Tuesday, October 30, 2007


We didn't make the boards like I planned. N reminded me early on that we had to carve our pumpkins. So we did and ate cinnamon rolls.

N did okay until the late evening. He was so tired and emotional. He gets to that point and struggles and wants to talk. I think, though, that it would be better if he went to bed. We've been trying for months to get him into bed by 9:00 at the latest. I think he purposely tries to stay up -- and in fact, won't go to bed until we do. Not only is this bad for him physically and emotionally, but it is eating up the last remnants of any couple time we've had. We finally persuaded him to go to bed last night (with some talking -- but not the hours he was gearing up for). There has to be a balance.

I talked to J about N this morning while going to the dentist. I've been so concerned that he has been getting neglected. He did say that sometimes he feels like N is getting something that he isn't getting -- but he couldn't put his finger on it. We talked about it and agreed to check in with each other to make sure that J is getting the attention that he needs.

Monday, October 29, 2007

2 Pounds

We had a rough weekend. N struggled through each day as though we've never made any progress. I've been concerned that with the relaxed structure of weekend eating, N wasn't getting enough calories. So I weighed him on Sunday morning. He had lost 2 more pounds. He is now down to 80 pounds.

My effort, then, to feed him more combined with his elevated struggles made for a rough Sunday. He said he feels particularly self-concious at church (possibly intensified by the fact that he was giving a talk in primary). We spent both Saturday night and Sunday night -- probably 3 to 4 hours total -- helping him come to some peace before he slept.

T gave him a priesthood blessing. I think that was good both for T and N.

I've been trying to help N use positive talk whenever he starts to hear the negative voice of anorexia. He'll make a disparaging comment -- and then I'll encourage/help him to turn it around to a truthful/positive thought. I noticed that Gary Gahl, as I read in his book, "Skinny Boy," was able to do this as he started to really get better. I hope that N can learn to insert his positive thinking comments to fight off the guilt and lack of self-worth.

I'm thinking about buying some magnetic boards that the boys can paint tonight for FHE. I thought that maybe I could hang all the good things that we can think of about N on the board. Maybe that would help him get through some of his hard times.

Friday, October 26, 2007

Skinny Boy

Nothing really eventful yesterday. We did get our flu shots -- and as usual, the boys did great. N went to see his pediatrician and was given some prevacid to help with his stressed stomach. For a long time I thought he had a touch of the stomach flu -- but as the stomach pains persisted and became acute when we was having a fit -- I thought it could be "hyperacidity" (doctor's word not mine).

I just finished reading "Skinny Boy" by Gary A. Grahl. It was good/helpful to see the author's perspective in many ways. This segment was at the end of the book. I'm afraid that I'm guilty of a lot of these things (1, 3, 5 and 7). But they are also many of the things that I'm trying to change.

"If you're the parent of someone with an eating disorder: 1) What expectations do I have for my (son)? Are they realistic. or am I trying to vicariously live out what I want through my son? 2) Do I feel at ease expressing genuine emotion in my son's presence? 3) Am I okay with granting my (son) permission to "stretch his wings," or do I feel the need to protect him like a mother bird? 4) When was the last time I hugged my son and told him I'm proud of him (not for what he's accomplished but for who he is)? 5) Have you provided your (son) with support and encouragement while at the same time allowing him to experience the consequences of his own decisions (unless safety is in imminent danger)? 6) How have I embraced his unique personality without trying to break him like a wild horse? 7) How much do I take responsibility for my (son), constantly attempting to control how he thinks, feels, and acts, instead being responsible to him?"

Note (added in 2011) - Reading this book was the first exposure that I had to the old, very-inaccurate idea that parents' control issues cause anorexia.  I have since come to understand that anorexia is a brain disorder and is not about control issues at all.  Finding the balance for giving a growing child independence is an issue for every family regardless of whether that child has an eating disorder.

Thursday, October 25, 2007


Yesterday was rough again. N struggled through the day -- and was 30 minutes late again. His primary teacher called me during the day while N was home. I stepped out of the house and sat in my car to talk (mostly because I couldn't hear). N asked who had called and why. We've been honest with him about those who know/show concern in hopes that he would realize how much people love him and care about him. N then admitted that he liked all the attention he was getting. He said that people had never really showed they cared in these ways before. This confession really concerned me. We've got to make sure that we are not reinforcing the anorexia -- but instead are rallying around him in different ways. I guess we've got to reinforce him most when the anorexia isn't the main issue -- to show him all the love/attention he is craving but not have it associated with or reinforcing his eating disorder.

Also, last night N started having loose bowels. He just doesn't have enough weight to get sick. I'm afraid he would end up in the hospital.

This morning, it all started over a gogurt. I've been letting him substitute a gogurt for his milk. He has been cutting them in half. This morning, though, I didn't have any that were frozen. So I insisted that he have the whole thing (a good change regardless because an entire gogurt is not even equal to 1 c. of milk -- in terms of calories etc.). He threw a fit again - crying and screaming and kicking. The most disturbing thing was his comment that I would be making him be hungry later if I made him eat the gogurt now. He then told me that he wouldn't eat as much during the day to make up for the extra gogurt. I insisted on the gogurt -- thinking that he would eventually adjust to having that much and wouldn't restrict his later eating to compensate (I hope!).

He is wearing a white t-shirt and a pair of Old Navy "skinny" jeans to school every day. I bought him a huge package of t-shirts so he wouldn't be stinky/dirty -- but he really could use some color/variety. He said that it is the fit he likes. I'll have to see if I can find some colored undershirt/t-shirts.

Tuesday, October 23, 2007


It's never simple, is it? N had, really, a great week. Yesterday, though, it became very apparent that it had all really been smoke and mirrors. He had been struggling almost as much -- but had been hiding it from us. We want him to have good days -- days where he feels good about himself. But we don't want him to hold it all in either. When you are judging behaviors by outward manifestation, how can you possibly know what he is really thinking/feeling?

I took him to pick out his earned funkey. I made the mistake of offering him the cash instead. The choice was paralyzing! He spent an hour obsessing and crying. I finally had to make the decision for him. Then he was so ridden with guilt. He went on and on about how we shouldn't have to do all of this for him -- that we shouldn't have to give him rewards (and insisted that he wouldn't take them). The evening just dissolved from there. He spent most of the afternoon curled up on his bed. He wouldn't do his homework. He wouldn't eat his afternoon snack. By the time we hit family night he was a wreck.

I tried not to make N make any decisions, so I made the call for our activity. N had really wanted cookies earlier, so I decided we would make cookies and then each add our own combinantion of chips. N really wanted to help cook, but wasn't done with his homework so I started the dough. By the time I was done, N was crying and screaming. T took him to his room and they spent about an hour talking before N was calm.

We found out several things:
1) N has still been counting calories. He has been using the cookbooks to find out the calories. The reason my dough-making was so paralyzing was because I doubled the recipe and was planning to change the size of my cookies (thus he could not figure out the amount of calories in each cookie).
2) He has been restricting his calories during the morning/day so he can have more at night.
3) He has not been listening to his body and has never really felt full.
4) He is so down on himself because we are having to do so much to help him. T helped him understand that when anyone is sick, we take them to the doctor and get medicine and do whatever we need to do to help them get better. Hopefully, that helped him understand -- but he is so completely riddled with guilt.

On a different note. Our Bishop contacted T yesterday wanting to talk about our "oldest son." So T contacted him. N's primary teacher had contacted the Bishop, concerned about N -- thinking he might have an eating disorder. The Bishop told him that he was pretty sure that N was too young. Bishop was very surprised when T confirmed that N did indeed have an eating disorder. This morning I contacted N's primary teacher. I let him know how glad we were that he was concerned about N enough to contact the Bishop. [At various points, we've also been contacted by N's scout leader and his school teacher.] I also gave him some basic instructions:
1) Give N authentic praise.
2) Let N choose to NOT have treats. Don't let the boys make a big deal about this.
3) Change the subject when the boys start calling people fat or skinny or whatever.
4) When they teach the "Word of Wisdom" call me -- so I can prep them not to label foods good and bad. And then they can use the word "healthy" carefully.

We've really tried to keep things under wraps -- not because it is secret -- but because N needs to work out things on his own terms without everyone in the community looking over his shoulder. However, the list of those who know just grows. I'm not sure how much we can contain it.

We went to a local corn maze for a delayed FHE activity on Tuesday night. N had fish and chips for dinner as part of this outing. Afterwards, N had scouts. He put on his scout shirt and flipped out. I spent 20 minutes convincing him that he looked great (he even took me to his room and showed me in his mirror how he looked "fat"). I finally got him to go -- just to discover that scouts had been cancelled.

Monday, October 22, 2007


N finally earned his third day on Saturday. He argued that Friday should have been counted, but he threw a fit and argued about his food on Friday morning. I want to reinforce good days -- but help him to recognize things that are still problems. I need to determine a new reinforcement. It was surprising how much a $6 toy motivated him. Once he told me that he thought he could be "all better" if I got him a wii. What? Is that possible? Could it be that simple? If it was, I would offer it in a second.

Sunday wasn't quite as good. He really doesn't like his church clothes and spent a lot of time fixated on finding an old sweater to wear over his shirt. After church, he just wants to cook. But he never actually makes anything. He just spends hour reading over cookbooks, trying to find a recipe. I probably shouldn't let him do this. But if he would make cookies and eat them, that would be fantastic.

He let himself have some treats over the weekend. He has stopped limiting them. However, after he eats much, he still feels so guilty and "self-conscious." Many nights he'll cry because of what he did or didn't do with food that day. I've taught him some relaxation tricks (like imagining a ball rolling through all of the parts of your body, slow breathing, or envisioning Christmas morning). I usually have to remind him to do those things to help him fall asleep.

I've got to watch him. I've been serving him breakfast -- but he is so into predictable foods (where he knows the calories, I think) that I've let him serve himself for several days. However, I realized that he was going to walk about of the kitchen have only eating a 1/2 gogurt. I insisted on cheerios and an apple. He is late almost every day to school so I had to take his brother to school before he was ready. But when he came to the car, he had only eaten 1/2 cup of cheerios (and the 1/2 apple). I've always required a full cup of cheerios -- that makes me wonder if he is fudging other requirements. I'm pretty sure that he never lies to me -- but maybe he just conveniently "forgets."

I'm also wondering about bullemia. I really don't think this is a problem. My husband asked how N would even know about it. On the insurance questionaire that N helped me fill out, there was a question about throwing up. N saw it and said he didn't do that. But we didn't talk about it after. If I had known that question was there, I would have never let N see the paper. N has been locking himself into the bathrooms lately. Twice he triple-locked himself in to the master bath (toilet, bathroom, bedroom locks). Last night, my husband went to listen (N went to the bathroom right after dinner). He said it did sound like N was really going to the bathroom. I'll just have to watch him carefully. I don't want to ask about it out-right. I worry that it would just give him ideas. Maybe that's naive.

Friday, October 19, 2007

Dr. R

On October 4, we finally met Dr. R. We really like him a lot. We've met with him three different times so far.

N's weight loss has leveled off. He still fluctuates anywhere from 81 to 84. The weight loss finally stopped once Dr. R got involved. Dr. R said that N's case is severe. However, we have duration working in our favor. Because N has only been struggling for about 4 months, habits are not deeply entrenched. Hopefully this means that recovery can be faster.

Here are some things that he has us doing:
*Do everything to help N understand his self-worth.
*I fix N's breakfast and dinner.
*3 mandatory meals and 3 mandatory snacks.
*I don't fuss over "healthy" foods -- calories and survival are key right now.
*We've worked out a reward system. Right now, if N can have 3 good days without obsessing then I will buy him a funkey.
*Emphasize eat when you are hungry, stop when you are full.
*Don't let N count calories.
*Externalization - anorexia is the enemy.
*Distraction - during/after/before eating so N doesn't obsess
*Tool Box: Things to do when you feel like anorexia is getting to you (talk, pray, write, distract).

N has had two good days this week. This is huge! I think he has had a total of 4 good days since late September. However, he got a new retainer yesterday and is having a hard time eating. We talked him into a shake last night -- instead of the spaghetti. He agreed but is having a bad day today because of it. Two steps forward and one step back -- that seems to be how it always goes.


[This first paragraph was added on June 26, 2008:]
I found this log as we cleaned out the car to drive to our family reunion in June of 2008. It's amazing to reread these notes and realize how far we've come. These notes were made before we ever saw a therapist and months before we discovered Maudsley. I'm also amazed at my mother's instincts. So much of what I thought, ended up being exactly what N needed. But, I was still trying to "back off" and wasn't listening to those instincts.

I created this eating/behavior log in anticipation of meeting with the therapist for the first time.

Wednesday, September 24, 2007
2 med buckwheat pancakes
1/2 banana
1 c. milk
Spent 15 min. debating about normal vs. buckwheat pancakes. Concerned about caloric difference. Which one is "healthier"?
Elapsed time 30 min +.

(Didn't eat school lunch - says going to eat at home)
Start 1:30
3 Strawberries
1 c. milk
1/2 microwave pizza (minus cheese)
Had a 30 minute discussion on what to eat for lunch. Before he would eat anything I had to add up calories for him. [I indulge about counting calories because if I do, then he'll eat as much as twice as much compared to when we wouldn't let him count.]
(Total calories needed: 2200, minus breakfast, minus biggest total possible "Family Home Evening" treat - still has 1400 to go).
Agreed to have micro pizza. I left package out - while it was cooking he saw calories on label. Is curled up on floor crying that it's too many calories. Saying, "I hate this." Came & got a hug. Trying to negotiate for a wheat bread stick with peanut butter. I say fine and remind him about his goal to eat "more." 15 minutes later, still on the floor. Cuts pizza in half. Removes cheese and pepperoni. I remind of need for protein - argues and agrees to eat pepperoni, but not cheese. Drinks milk without problem. Apologizes.

My thoughts:
I think sometimes he would like me to "make" him eat things. I think giving him a choice makes his dilema longer. Also, he ate the strawberries first. After 15-20 min., he is more "rational." I think the hungrier he is, the harder it is.

End of eating: 2:40 p.m.
Elapsed time: 1 hour.

1 wheat breadstick

N's Comments:
"I think that being obsessed really sucks right about now. I get so hungry that I act pathetic and can only think about calories and how terrible something is for me. I don't even care how much I want to eat something, all I care about is how bad it is for me. I also say something is bad for me when it's just normal food. You know what, I even think I might secretly be trying to land a couple hundred calories short every day. Stupid or what? I do't really have a problem with only eating treats on Monday nights, but it's really stupid of me to be shunning normal food. I guess I keep doing this because I don't feel self-conscious any more at school and that gives me a feel of relief and freedom. But I've gone into the extremes."

My comments:
N wrote his log (above) - said maybe he shouldn't try to cheat those couple hundred calories. Said - What about a snack? Will I overeat? I agreed that I wouldn't let him. He eagerly ate it.

1 c. pasta
some tomato sauce
1 pickle
N made/chose the pasta. I had his plate made between football stuff. He only called into question the amount of sauce we put on.

1 hour of football practice

Family Home Evening Snack
2 cookies
We told N several months ago that he was not allowed to opt out of the FHE snack. Tonight was his turn to choose it. He carefully planned and chose the treat with the fewest calories. No guilt afterwards! In the past he has "punished" himself the next day. I don't think he will this time.

Thursday, September 25, 2007
2 buckwheat pancakes, no syrup
1/2 banana
1 c. milk
No problems this morning. Was a moment's hesitation about pancake size - "this isn't a medium pancake." Also a referral to his "old fat" self that ate treats all the time. I asked if I was the one that told him he had been eating too many treats - "yes." But you weren't fat. Needed a reassurance that last night was only "1" treat. I'm sure that's because I said treat(s) are okay to have - it's only a problem when you have 5 or 6 each day. On time to school - said it was because he knew what he would eat for breakfast, chose school lunch and knew what he would wear.

1 glass milk
1/2 pickle
1/2 c. grapes
Ate only pasta that was served at school. Drank milk, ate pickle and fruit here at home. Dinner portion of chicken taco salad 1 glass milk No problems - except he picked out tortilla strips. We didn't comment.

Scout Activity
His scout group went for ice cream. He said he would not eat anything per our contract (is in our contract that we won't "make" him eat treats except FHE). Apparently, it was a big scene. I was not here at his return - but discussion with Dad yielded that he likes the "self control." Dad said he prays every night that N won't hurt his body anymore. Every day he is so far under his calories.

1/2 banana

N's Comments:
"Breakfast - I did refer to my "old" self and did need reassuring, but I didn't want to eat 2 treats last night. I think I might be comfortable eating Monday-night treats. No punishments this time. Yeah!!!!!! Lunch - Not much of a problem."

Friday, September 26, 2007
Elapsed time 1 hour + 15 minutes.
Not quite this bad because he took a few minutes to get out of bed.
1 lg. pancake
1/2 banana
1 c. milk
Woke up at 7:00 - is 7:56 and he is just starting to get dressed. Apologizes after hearing me cancel my 8:00 walking and gets going. Has been laying on floor crying, paralyzed by the pancakes being bigger than "medium" sized. I suggest eating one large and then another half - but he won't do it. Finally eats. I accidentally pour him some of his brother's whole milk. He drinks it and then freaks out. Cries for 5 minutes. Next issue - What to have for lunch? 3 choices: Hamburger, Potato bar (which he loves) or home lunch PB & J. Takes 15 minutes to decide. I finally have to say you have 2 minutes to decide or I'll decide for you. Takes up to last minute. Decides peanut butter and jelly. Cries because I put in too many grapes.

N's Comments:
"I absolutely hate whole milk. It's a nightmare when I drink it. Potatoes are stuffed with starch! A handful of M&M's would be healthier. I was pretty stressed by then. I think I got up on the wrong side of the bed."

1/2 PB&J sandwich
1/2 c. grapes
1/2 pickle
1 c. milk

N's Comments:
"I was pretty hungry by lunch time. I hadn't gotten down to the lunch room and I was already eating my sandwich. Yum. That was a darn good sandwich. The grapes weren't half bad either. Yum, Yum, Yum. I don't think I will eat a snack. I might."

Cheesy Chicken with rice
1 c. milk
4 strawberries

N's Comments:
"No complaints except for the rice because he hates cheese."

Monday, October 1, 2007
N has done extrememly well the past few days, as long as his meals are completely predictable. He has his standard 2 large pancakes/fruit/milk for breakfast, pb&j sandwich/fruit/veggie/milk for lunch and prrotests, but usually eats what I serve for dinner. Still talks about it tons. Did eat a granola bar on Saturday and Sunday. Also had 2 cookies for Family Home Evening - didn't cause any problems. I weighed him. He hasn't gained any weight over the past week, but I won't let him see what he weighs or weigh himself. Also, I've continued to let him add up calories. At least he tries to eat "enough" that way.

1 c. cheerios
1 c. milk
1/2 apple
Small "fit" about size of pancakes (not medium) that I made yesterday. I told him that he could make them next time.

N's Comments:
"Enjoyed cheerios."

Granola Bar

Scout leader talked to N about needing to eat in order to participate in scout activities.

Tuesday, October 2, 2007
1 c. cheerios
1 c. milk
1/2 apple

3/4 pb&j sandwich
1 granola bar

After coming home, ate 1/2 apple, 1/2 pickle. I insist on carrots, strawberries before football. He must have had a bad day, somehow that was enough for a fit. I was not checking - and he went to football without eating the strawberries.

Had Parent-Teacher conferences. Teacher asked if N was sick, tired or sad. Said seemed all of those things.

N thinks he is cured because he didn't lose any weight.

*N is doing "extra" exercise to burn off anything that he eats. He'll eat and then want to go running. Once, he even did laps around the church to burn off a meal.

Thursday, October 4, 2007
1 c. cheerios
-1 c. milk- 102
-1/2 banana - 53

– Popcorn chicken

– 1 wheat pancake
- 3 pieces of bacon
- Small square of quiche
- ½ banana
- 1 c. milk - 102
Was difficult to not count calories. Cried for 90 minutes. Talked about stress of football and concerns about relatives thinking he was fat. He had stress stomach pains. We kept him home.

Friday, October 5, 2007
- 1 c. cheerios
- 1 c. milk - 102
- ½ banana (wouldn’t have a small banana, it had to be a ½ banana)
Ate granola bar before he left for school because he was hungry (said he was “borrowing” from lunch).


– 6 saltines

– Mandarine Chicken
-1/4 c. green peas
-1/2 c. strawberries
-1 C. milk - 102
I gave option of pizza. He wouldn’t eat it because I would require 2 pieces. I finally made the chicken because he wouldn’t agree to the pizza.

Saturday, October 6, 2007
-1/2 banana
-1 c. cheerios
-1 c. milk - 102
Cheerios weren’t measured. N threw a fit – T measured, it was short so he added more.

N is unwilling to play conference bingo- even with peanuts. Is asking for lunch at 10:45 – but won’t eat something.

[End of log]

Low Weight

During October, N hit his new low weight - 82. He has lost 22 pounds (20 of it in two months). I figured he had been losing one pound every three days. He looks very angular -- though not skeletal like pictures I've seen. At this point, I started to be concerned for his life.

Finding A Doctor

Thus began the search for a doctor. We were not able to find anyone who primarily dealt with boys and eating disorders. In the end, our neighbor recommended a doctor that worked mostly with young women but was currently working with another 12-year old boy. This doctor was out of our insurance network -- but came with such a strong recommendation (honest and a good man) that we finally scheduled to see him.


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.

Doctor's response:
*it's time to get help.

Continued Correspondence - August 21

Thanks so much for all of this information. We've been listening carefully to N the past few days. He continues to loose weight, though. I hid our bathroom scale, but he searched for and found it -- and has lost another pound (he has lost 13 pounds in one month). The scale is now "unfindable."

I told him yesterday that he could only go to football if he promised to drink 1/2 of a 12 oz gatorade during his two-hour practice. He refused and cried and refused and cried. Finally he said that he would not go to football (I think trying to call my bluff). I said, "fine." After much anguish, he went to football and said that he did drink 1/2 of the gatorade (could be lying but he is usually honest about things). It was probably the wrong thing to do -- but I have become much more concerned about his health because of it. Last night he talked at length about everyone in his class remembering the heavy N -- and getting to see him a lot thinner. I'm wondering if this is part of the payoff he is seeking (admiration of his classmates). Might the obsession settle down after school starts and the payoff ends (or doesn't materialize)?

Anyway, the short part is that I called his pediatrician to see what he recommended. He referred us to Dr. H, a psychologist that specializes in children. It doesn't state that Dr. H deals with eating disorders. Is that a concern? Do you know Dr. H -- and would he be good to work with in this situation? Am I jumping the gun? Or should I give N some time and see if things work on their own?

Thanks so much for guiding us. We're pretty clueless and it feels overwhelming that we might need to take N to a Psychologist.

Doctor's response:
*explained there is a reinforcement.
*Dr. that was recommended deals primarily with delinquent children.
*okay to make football dependent upon eating.
*try reinforcements/set limits and wait to see if it works.

Looking For Help

We are very religious people. Early on I saw Heavenly Father's hand guiding and helping us.

We live four houses away from a Psychologist (Ph.D) that specializes in eating disorders. They are friends and also attend church with us. We are also very private people. But after lengthy discussions and concerns, we decided it was time to find some help. So I contacted our friend.

This is my email from August 17 (modified to removed names):

I have a concern about N -- and because of your professional training, I'm hoping you might have some recommendations.

N has lost 12 pounds in the last month:

He had a friend tell him that he was fat. I showed him on a chart that he was a perfect weight for his height. He had a pediatrician visit and the doctor also confirmed that N was right where he should be. But N was so concerned about it that he started obsessing about everything he ate. Right now, he won't eat anything with artifical sugar. Which is fine, but his overall caloric intake is so low (especially with him practicing football for two hours every day). I have been able to get him to drink 4 or 6 oz. of gatorade at his football practices -- and I feel like I'm almost forcing him. But I've been so concerned -- especially when he developed a metallic smell to his breath.

Anyway, something about it is self-reinforcing. He has commented that he feels better about himself when he doesn't eat. He also is ALWAYS talking about it -- calories or fat or snack vs. treat. I finally got online and made him a personal "nutrition" chart based on the current recommendations. Again, the obsession with the chart -- and he made comments like, I don't feel good if I eat that much (speaking of the recommended amounts).

Both T and I have been very concerned (enough that I'm contacting you). N knows that I talked to your wife about it. I actually think N realized how seriously we were concerned once he knew that I was asking for help (and I've seen some improvement over the past 24 hours). But he weighed himself this morning and had lost another pound.

Obviously T and I both struggle with weight. I have to watch my sugar because of insulin problems. But we have tried to not dwell on these issues. Since the boys were little, we've always talked about making healthy eating choices and not worrying about weight. We've tried to teach them to be moderate and wise.

So my questions:

Is this just a phase?

How should we respond to N when he obsesses about food?

How should we deal with the issue generally?


The doctor's response was:
*he didn't deal with children.
*to get rid of the scale.
*to deemphasize calories/fat.
*to help him talk/journal about his feelings.
*talk about food as energy.
*look into intuitive eating.
*could be a phase.


Football practice started the last week of July or the first week of August. He had always wanted to play tackle football -- especially since two of his friends had been so involved with football the year before. I'm not sure he really loved the idea of playing football as much as he loved the allure of football.

Practices were two hours every day. They were conditioning and working hard in the hottest part of the summer. At this point, I really saw his weight coming off. He informed me when he hit 92 lbs. That was when I really started watching and worrying.

The Beginning

I suppose there was no definite beginning to his disease. There were only small clues (and if I had only known -- I would have done a million things differently).

I remember the first clues from this past July. I don't remember what order they came in. One clue was that he stopped having treats. That was okay. We could all probably be fine with fewer treats. Another clue was his confession that his best friend had told him he was fat. I also remember him standing in front of a mirror and looking at his love-handles. At some point during the month, he found our scale and started weighing himself. And little by little, he started talking more and more about food. He started scrutinizing every food and every menu. I didn't know this at the time, but he had also heard Grandma talking at length about her new diet. I was so surprised to hear him suggest while at his lowest weight that he should go on Weight-Watchers with Grandma.

He had a pediatrician appointment mid July. I had his doctor emphasize to him that he was the appropriate weight for his height. At this point he was about 98 lbs (4'10 1/2"). He had already lost 6 pounds from his high weight of 104 lbs. At this point I even showed him his BMI -- and that he was completely normal.

Leading Up

He was never fat. I did have to buy him some "husky" sized church pants once. At that point, I was more concerned about his eating habits than I was about his size.

We've never emphasized weight in our family. In fact, because of observing others who talked about weight at every turn, we really didn't discuss weight at all. There were some exceptions. First, I'm prediabetic. I have to be so careful about the things I eat and my exercise habits. He has observed this about me since he was four years old. Right now his dad is heavy. He has struggled with his weight and yo-yoed in and out of the Atkin's diet three or four years ago. I did the Atkin's diet with his dad -- since so many of the principles were consistent with diabetic eating.

Instead of talking about weight, I would talk about being "healthy." We all talked about healthy choices, healthy habits and healthy foods. Unfortunately, I also labeled foods as good and bad. He seemed to hear these discussions and partially apply them to his eating and habits, but it was never an obsession.

He is such an intelligent boy. He was academically gifted from the beginning. He had passed by the other kids his age years ago. His teachers varied, though, on whether they would make accomodations for him. Two were fantastic and kept him busy. Three teachers, however, insisted that he stay with the class. He became bored and developed bad work habits. So, in fifth grade we had him tested for an accelerated classroom. Of course he qualified. We were very prayerful about having him attend -- and in the end we left it up to him. The program has been both good and bad. Good because he is finally challenged. Bad because he no longer stands out among peers. Bad because it was a very rough year helping him to change his bad work habits.

N has always been obedient -- a good kid that wants to please us and do what is right. I realize now that I have always put a lot of pressure on him. I have very high expectations. I always have my fingers in a million things. We spend regular family time together -- but I also volunteer at the school and spend significant amounts of time in church service. I play in a local orchestra and am involved in local politics. Family is my priority -- but not always my immediate focus.

I have good kids. They are all good, obedient and kind. We praise and support them anyway that we can. He hasn't been involved in too many things. He plays the guitar, attends scouts, and plays occassional sports. He loves video games and reading. He is like any other kid and can take a whole Saturday to finish 15 minutes of chores. I really thought he had a good sense of self-worth.

I could never have imagined that anorexia could affect any of my boys -- it's a girl's disease. It's been a surprising and overwhelming at times because of this misperception.