ABSTRACT
Stephanie developed anorexia nervosa (AN) at 11 years of age and is undergoing treatment using the Maudsley approach.
Stephanie developed AN in fifth grade. I first noticed her developing a strict routine around school, dance, study, chores and healthy eating. Meals were not finished, water was requested rather than milk and lunches were coming home half-eaten. Despite this, Stephanie exhibited few eating disorder symptoms; she wasn't over-exercising or hiding or refusing food. In fact weight loss was the only symptom until one day we were walking and she felt faint.
Within a week I approached our general practitioner who advised to bring Stephanie in for a ‘chat’. This discussion focused on healthy eating though, of course, Stephanie knew all she was being told and more. Visits during the next six weeks revealed rapid weight loss with food consumption notably more difficult. Eventually my husband insisted on a referral to a specialist. Our general practitioner who, by her own admission, was completely out of her depth researched adolescent eating issues and directed us to a paediatrician and hospital specialising in family-based treatment (FBT).
I'm glad that rather than excuse Stephanie's behaviour, I insisted on an assessment by a qualified practitioner. I learnt that early intervention has a big influence on treatment outcome. Without FBT I doubt Stephanie would have survived. We could not reason with her and struggled to make her eat.
When Stephanie was developing AN, she became clingy and was at my side a lot. She stopped playing with friends, was obsessed with achieving the best in her studies and dance and became inflexible with 226plans. She was only animated when shopping for food, preparing food or watching TV cooking shows. She aimed to be a world-class chef and looked up training opportunities and menus. As this made her happy we encouraged her culinary interest. When Stephanie was diagnosed with AN, I felt robbed, like the previous months sharing her dream had been a lie and the illness somehow had sucked me in.
We attempted FBT following our first visit with the clinician; it was hell. Two days after our second appointment, Stephanie was admitted to hospital via emergency suffering low heart rate, low blood pressure and dehydration. The naso-gastric tube saved her life and, after six long weeks, where the staff never gave up or let me give up, she was finally able to eat a full meal.
Stephanie accepted the naso-gastric tube willingly and immediately her vitals began to improve. She left hospital seven weeks later, the day before her twelfth birthday; she had gained 8 kg and had been off the nasogastric tube for only a week. To see her eat was like a miracle. Our clinician said he would get our daughter back and we trusted him and he has kept his word. To hear Stephanie laugh and share her feelings again, to see her impulsively skip, are pleasures I feared may have gone forever.
Ten months on, Stephanie is eating six meals a day and has regained her lost weight plus the weight she should have gained during her illness (13 kg in six months). This has given us much hope. She has some way to go and maintains an interest in supermarkets but I'm trying to limit this.
Stephanie's mother