By this point, N had lost 20 pounds. The obsession and daily emotional battle wagged on. We knew at this point that it was probably time for some help. N weighed 84 pounds.
Here is the correspondence with my neighbor-doctor from September 18:
At what point, in your opinion, should we seek professional help with N? He has continued to lose weight. His idea of what is "healthy" just seem to get stranger and stranger. He is seems to be thinking/talking about food 24/7. He'll offer to cook, but won't be willing to eat it. He scrutinizes every single calorie and gram of fat. By the end of the day, he is so hungry, emotional and frustrated that he usually winds up in tears. We've set up "conditions" for playing football. Those conditions seem to be day-long battles. He asks over and over and over if "this is healthy." At some level he can't even choose what to eat for himself anymore.
We've tried to de-emphasize calories/fat and tried to emphasize food as good fuel. Still, he over scrutinizes every choice and tries to find the "better" foods. He is so concerned that every food that he eats will make him fat. But at this point, he is barely eating enough to stay alive.
It sounds like Dr. H may not be the best choice for N situation. Is there someone in the area that works with children and eating disorders? We'd trust any recommendation that you make.
*it's time to get help.