Hello again-well if it's not one problem with me it's another... This is quite serious, however, and I'm asking for anyone for some good advice on how to handle this situation...

I have a 13 year old daughter-she is a very wonderful person-she has her teenage girl moments, but overall is a very well-behaved child...

I've noticed within the past week (maybe 2 weeks at the most) she has had very rapid weight loss. At first I didn't think much of it, but then I noticed she has started eating less and less during dinner time. In addition to that, I have also noticed that she isn't falling asleep until around the hours of 1:30-3:00am-which is not the norm for her.

She came to me the other night and told me that her stomach had been hurting a little, so I asked her the basic questions: Have you taken anything/eaten anything out of the norm? Of course her reply was no...

She has not mentioned one single thing about not being able to sleep at night at all... she only complains about her minor stomach pains here and there...

As bright as my daughter is-she has had some self-esteem issues I'd say for the past 2-3 years regarding her weight. She is by no means fat or even chubby and as much as I and others have tried to reassure her of that, she just thinks we are saying that because we are her family/friends...

This morning, she also complained of having a dry mouth lately...

I don't know if I am jumping to conclusions, but should I be concerned that she might be taking something? Such as diet pills, or even worse possibly some kind of drug? A couple of her friends I believe are on some anxiety medication (antidepressants), her behavior even exhibits some side effects of possibly being on something like that... She doesn't seem to be irritable-actually, she seems less irritable than normal.

I know I'm throwing out all of these crazy things, but I'm very concerned about what is possibly going on with her. I need advice on how to approach her and possibly get the actual truth out of her. There are more details I can share, but without getting into writing a novel here, I may be able to give them in response to replies I get on this.

Thanks again for your time.

TJ

I recommend you call your pediatrician right away when your daughter cannot overhear your conversation. Tell them that you are worried your daughter may be taking something for weight loss, and may have bulimic and anorexic symptoms and you are worried about her loss of sleep, complaints of stomach problems and also her rapid weight loss and self esteem.

They should look for physical symptoms as well as behavioral as stress, ulcers and other physical ailments can cause these symptoms as well. But I do think that given her age, self-conciousness, preoccupation with losing weight when she's not heavy to start with - are indicators that she may be vulnerable to an eating disorder and/or have an unrealistic picture of her attractiveness (negative).

I would ask for a complete physical including blood/urine tests to determine if she's healthy (not anemic, etc.) and also to determine if there are foreign substances such as stimulants, laxative compounds, diuretic medications, etc. in her system. I would not tell her she is being tested and would not tell her about the appointment until the last minute. You can just say, "hey, I called for a physical for you to get that done before school next fall and they said I can bring you today - so, let's get that taken care of". This way she won't be able to stop whatever she's doing to prevent it from showing up.

Even if nothing is proven, if she's found fit, just based on the rapid weight loss, ask the doctor if someone on his staff would be particularly good to address this issue with her and discuss how she feels about her weight and things of that nature.

Given her self-esteem issues, I wouldrecommend counseling anyway - might as well keep her healthy now even if she doesn't have a serious issue and address the issues as they come up rather than putting it off and letting her continue to erode her self-image with negative self-perceptions.

Some things to watch for related to eating disorders would be whether she talks about calorie content of stuff, tries to only take low-calorie food offered, pushes her food around rather tha actually putting it in hr mouth, or gets up to use the bathroom during or right after meals - a lot of these kids with such problems will eat in front of you and then throw it up.

My son told me that a lot of kids try to buy his ADHD medications for weight loss and that a lot of kids at his school (a very affluent school with kids from stable families and good care, so don't think it's not happening at your school) sell their medication to each other. ADHD meds are strong stimulants and if someone who doesn't need them takes them they have a speed-type effect - the person will have trouble sleeping, will lose heir appetite and be basically speeding. My son feels this is such a big problem that we went to great efforts so he does not have to take them at school - he doesn't want anyone to know he takes them because he doesn't want to deal with the pressure to sell the pills.

He even wants them kept locked in my room because he's worried friends who come over will find out he takes them - so I think this is more than a casual issue for kids today. My son is 16 but was first asked for his meds in 6th grade by another student.

Best wishes to you and your daughter.

Yes I remember how I was with my own weight issues when I was her age. When she started complaining about her tummy hurting, by this point, I chalked it down to hunger pains. I'm glad I posted this because I knew there was a possibility of underlying medical issues that I wasn't aware of. I also know that hunger pains can keep you up at night as well.

I also know that being at this age and being in middle school, she is exposed to a lot of peer pressure and there are all kinds of new thingsall around her. I know that I can't protect her forever from these things, but I would hope that I can influence her to sway in the opposite direction.

She knows better already. I definitely think she should see the doctor, but I wonder if I should have some sort of discussion with her first. Reason being-I don't want her to think she cannot come to me ever if she is in trouble. She seems to already think that in the first place. I'd like to be able to communicate with her to let her know I am here for her, not that she will be in trouble... Thanks again.

Her physical symptoms could be stress related, but only a doctor will be able to rule out a physical problem, could be hormone related, the list could go on, a few tests will probably give a bigger picture.

Sometimes kids will talk to another adult about what's going on in their life, its not that they don't love you, more they don't want you to worry, if she is close to a aunt or grandparent they might be able to draw her.

A call to the school to see how she's getting on and if they have noticed anything there might help.

This is going to be like putting a puzzle together, information coming from all sides, your daughter, the school, other relatives, the doctor, eventually you will be able to see the full picture.

Keep talking to her, I found doing something while they talked seemed to help, I might be making dinner or driving and something would come out.

The teenage years are tough, on the parents and the kids.

A trip to the dentist may be in order also, if she is vomiting, and I'm not saying she is or anything you have written makes me think that, only IF she is, her teeth will tell a tale too.

Do you think the first step would be her pediatrician, or some kind of other specialist?

Your local doctor is the first step, they can refer you for further investigation should she require it.

There is a new era of parenting that seems to have developed over the last few years, of bringing teens to councillors and specialist behaviour professionals, when a lot of problems are just teenage angst... in saying that some teens do need specialist help, today's pressures, the availability of drink and drugs the professions are needed.

Rule out physical first, and take it from there, her sleep is vital, the less she has the less likely she will be able to cope with everyday situations.

If she can purge what's going on in her head that will help, either by writing in a diary or painting or some creative activity, it won't do any harm, in fact I believe all teens need a positive way to purge their thoughts and emotions.

Yes, I think maybe she may need some more time with just me. As I spend everyday making sure she and her siblings have everything they need, sometimes I pass up that time where they simply just need me. I'm going to try and talk to her, but am also going to call the doctor first thing in the morning. She may just very well not feel good as she claims... Thanks again!

I was thinking, about your concern about her feeling she can come to you and want to caution you to be careful about being too careful...

That is, parents don't want to embarrass their kids, so don't find out they are having unprotected sex until there's a pregnancy -

Or they don't want to invade the child's privacy, so don't find out that the child is using crack or heroine until there's a full-blown addiction...

Or they don't want to intrude on their children's online accounts, so don't find out their teen daughter is corresponding with a predatory older man...

When a child is in serious trouble, he or she will lie, whether they are suffering an eating disorder, doing drugs, huffing, etc. So I really feel that we have a responsibility to be in our kid's business and to be honest with them from the beginning - your still a minor, I'm responsible for you - your behavior will determine how much privacy you get, but you should never think you have total privacy because it's our job to check up on you.

The trust will be built based on how you react when your kids are caught doing something inappropriate - do you fly off the handle and become unbearable and impossible to talk to, or do you try to listen but remain firm and be a parent, or do you just listen and let it go to be your child's "friend". I personally think you have to make yourself a safe person to lean on and talk to by being reasonable and calm and by listening more than you talk, but you also need to be the parent and need to be firm, and when your child is over hear head with something, you need to take charge.

You might have to hurt or upset your daughter's feelings, embarrass or anger her if she has an eating disorder and might have to ignore her pleas and promises and stick her in a treatment program that she doesn't want to go to, and that may mean she'll take it out on you for a while. You have to be willing to do that to help a child in such a situation, and only then when they become healthy can they participate in an honest relationship with you.

How are things going for her?