parents to know exactly how to respond in the most supportive way, and when there are two parents, it becomes twice as hard. See Chapter 3 on Confronting the Child.

The main thing is that you will need to get feedback from your child on
what she needs from each of you, and to keep updated on how these needs of hers may change from day to day, week to week. The thing you will want to remember , too, is that she will need to work with health professionals
who will include you in the recovery process, who will help you learn how best to support your daughter through this process. It's a confusing process and parents need assistance as much as the child patients do sometimes.

Good luck to you. Abbie

Dear Abbie.
I'm sure you get thousands of letters very similar to mine but here goes. I will give you the short version. I have been divorced from my daughter's father for more then 4 years, (we live in the same town, he's remarried, I'm getting married). My daughter lived with him for about a year and a half and then expressed her desire to move back in with me. During this time, I noticed that she had lost a lot of weight ~ needless to say, she is an anorexic. She completed a stay at an Eating Disorder Unit and also completed their outpatient program. I take her to counseling at least 2-4 times a month to a local therapist who has some experience with Anorexia. I've noticed that my daughter is going back to her old eating disorder habits and I have confronted her. Needless to say, she does not like to talk about it. I contacted her therapist with my concerns and she said it would take some time to do anything. I would appreciate any advice that you could give me.
Thank you for your time.

Abbie's Response:
Hi. The key is to get yourself into a meaningful dialogue with your daughter's therapist. Hopefully, she will include you in family counseling and you three can discuss what needs to happen next. Be sure that she has access to a nutritionist and a medical doctor too, if she is actively into the disease.

My hope is that you can get hold of a copy of my book as it will guide you through what to say and do and what to expect and look for in the therapy process. It will also describe the unique recovery process with this disease, which often does not resemble progress at all.

Good luck to you! Abbie

Dear Abigail,
My 16 year old has bulimia and was anorexic for awhile. I am fighting the battle to get her adequate care. No one wants to take on a child with anorexia comprehensively . The pediatrician is scared of anorexia but is helping after I begged her; the therapist is good, but is giving me that " confidentiality" song and dance. I will order your book tonight. I am a Registered Nurse with pediatric experience. Your book confirms my opinions. I have been feeling really stupid and guilty that I am the cause of it all. I am embarassed by the fact that my daughter has it. I realize now that our whole family needs to be seen by a therapist. Finding the right one might be tough.

Abbie's Response:
I so appreciated your email, and am glad that you could benefit from the articles on my site. Good luck with your daughter. If she already has a good therapist, give this practitioner a copy of my book, When Your Child Has an Eating Disorder and suggest that he or she reads the sections on the importance of family treatment. (Chapters 4 and 5) The therapist will come to understand that through the use of skillful family therapy, it is possible to meet your needs as a parent, at the same time as your child's needs as an autonomous, maturing young woman... without any fear of breaching confidentiality. As a parent, you need to be brought into the recovery process, to better understand what your daughter is going through and to learn how you can become, and remain, optimally supportive to her throughout the various stages of healing.

Best Regards,
Abbie Natenshon