# Dr. accusing 14yo of eating disorder



## bren94 (May 16, 2014)

My younger sister just turned 14. She is naturally tall and thin, always has been. Currently she is 5'6" and weighs 95 pounds. I know this is considered underweight but this has always been her body type and she's just now beginning to go through puberty. 

I'm concerned because at her last check up her doctor accused her of having an eating disorder. He told her she's the only girl her age in their records that weighs as little as she does and that if he wants to he can have her admitted to the hospital. He told my parents they aren't to allow her to play sports until she's no longer considered underweight. They are no longer allowing her to go on weekly runs to practice during off season for cross country. Her mom passed away a few years ago and my dad leaves most of the parenting up to my stepmother who isn't very sensitive and is constantly accusing my sister of being anorexic and forcing her to eat unhealthy foods in extra large quantities. I'm very close to my sister and know her eating habits very well and can say with certainty that she does not have an unhealthy relationship with food. Any time I try to convince my parents of this they tell me I'm not a doctor and to stay out of it. 

I'm wondering if anyone has any experience with this? Is there anything that could be causing her weight to fluctuate? She has lost a few pounds apparently, no more than 5. I'm just very worried that my parents are forcing her to have unhealthy habits and she's been really down about how they're treating her. Any advice would be greatly appreciated.


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## Blue99 (Feb 3, 2015)

You may know her eating habits well, but that's only a very small portion of the relevant facts in determining if an eating disorder exists. She could be taking drugs/binging & purging etc. And there is no way you can be positive of that. 

That weight/height is VERY underweight. Does she ever have low energy levels? Menstrual problems? Etc. 

Eating shit tons of junk food isn't the answer, eating disorder or no. 

However, I would get a new doctor. Threatening someone who may have a MEDICAL condition with forced hospitalization and guilt trips is the shittiest thing you can do. Denying her her preferred healthy, physical outlet and forcing her to eat junk is also shit.


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## bren94 (May 16, 2014)

She just started her period a couple months ago and so far it has been typical. She's very energetic. I know it's impossible for me to know for certain but I really do not suspect an eating disorder is the issue here. If you compare a photograph of her to one of her mother and grandmother at the same age, their bodies are nearly identical. I convinced my dad to make an appointment with a nutritionist so I'm hoping she'll be able to get to the bottom of things.


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## Claudia Chapman (Aug 9, 2012)

bren94 said:


> She just started her period a couple months ago and so far it has been typical. She's very energetic. I know it's impossible for me to know for certain but I really do not suspect an eating disorder is the issue here. If you compare a photograph of her to one of her mother and grandmother at the same age, their bodies are nearly identical. I convinced my dad to make an appointment with a nutritionist so I'm hoping she'll be able to get to the bottom of things.


I think you may need an endocrinologist rather than a nutritionist.


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## bren94 (May 16, 2014)

Claudia Chapman said:


> bren94 said:
> 
> 
> > She just started her period a couple months ago and so far it has been typical. She's very energetic. I know it's impossible for me to know for certain but I really do not suspect an eating disorder is the issue here. If you compare a photograph of her to one of her mother and grandmother at the same age, their bodies are nearly identical. I convinced my dad to make an appointment with a nutritionist so I'm hoping she'll be able to get to the bottom of things.
> ...


 Thank you that's very helpful. I'll bring that up to him.


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## MeepyCat (Oct 11, 2006)

At that height and weight, I would be extremely concerned about your sister running. She'd be at high risk for injury, and if an eating disorder is a possibility, also at risk for heart failure.

It takes a lot of food to stay healthy as a runner, especially if long distances are involved. "junk food" (ice cream, pizza, etc.) is often very calorie-dense, which makes it extremely helpful in this context.


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## elus0814 (Sep 21, 2009)

Just going by her bmi she's in the 'severely anorexic' category and if she loses just two more pounds she will be past the severe category. That really is a very low weight. The doctor doesn't seem to be handling it well but it does sound like seeking a second opinion would be a good idea. She could have something else going on, maybe even something genetic since it runs in the family, that is causing such a low weight.


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## TCMoulton (Oct 30, 2003)

I would be extremely concerned at this point - I had a childhood friend that successfully hid an eating disorder for many years. It went untreated for so many years that the damage to her body has aged her decades beyond her true age. 

Also you mention her mom passed a few years ago - do you know the cause? You say they had a similar frame - is it possible that she too suffered from an eating disorder?


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## bren94 (May 16, 2014)

Her mother passed away from breast cancer and no, I can assure you she never struggled with an eating disorder. I have seeked a second opinion from a doctor and have been assured that many young girls are built this way. In fact a friend of mine has twin daughters with the same height to weight ratio as my sister. After reaching out I've had many parents tell me their children are built this way. My own DH is also very tall and skinny and has been accused of eating disorders and the like in his youth, turns out it's just genetics at play. Some people are tall and thin and we're so used to seeing just the opposite. An eating disorder causes much more than weight loss. In a person with an eating disorder there will be electrolyte imbalance and malnourishment. My sister has neither. I thank you for your opinions on the matter.


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## bren94 (May 16, 2014)

And "severely anorexic" is not a body type. "Severely underweight" would be more appropriate to say.

Annorexia is a mental disorder, not a body type.


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## salr (Apr 14, 2008)

OP, I think you're on the right path. Talk to lots of people. Get actual second opinions for your sister. Keep the possibility of an eating disorder in mind, just like you would for anyone. But you're right that it's possible to just be tall and skinny and spend moments of your life defending your body type when there is nothing wrong with you. If your sister needs to gain weight she can eat avocados, coconut oil, maybe milk. No one needs ice cream to be healthy. I can see how any food would be better than nothing in some special cases. But if your sister eats healthy fatty food there's no need to add in junk. I'm sorry that doctor threatened your sister. It's great she has your help.


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## bren94 (May 16, 2014)

@salr thank you for that reassurance! Was starting to feel a little crazy.


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## avocet (Apr 8, 2014)

It is really good that you are in her life and paying attention. It doesn't sound like the way her step mom and doctor are handling things is helpful at all! From the way you describe it it seems like they are being very authoritarian and forceful. 

I have always been thin, and in high school was ultra thin (less than 100lbs), just the stage in life before I had any adult fat and had reached my full height. I was made fun of a lot in middle school and high school for being so thin, called anorexic etc. I also naturally have a small appetite unless I am doing a lot of physical work or movement, have never had an eating disorder, and am a healthy adult weight of 120 lbs at 5'6". I am from a family of six kids, but the only string bean in the family.

I totally agree with the comment that you should keep the idea of an eating disorder in mind but not make any assumptions. Is there any way you can reach out to her step mom and help her create a more compassionate and balanced approach to her stepdaughter's health?


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## farmermomma (Oct 30, 2012)

bren94 said:


> And "severely anorexic" is not a body type. "Severely underweight" would be more appropriate to say.
> 
> Annorexia is a mental disorder, not a body type.


Right on! I wish I had/have a sister like you.


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## luckiest (Apr 29, 2009)

What an awful doctor...unprofessional and unproductive. 

With that height/weight ratio, plus a bit of a later start into puberty, everything could be very normal, or not. If anything, her doctor should have suggested bloodwork, thyroid panel, or a referral to an endo. I wouldn't completely dismiss the possibility of an eating disorder - they can be VERY easily missed by the closest people in their lives. Also, someone can be malnourished and/or underweight without having an eating disorder, and someone can have an eating disorder and appear healthy or even be overweight. 

I would encourage her to see a new doctor and ask about checking some hormones and her thyroid. Maybe also talk to a GI doc and/or nutritionist to check for assimilation issues; maybe she's eating plenty but not digesting well. 




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## JamieCatheryn (Dec 31, 2005)

Aside from scared or annoyed by this doctor, how does your sister feel about all this? She's an athlete and exercise feels good to her, right? What's she say about the possibility of gaining? Anything she says sound like body image insecurities or signs she's trying to diet? If she is happy with her body and working toward a healthy athletic figure, gaining shouldn't be a problem for her, psychologically.

A 5 lb fluctuation sounds like bloating and dehydration to me, typical weight changes under 8 lbs that happen very quickly are water weight. Happens in my case when it's a temporary 4lb gain from a couple slices of pizza, or loss from forgetting to drink water.

Now about food if you care to pass on info, there are healthy ways to get bigger. Enough good fats are important and they give many calories, but a high fat low carb diet actually causes weight loss not gains. High doses of carbs such as the 300g FDA RDA causes fat gains for most people, which is a plus for her. Protein plus strength training causes muscle gains, another plus for her. Overall increased calories should cause weight gain unless the metabolism changes to keep up with it. Healthy carbs: potatoes, yams, fruits, rice. Healthy fats: olive, avocado, coconut, animal fats, cream/butter (for those dairy tolerant), some nuts. Healthy proteins: Meats/fish, eggs, some of lentils nuts and seeds, dairy if one tolerates it, hemp or whey or pea powders. If grains don't bother her system (many have indigestion or inflammation and feel better without them, I really believe everyone should try going off them for a couple weeks and find out) other whole grains like wheat oats and cornmeal give carbs and some protein too. I'd go higher protein (80g-140g/day at her size, and especially eat them after strength workouts), high carb (maybe 220g/day, plus lots extra every few days after workouts, think thanksgiving dinner or the never ending pasta bowl), moderate good fats (65g/day), and replace the running and any hard cardio with walking/hiking, slow biking, or slow swimming, instead do some pushups, pullups, squats, planks, maybe even lifting, with the occasional wind sprint thrown in. 

Hers sounds like a classic ectomorph body type, tall and skinny with a fast metabolism, it's totally from genetics, makes it hard to gain at all. Almost seems like something to be envied, but it comes with challenges too, physical and social ones. It sounds to me it's just her body type, her metabolism and a little bit her habits. Even if she were obsessed with her body with a few tweaks she could use that effort toward a healthy very athletic figure. I would switch doctors to someone more open minded and respectful. Maybe her parents can have her speak to a therapist about her body image to double check all's well if they want to humor him. If she seems comfortable about her body and not afraid of gaining a little more mass, pass on info aimed toward gains in ectomorph athletic women.


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## Turquesa (May 30, 2007)

What separates "very skinny" from "anorexia " is mental health. Either way, nobody on an online forum is in a place to make that call. Have you considered letting her see a counselor just to have a heart-to-heart about her rough family situation, (loss of mother, tensions with step-mother, etc.)? It wouldn't be inconceivable for someone facing loss to resort to an eating disorder. BUT she may also be a naturally skinny person who also happens to be facing some tough circumstances. The right therapist can help sort through that. Even if she isn't anorexic, therapy can't harm in her situation. The other advantage is that therapists are pretty in-the-know on doctors and can recommend a better one for you.

What bothers me about her current doctor is the unwillingness to consider another underlying medical condition. Here's an article about why that may be happening. http://www.kevinmd.com/blog/2011/10/major-cognitive-errors-physicians.html

If her weight isn't compromising her health or influenced by dysfunctional eating patterns, you don't have to worry. If her weight really is compromising her health and it's NOT anorexia, it would really help to get to the bottom of what's going on.


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## Viola (Feb 1, 2002)

Has she always been thin, or did she suddenly fall off the curve? Maybe she gained a lot of height and her weight hasn't caught up with her? I've known people who have lost a lot of weight due to metabolic disorders, and my brother-in-law struggled with malnutrition at times in his life because of a medical issue. I like the suggestion of looking for other medical issues. It's amazing to me that when the issue is weight loss or gain, the first suggestion is to think the patient is lying or underreporting things before looking at medical causes, but I'm not a doctor and I don't know what they see. And if it's an eating disorder, there should be better ways to diagnose it than BMI.

I have a teenaged daughter who lost weight around the age of 13 or 14, and when I took her and my other child to the doctor for checkups, the APN was concerned that my one daughter was too heavy, and the other daughter had lost weight. She told me to bring the younger one back for a weight check in two months because I couldn't allow her to gain anymore weight. And then she told me to bring the older one back too because, "I don't trust her." Then she looked right at her, smiled and said, "I don't trust you." My daughter seemed unfazed.

When we got to the car, I asked her why she thought the nurse practitioner had said that, and she had no idea, but said probably she thought I fed them junk food. I told her what I thought the APN meant, and she got pissed and was going to march back in their and give her a piece of her mind, but I stopped her, partly because I figured if she was defensive about it, the APN might take that as a bad sign. I did have at least one other person tell me that her own daughter, who developed anorexia, started off the way my daughter did, with weight loss that put her in the "normal" BMI range. But the whole thing is just difficult to fathom when you realize that if my daughter hadn't lost any weight as she went through puberty, the doctor would be telling her things she could do to be thinner. 

Like Turquesa said, what separates very skinny from anorectic/anorexic is mental health. You can actually have anorexia and not be too thin, you can be really thin and not be anorectic. But it feels like we just want people to get to some magic number, and then they are fine, we don't have to worry about their health, which isn't true. 

There used to be a thread here for Skinny Mamas, and they might have some information for you. I think the last one kind of petered out in 2012, but some of those members may still be here.


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## bren94 (May 16, 2014)

Wanted to come back and say thank you for your replies. 

Since I last posted, my parents have stopped taking my sister to that doctor. She saw a nutritionist once who chalked her weight up to genetics and gave her a high fat diet to follow if she chooses. I think she did for about a week before going back to just eating how she wants. She's in a running camp right now which makes me so happy because she really does love it and I think it's a great outlet for dealing with her emotions. She's also seeing a therapist now which seems to make her happy. It's good for her to have someone to talk to about her mother's death and such. 

Thanks again for those of you who gave me kind and constructive responses. 


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## Turquesa (May 30, 2007)

Yea!! Thanks for the update!


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## jmarroq (Jul 2, 2008)

Just wanted to give a different point of view. There are people who are extremely thin by nature and wish they were heavier! Both sides of my family had thin people..even the men! I fluctuated between 98-117 all my life (except a stressful time when I was 19 when I was down to 88....and when I was pregnant and up to the 140s). I am 5'6". Overall, I am healthy. My doctor can't believe my cholesterol levels! She is amazed that I don't exercise and I stay so thin! 

I don't remember doctors making a big deal growing up, but I heard about the school officials accusing my aunt and uncle of not feeding my cousins. My aunt cooked from scratch daily...the most amazing recipes from their home country, cooked with fresh ingredients and lots of love...and real butter! We always drank full fat milk with every meal too. People probably thought we were either sick, neglected or just too poor to buy food...if only they knew! 

Appetite in general fluctuates during stressful times. In my case, anxiety made me lose weight. I wasn't hungry. I also suspect some sort of hormonal, endocrine, digestive or blood issue. I've had some strange health symptoms on and off throughout the years, but no diagnosis. 

That's good that you have her talking to someone. If there is a mental health issue, it will be addressed.


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## Silversky (Dec 13, 2016)

The doctor is not handling this issue well.
He should not be threatening her with hospital when there is no definite answer as to the issue here. I'm inclined to trust your instincts as her sister - I'm sure you know more than any of the professionals do about her. I'd talk to your sister and see if she is interested in gaining a little extra weight for health reasons and see an endocrinologist and nutritionist. I guess the outcome of that would tell you whether she's afraid to gain weight, in which case there might be a little more psychology there and if she is actually struggling with an ED. 
On the other hand, I struggled with anorexia since age 13. My whole personality changed as I dropped weight. It was very noticeable. I don't think it sounds like this is what is happening to your sister, although I could be wrong. They do go to a great deal of trouble to try and hide the problem, but it does get very difficult to do.


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## lauren (Nov 20, 2001)

Silversky said:


> The doctor is not handling this issue well.
> He should not be threatening her with hospital when there is no definite answer as to the issue here. I'm inclined to trust your instincts as her sister - I'm sure you know more than any of the professionals do about her. I'd talk to your sister and see if she is interested in gaining a little extra weight for health reasons and see an endocrinologist and nutritionist. I guess the outcome of that would tell you whether she's afraid to gain weight, in which case there might be a little more psychology there and if she is actually struggling with an ED.
> On the other hand, I struggled with anorexia since age 13. My whole personality changed as I dropped weight. It was very noticeable. I don't think it sounds like this is what is happening to your sister, although I could be wrong. They do go to a great deal of trouble to try and hide the problem, but it does get very difficult to do.


Just wanted to let you know this thread is two years old. It can be hard to notice that sometimes!!


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