You could call your insurer and ask whether it covers out of country. If so, then call a center and ask if they take your particular insurance.
Originally, my D’s therapist referred her to a dietitian and that’s who insisted to her that she needed treatment.
About your D feeling guilty: in the last meeting, my D’s facility therapist explained there’s often a lot of shame associated with ED, for various reasons. The need, the purging, the sense of helplessness. It builds a vicious cycle.
I know of a few people who were inpatient at the Renfrew Center http://renfrewcenter.com/ and either they or their parents spoke highly of the care they received.
The good news is that there ought to be English speaking specialists in Paris. Probably “non conventionnés” but still cheaper than in the US. They should have advice about how to proceed.
Hurry though because as you know most people including doctors will be gone July 14-August 15.
I went to a workshop a few years ago presented by professionals from this clinic/hospital in Miami. It seemed like a good program but would check out reviews. https://www.oliverpyattcenters.com/
I do think finding a psychologist in France who specializes in eating disorders would be the best strategy. Then work with that person to develop a long-term plan and get recommendations.
I hear you about the worries about insurance and treatment language.
You need to find an inpatient place and that soon, you need to be able to afford it, and treatment ought to be in English - because if she is feeling uncomfortable linguistically or culturally, that might be an additional risk.
Your cheapest option would probably the UK, and it’s easily accessible from France. I am assuming she is still legally resident there? What citizenships does she have? As a student, the NHS should cover her in any case, but you need to find out a) whether they will do so if she were to take a leave of absence from university and b) if there are places available at all. NHS usually means waitlists.
Private probably won’t, but then it may become unaffordable again.
Not sure whether „hating London“ has anything to do with the British mentality or if it’s about the city itself. After a year there, she shouldn’t feel so culturally alienated to be unable to cooperate on treatment, but you’d have to weigh that possibility.
I am assuming costs would mostly be covered for her in France, but you would need to find a facility that a) works in English (I’m sure there are outpatient options, wouldn’t be so sanguine about inpatient options) and b) has places. Again, both problems are more easily solved if you are ready to pay out of pocket, but you have no idea how long inpatient treatment might take.
If in the US, insurance cover is iffy, and it isn’t easily accessible. However, I would assume that places might be easier to find than in Europe, particularly if you were able to pay out of pocket. think about whether you can afford that for inpatient treatment.
I think that you should start making lots of phone calls to insurance providers and facilities ASAP and I don’t think you can afford to be picky.
McLean (referenced above by @compmom) has a phenomenal program. One of my swimming buddies used to be a doctor in the program (he retired last year). The work they do is nothing short of amazing. Agree with everyone - her health is key. School, etc. can wait. Good luck…stay strong.
We don’t know whether McLean will be an option to her, but again, it’s where my D has been, for ED. They have my confidence. Any time you mention McLean, med pros react positively.
One thing to remember is that it’s not just the program, it’s also how the patient responds, works with it, learns new ways. No one program resolves this problem.
The more I learn, the less I know. But ED isn’t a problem that just pops up our of nowhere. There’s no simple fix.
We are dealing with an ED with our 17 year old daughter. We found out in January because my older daughter was home from university and recognized what was going on. (we found out through therapy that it began in the prior summer)
We had already been on the search for a therapist for her anxiety. It took us 6 weeks find a therapist and a first appointment. We all liked her very much, but she is not an Eating Disorder Therapist. She was willing to work on the anxiety issues while we worked with our primary care pediatrician to get in to an ED program. We are in Philadelphia and our Children’s Hospital is wonderful. They have an ED clinic, however it took 4 months to get our intake appointment and that was only because we took a last minute cancellation. While we waited we had to see our pediatrician every 2 weeks for a weight check, blood check and those were also sent to CHOP (Children’s Hospital) to monitor. She is 5.4 and at one point was hovering at 100 lbs. Had she gone below that they were going to force admit her to CHOP as an inpatient for forced feeding.
In the last 2 months she has gained weight to her initial goal of 120 lbs and has had 2 consecutive periods. They want to see 3 in a row (she hadn’t had 1 in over a year). She is also starting to have regular bowel movements. We did this though monitored eating through a food plan with their nutritionist. We make breakfast and she then would eat a packed lunch at school with her counselor. She would have a snack and then dinner. Once she ate she could not leave supervision for 90 minutes so not vomiting. She is not allowed to argue or negotiate her meals. She has no real input (of course we know her preferences and tailor to that).
She will be in an intense out patient facility (the Renfrew Center) on the Mainline (suburbs of Philadelphia) for out patient treatment for 6 weeks. She will be there from 8:30 - 2pm. Monitored breakfast, snack and lunch. She will see a therapist, nutritionist, and doctor. They will learn strategies. If all goes well, she will transition in August for 2 weeks to their afternoon program for snack and therapy. Then back to CHOP in the fall.
She cannot row crew over the summer or work her lifeguard job. There can be no linking of working out and weight loss in her mind. We recognize that just gaining the weight is not enough. There is a physical and mental component. She is not happy about the weight gain.
We work really hard to see the negative behaviors (she would binge, vomit, feel bad then restrict calories then binge and the cycle went on) of lying, stealing money for food (the binge part of the cycle), arguing were and are the eating disorder and not her.
We are lucky enough to have good health insurance and the Renfrew Clinic for this summer and the CHOP clinic are covered except for a daily co-pay. We understand that this may take 6-12 months and then a life time of checking in.
Our daughter is a rising junior in high school so we hope to have enough time to get her “well.” She understands that this a condition for going away to college. If not, depending on where we all are she may go to college but commute from home. Time will tell.
@amom2girls your post is so similar to our experience with facility, program and revelations.
I learned last Thursday that this has been going on since high school, off and on, only reached crisis recently. Total shock to me- and I’m an aware parent, close to both girls. I don’t know why she assumed I knew. Her sister expressed similar surprise.
D2 was diagnosed with anxiety and some obsession, earlier. I never saw the latter (no more than any of us can occasionally fixate on something.)
Mine’s overweight. But the restrictive eating, binging and over exercising, even after a back muscle pull, are/were there.
I never thought I’d be sharing this. Today may be her last partial day. I have no idea if she’s ready to leave. Her search for an ED therapist post program is not going well. She sees her regular dietitian later this week.
I also don’t know what my role should be, going forward. She’s 27, lives an hour away.
I am going to put a different spin on this. And I have probably read only 1/2 of these posts, so this may be a repeat.
My mom died of adult anorexia. My roommate in college had it to the point where we talked to her parents all the time - she was down to 80 pounds. My oldest had an eating disorder. And my neighbor’s daughter had/has it. I have seen a lot. Be very, very careful with how you approach this. Eating disorders are about control. And if you take that control away from your daughter, then I fear it will get worse vs. better. All the advice about “bringing her home no matter what” sounds great, but it may not work unless you put her in a hospital - and you can’t force her to do that at her age. You can force her to come home, but then she doesn’t have that control anymore.
It seems that what she CAN control is her living situation. She needs to be the one in control here to make her feel better about herself. so you need to put a spin on it that it seems as if she is in control, but that you are steering things behind the scene. So, put some parameters in place. Tell her that you trust her opinion, but you are still nervous yourself (put it on you) and that to make you feel better, maybe she can do check-ins with you. I would insist on counseling over there, even if just through the school. Weigh ins. Grade checks. What is she doing for fun? Talk to her about how you are open to transferring her to a different school if it gets to be too much. Relax her - don’t stress her out because it makes it worse. If you focus too much on her living situation, then the control is not hers again. You have a bigger issue to deal with - her health - vs. where she is living. Is she manipulating you? Probably, but not in the way others see a manipulation. She sees things differently. Has different perspectives on things. It’s really important for you to see things through her eyes.
So what happened to all these people I mentioned above? And there are many, many others who do worse - don’t get me wrong. Eating disorders are horrible, but there is WAY more than one way to help this out.
My mom died - she had a tough life and didn't have a lot of control over anything.
My roommate in college went abroad for a year and gained 30 pounds back, and to this day is in a good place. Her "control" was her living in a foreign environment doing what she wanted to do.
My neighbor's daughter was hospitalized several times when she was younger, and put in extended "homes" until age 18. At 18, took her life into her own hands, went across country to a college and is doing much better.
My own daughter went to health services on campus. We, as a family, always talked about her weight. She loved that because she got the attention she needed. We finally stopped and focused on other issues. Do we still fight about it sometimes? Sure we do, but we make sure it's not the main focus, and she is at a healthy weight and just obsesses about it from time to time.
I am NOT a health provider or psychologist, etc. So just take this advice as from a different perspective - that of your daughter’s. This is no an easy situation. I am so sorry.
Earlier, I wrote about control. The next family meeting, I learned it’s more complex. In effect, my D has control of the vast majority of her choices and actions. But as a whole, is not leading a life we’d call healthy, in terms of various balances. She wasn’t working full time, so her income is limited, her money decisions are off, I think her living situation is constricted, for reasons that would drive anyone nuts. One big vicious cycle.
I don’t think she has any idea what would better fulfill her. I see it, but she doesn’t. Yet.
Look into Family-Based Treatment (FBT). EDs are brain-based disorders, not about control. Your daughter’s reaction is typical. You hold the financial key to her continuing at school, so bring her home and get her well. EDs take a long time to recover from. Look into FEAST – a support group for parents of children with eating disorders. Good luck, and remember that you can help your child recover, but her ED will fight you. Stay strong.
But that ^ is not what mine has been experiencing at Klarman now. In no way were we, as parents, or me, as the mother, blamed. I was told not to assume it was me. Not. None of this was blamed on family dynamics or expectations, though my D, on her own, recognized competition with her sister, brought this to the table herself.
But yes, each kid can have their own patterns of trouble and some disconnected thinking.
I respectfully disagree with 3mamagirl’s post about control, which is oversimplifies it. An established eating disorder will follow the person no matter how much control you restore to her in terms of choices or environment. “Control” is a very complicate matter indeed. The transition to adolescence and the transition to college seem to be two danger points, though clearly adulthood holds risks as well for some.
As I said, I had an ED in the 1970’s, before there were programs. An ED can become enmeshed in your daily life, in ways that are not apparent to others. Movie stars, students, professionals, many people whom you might not imagine, are coming home after work and engaging in ED rituals- which is what they are, rituals. It is very hard to give them up, and it took me 10 years. I have been totally healthy since age 28, a long time ago.
Fortunately, today there is a lot more knowledge and there are programs. It is really important, I think, to get your daughter into a program before this disorder becomes a part of her life chronically. I really believe that.
You may be able to argue that she is a danger to self.
Eating disorders are protective even though they are hell. They are mechanisms to protect the person from all kinds of unconscious dangers, and ultimately, from feeling. They are powerful. Only a program will have the power to counteract that hold the ED has on a person.
I do wonder if EMDR might be helpful. That allows the person to focus on their greatest fear and resolve it, then feel safe. It is quite amazing and I often wonder if it would help people with an ED.
@compmom I totally understand where you are coming from. But my point was that this is a complex issue. I was trying to offer another viewpoint from the D’s perspective and what I have lived with in my own life. There is often more than just one solution. I clearly don’t claim to know all the answers…