Dear Dr Jennifer: I fear my daughter is battling anorexia
Dr Jennifer Grant answers your health queries...
My 17-year-old daughter has turned into a very fussy eater. It started with her cutting dairy and only drinking coconut milk — I make sure I get a substitute that has lots of calcium for her bones and she does drink a fair bit of it. But she then became vegetarian, cut out eggs and is on the fence about cheese.
She’s become quite thin — it’s hard to really know how thin as she wears hoodies and baggy jeans or tracksuit bottoms most of the time and her school uniform is a long skirt with a big jumper. But it is clear from her face that the weight is falling off her and I suspect we might be entering dangerous territory in relation to an eating disorder. What’s the best way to address this?
Dr Grant's answer: The story you tell is concerning in terms of a potential case of anorexia nervosa and you need to get your daughter to a GP as soon as possible to assess the gravity of the situation. Anorexia nervosa is a Western phenomenon with preponderance for females in their mid-teen years.
If your daughter’s body mass index (BMI is weight in kg/height in metres-squared) is below 17.5 and she has an intense fear of gaining weight, as well as a distorted perception of her body weight and shape, then she meets diagnostic criteria.
There are many complications of anorexia, including low blood pressure, slow pulse rate and reduced core body temperature, lack of menstrual periods and severe bone mineral density loss.
The organs affected due to starvation include the heart, brain, kidneys, liver, intestines and muscles. The degree to which they are affected depends on the severity of the weight loss. Your GP will evaluate the risk of these complications, help exclude other medical causes of weight loss and assess whether she might need hospital admission.
If your daughter is diagnosed with anorexia, she will need family support and commitment to a long-term treatment strategy. She will require psychiatric, psychological and nutritional input and close monitoring as relapses are common. Nutritional rehabilitation is the first step for all patients and involves education on the body’s nutritional needs.
This could be a long and difficult road for you and your daughter, so don’t waste any more time, just get her assessed.