Part Two: If It Were Cancer…


Clementine Advisory Board Member Cherie Monarch shares part two of her series in this week’s blog post. In her series, Cherie shares the pain felt by a family when a loved one is struggling with an eating disorder. 

Read Part One of Cherie’s Series HERE

You, or your loved one, are a shell of their former self, and barely recognizable. As a parent, you’re doing everything you can to provide care, support, and try to understand what the hell is going on. You just know that a terrorist is holding your loved one captive. In fact, he’s holding your entire family captive.

When our loved one has an eating disorder,  it’s like the whole family has an eating disorder.

What is the answer? How can we help ourselves or our loved one navigate this journey with an eating disorder? How can we help others understand this journey?

When I was walking this journey with my loved one, it really helped me to reframe every step of the process in terms of cancer. If it were cancer…

The thing that is important to quickly understand is that food and stopping behaviors  is their chemo. Without chemo they will die. Without food, they will die.

Every decision, every action, every statement needs to be addressed in terms of cancer.

If it were cancer…

If it were cancer… Would it immediately evoke empathy, compassion, support, and action?

If it were cancer… Would you think you or your loved one chose it? Would you think they could just stop?

If it were cancer… Would you allow your loved one to refuse the medicine or the treatment?

If it were cancer… Would you think that it was a phase? Would you think that it would just go away?

If it were cancer… Would you think they had a choice? Would you tell them just to eat?

If it were cancer… Would you negotiate whether or not they need chemo? Life-sustaining medicine. Food.

If it were cancer… Would you run cancer around life? Or life around cancer?

If it were cancer… Would you hesitate to quickly assemble a multidisciplinary team? Would you hesitate to find the best practitioners in the country? In the world?

If it were cancer… Would you be concerned about geography? Would you care if the treatment were in your state… or would you travel across the country without question?

If it were cancer… Would you even think about school? Would you be concerned about graduations, or college applications, and whether they graduate with their twin?

If it were cancer… Would you search out the best possible program? Or just go with one that’s closest?

If it were cancer… Would you allow a provider to wait a month, two or three until the next appointment? What you wait until next week to call for an appointment?

If it were cancer… Would you schedule treatment around holidays, vacations, school, or summer camps?

If it were cancer… Would you postpone treatment a few weeks? Would you think it won’t make a difference. Or would you start today?

If it were cancer… Would you continue competitive sports, dance, and exercise? Or would you rationalize that their body needs rest, needs to heal, and restore strength and energy to fight this demon?

If it were cancer… Would you accept partially healed? Or would you push for full recovery/remission?

If it were cancer… Would you hesitate to share with family, friends, or your entire community?

If it were cancer… Would it matter if they were 12, 18, or 30? Would the fact they were over 18 keep you from insisting they complete treatment or take their medication? Would the fact they were 18 even enter your mind? Would you even consider their adult status when mandating them to complete chemo and radiation?

If it were cancer… Would you let them leave the treatment program before the chemo was complete? If 10 chemo treatments were prescribed, would you let them stop after five?

If it were cancer… Would you postpone or delay treatment because they’re looking a little better? Would you think maybe this is a phase? Maybe they don’t need treatment? Would you even care about the way the looked?

If it were cancer… Would you let them forgo the chemo because it caused them distress and made them sick?

If it were cancer… Would they leave treatment and go right back to school and life? Or would they automatically be allowed time for recovery?

If it were cancer… Would you negotiate treatment at all? Or would you lovingly and definitively state treatment will save your life… It’s not an option.

If it were cancer… Would you let them go to college? Would you let them finish the semester and rationalize it’s only three more weeks? Chemo can wait.

If it were cancer… Would you postpone an intervention?

If it were cancer… and your loved one called right after they started treatment and said I hate it and I want to come home, would you let them? Would you pick them up and allow them to leave AMA?

If it were cancer… Would you care what friends, family, or neighbors said or would you just be focused on getting your loved one well?


For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

“You Better Check Yourself: How to Handle Challenging Situations in the Treatment of Eating Disorders”


Please join Clementine adolescent treatment programs for “You Better Check Yourself: How to Handle Challenging Situations in the Treatment of Eating Disorders” presented by Clementine Medical Director Lauren Ozbolt, MD. 

Parenting an adolescent is really hard work and parenting one navigating an eating disorder greatly intensifies the situation. How do you enforce boundaries and limits when your teenager is underweight and at risk? How do you encourage them to follow rules or a meal plan when they are at a stage of development where they are “supposed to” rebel and not follow the rules? By gaining understanding about the pathology of eating disorders and the normal separation-individuation process of adolescents, we can employ strategies to partner with the adolescent as opposed to fighting this natural process. This presentation will focus on these strategies and tools used in the treatment of adolescent eating disorders.

In this presentation, participants will learn to name three factors that make treating adolescent eating disorders especially challenging, state the developmental tasks of the adolescent and state the rationale for the use of psychotropic medications in eating disorders.

The presentation will take place at Wine Cask in Santa Barbara, CA on Thursday, September 14th. Check-in will begin at 11:30am and the lunch and presentation will be from 12:00-1:30pm. Please RSVP to Regional Outreach Manager Mary Andreasen ( to join.


For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

To learn about summer programming at Clementine, please visit our website or reach out to an Admissions Specialist.

Questions Parents Should Ask


There is an enduring misconception that eating disorders are simple and relatively benign illnesses. Some of these misconceptions have significant implications for how parents respond, both practically and emotionally, to their child. The complexity, ambiguity and intensity of these disorders can leave families feeling overwhelmed and anxious and, unfortunately, many even feel responsible for creating the disorder. Making informed decisions about treatment options is challenging, especially when your child is threatened by a dangerous disorder.

Eating disorders are complex disorders that require specialized expertise by a multidisciplinary treatment team. When looking for an eating disorder program that specializes in treating adolescents, you will want to consider asking the following questions of a residential provider:

  • What is your programs’ experience treating eating disorders, and how long has this been an area of specialty for your eating disorder treatment programs?
  • Is your program accredited and licensed, and by whom?
  • What is the age group your program treats?
  • Is there a nurse present 24-hours a day on site?
  • What kind of evaluation process will be used in recommending a treatment plan?
  • Does your program have a board certified Adolescent Psychiatrist?
  • How many years of experience does your programs’ Adolescent Psychiatrist and Medical Director have? What are their training and credentials?
  • How many years of experience does your programs’ Clinical Director have? What is their training and credentials? Does the Clinical Director meet with the clients at least weekly?
  • How many years of experience does your programs’ Director of Nutrition Services have? What is their training and credentials?
  • Does the Registered Dietitian provide meal planning, dine with the adolescent, meet individually with the adolescent and provide family coaching?
  • How many adolescents does each Primary Therapist oversee?
  • How does your program measure effectiveness?
  • Do you offer high-frequency individual therapy?
  • What evidence-based treatment modalities does your program offer?
  • What does the educational component look like for my daughter at your program? Are there state-certified teachers overseeing the educational programming?
  • Does your program offer family therapy, coaching and psycho-educational groups in its family programming? How often is family programming offered?
  • How do you collaborate and communicate with the family, outpatient professionals and schools while my child is in treatment with you?
  • What are the setting and milieu like?
  • Do you provide step-down options for when my child is ready for a lower level of care?

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

To learn more about our newest location, Clementine Briarcliff Manorplease reach out to a Clementine Admissions Specialist at 855.900.2221.

A Father’s Heart, An Open Letter


Don Blackwell is a Trial Attorney with extensive experience in the eating disorder community. He has a unique perspective which he often shares through his honest and heartfelt writing. In this week’s post, Don shares a heartfelt letter on behalf of all dads to their daughters.

Dads are somewhat notorious for being poor communicators where feelings are concerned and, for some reason, that’s particularly true when it comes to their daughters. Regrettably, daughters often interpret their fathers’ silence (or awkwardness) in the face of life circumstances that demand (or would greatly benefit from) a heightened degree of vulnerability to mean that their dad is disinterested in them, lacks empathy or, worse yet, is simply insensitive to their needs.  Sometimes, daughters harbor those perceptions for the better part of a lifetime. And yet, nothing could be further from the truth! To the contrary, if the men I met during the course of our daughter’s illness (and, more recently, at conferences and webinars that I’ve been privileged to host) are fairly representative of the whole (and I believe they are), most dads care deeply about their daughters. Moreover, though we may sometimes appear to be “clueless” as to how to go about accomplishing it, I suspect every dad silently thirsts for a closer (i.e., more emotionally intimate) relationship with their daughter. I certainly do and while lately I think I’ve done a better job of figuring things out – at least where the vulnerability piece is concerned – I know all too well the sense of longing for (and uncertainty of the means to achieve) that objective, which is what led me to write this post.  So, if my fellow dads will permit me, I thought I’d share a few “secrets” of our own collective hearts in the form of an “open letter” to daughters everywhere, who may still be wondering about us and, more critically, about our feelings towards them:

To Our Little Girls –

It seems like only yesterday that we held you in our arms for the first time.

It was love at first sight.

From that moment on, you’ve held a very special place in our hearts – a place reserved only for you.

When you were little, it was “easy” to let you know that.  We could hold you tight, comfort you when you were sad, tell you bedtime stories and tuck you in – and we did.  You probably don’t remember those special father/daughter moments, but we do. 

But, as you grew older, things got more complicated for us where you were concerned.

You were becoming young women, perhaps before both of us were ready for all those changes – and we weren’t at all sure how to respond, how we fit in to your emerging womanhood.

We wondered if it was still “okay” to hold to you as tightly as we once did (or hold you at all), to kiss you, to tuck you into bed – to dry your tears and comfort you.

We looked for other ways to stay connected with you and share our love, ways to stay engaged in your life, to discern the role you wanted us to play as you entered your teenage years, but we confess we struggled with that – a lot.

We assumed, without asking, that your mom was the person you wanted/needed for all those “girl (and boyfriend) things” and that you would let us know if/when you needed us and how we could help.

Between your mom and your friends (who took on an increasingly important role in your life), it seemed like you were doing “just fine” and growing more independent (and less in need of us) with each passing day. 

Part of us was content to watch you grow, but we missed you – we missed “us”.

Only now have we come to realize, however, that we may have missed the most important thing of all – the realization that you were missing us too and maybe even misconstruing our distance and seeming “absence” as indifference.

If only we had known then what we know now. 

If only, rather than trying to “guess” at what each other was thinking or hoping one of us “would get it” from the unspoken “bread crumbs” we were leaving in each others’ lives, we had simply talked, allowed ourselves to be more vulnerable with one another.

Maybe we could both be a little better about that going forward?

In the meantime, lest there be any doubt in your mind, know this . . .

there has never been a day since you were born when we haven’t loved you, 

a moment that has passed when we haven’t thought of you,

an occasion where we weren’t proud of you or felt disappointed in you or

a time that we wanted anything but what was best for you –

today is no exception, nor will tomorrow be.

Because, while we may not always be great at showing it, let alone expressing it (!), we love you and we value you!

Your Dads


For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

To learn more about our newest location, Clementine Briarcliff Manor, please reach out to a Clementine Admissions Specialist at 855.900.2221.

Our Clementine Family: Dana Sedlak


Clementine Briarcliff Manor Primary Therapist Dana Sedlak, LCSW gives an inside look at her daily work at Clementine’s newest location. Dana shares how her and her team work together to support the adolescents on the path to full recovery. Read on to learn more about Dana and the Briarcliff Manor team…

What is your name and what are your credentials?

My name is Dana Sedlak and I am a LCSW with a master’s degree in clinical social work.

Please give us a brief description of your background.

I’m experienced in individual, group and family psychotherapy with those who have co-occurring disorders, eating disorders and substance abuse issues. I also have a background with using art as a therapeutic tool.

What does a typical day look like for you at Clementine?

Part of the day involves individual sessions with each adolescent that I’m working with where things like therapeutic assignments are explored. I could then be running a psycho-education group on topics from dialectical behavioral therapy to my creative arts therapy group. Behind the scenes, there are always case management tasks to complete such as creating treatment plans and calling insurance companies to request additional treatment days. Contact with family members and outpatient providers are also occurring. At the end of the day I get to sit down for a mindful dinner with the adolescents and possibly support them with an exposure to a challenge food. If I’m really lucky, the day may even involve singing a karaoke song or playing a round of Jenga with the girls!

In your own words, please describe the philosophy of Clementine.

Through the support of Clementine, full recovery is possible for each adolescent and her family by both fostering new relationships and repairing past ones. This happens first with one’s self and then with others.

How does your team work together? How do your roles overlap and differ?

We wouldn’t be successful if we were not a team at Clementine. We all rely on each other to provide a warm and comforting atmosphere for the girls. While there are responsibilities outside of our own disciplines that we may not be specifically trained in, no job is too big or too small for any of us. We all shine within our specific roles and are also very eager to learn from one another to better suit the needs within the program.

What is your favorite thing about Clementine?

I’m humbled by the resiliency that each and every adolescent girl brings through the front door. I’ve never witnessed such bravery anywhere else and it’s a privilege when they are willing to share that with me.

What are three facts about you that people do not know?

  1. I took piano and sewing lessons when I was a child but can’t play or sew for the life of me now!
  2. If you asked me where my happy place was, I would always say at a concert.
  3. I collect copious amounts of nail polish and change my nails weekly depending on my mood.


For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

To learn more about our newest location, Clementine Briarcliff Manor, please reach out to a Clementine Admissions Specialist at 855.900.2221.

Fat Chat is No Light Matter



Andrea Wachter is a Licensed Marriage and Family Therapist and author of Getting Over Overeating for Teens. She is also co-author of The Don’t Diet, Live-It Workbook and Mirror, Mirror on the Wall: Breaking the “I Feel Fat” Spell. She is an inspirational counselor, author and speaker who uses professional expertise, humor and personal recovery to help others. In her writing, Andrea shares strategies to help parents foster a positive relationship between their children and their bodies.

As an eating disorders therapist and woman who spent the majority of my life in the grip of a weight and food obsession, I walk around with my antennae tuned in to whatever might help me understand how we got ourselves into this mess. Obesity is now considered an epidemic. My young bulimic clients tell me, “Vomiting is no big deal.” Every day, people die from anorexia-related complications. And let’s face it, folks: Even many Americans of average weight are preoccupied with food and body image.

Recently in a grocery store check-out line, I stood behind a thirty-something mom and her little girl. The mother was chatting on her cell phone while the daughter was clinging to her mom’s leg with one hand and sucking on the thumb of the other.

The mother’s side of the conversation went like this: “Oh, I was so bad yesterday! I had a whole piece of chocolate cake at the party. I am not eating any carbs today. I feel as big as a house.”

I wanted to hand the daughter my business card right then and there! I refrained, though, since the kid, still in diapers, was a little too young for therapy.

My point is that your children are listening. They are listening when you partake in what I call “fat chat.” They are listening when you say you feel “fat” (which, by the way, is not a feeling). They are listening when you say you were “bad” or “good” or “evil” or “sinned” because of a food you either ate or passed up. They are listening when you say you need to go to the gym to work off your dessert. They are listening when you comment on other people’s bodies or your own. Your children are listening and learning and following suit. And what they often end up thinking is: “I better watch out. I might get fat. Maybe I am fat. If I am, then people are judging me. I better control my eating. Uh-oh, I can’t stop eating. Hunger is bad. Fullness is worse.”

Every year, my clients get younger. I have seen six-year-olds who are already dieting and know about carbs, fats and calories. I worked with a seven-year-old girl who was spitting up her food because she was convinced that calories were bad for her. Last year, I had a nine-year-old client who had to change her school clothes several times each morning till she found something she didn’t feel “fat” in. Most often, though, people don’t get to my door until they have been entrenched in food and weight struggles for many years. While an eating disorder is possible to overcome, the longer it goes on, the harder it is to heal. We need to do prevention at the ground level. We have a choice: We can teach our children to relax, listen to their bodies and love themselves, or we can teach them to be anxious, controlling, and out of touch with their own hunger and fullness.

My message here is not to blame or to shame, but merely to highlight the fact that unless we model a healthy, balanced, and loving relationship with food and our own bodies, children are at risk for developing disordered eating, poor body image, and/or weight problems. Take a look at the messages you are teaching. Learn to enjoy food again. Stay conscious of your body’s hunger and fullness levels and act on them. Get help if you can’t. Treat your body with respect and appreciation. After all, isn’t this what we want our kids to do?

Tips for Helping Your Child with Body Image

• If you find yourself “feeling fat,” explore a little deeper to see if there’s something else going on in your life. Model for your children that “fat” is not a feeling, but rather “feeling fat” can be a distraction from more difficult issues.

• Try not to label food as “good” or “bad.” Some foods are more nutrient dense than others, but morally all food is equal — it’s fuel! Talk with your kids about the nutritional value and variety of different foods, the art of cooking, and the fun and the pleasure of eating.

• Talk to your kids about the difference between emotional and physical hunger and how the two often get mixed up. Physical hunger is a feeling in the belly that the body needs fuel. Teach kids to notice degrees of hunger and fullness as well as how to eat when they are hungry and stop when they are full. Emotional hunger is usually a need to express feelings or have feelings acknowledged. When kids are sad, they might need to cry, talk about it, or draw a picture. When they are mad, they might want to write, draw, punch a pillow, tell you about it with gusto, and have you really hear them.

• Along these same lines, talk about the role of feelings: that they are signposts for living, and not to be “stuffed” or “starved” away. Teach them that just like there are no “good” or “bad” foods, there are no “good” or bad” feelings.

• Do not comment on other people’s bodies. This sets up a comparison mentality that is harmful and hard to give up. Talk about how everyone is beautiful in their own way, and that beauty is an inner quality that can be expressed in outer characteristics such as kindness and enthusiasm.

• Exercise with your kids for the joy of movement, not for how many calories you might burn.

• Look at family photos and talk about where your size and shape came from.

• Watch TV together and discuss the emphasis our culture places on looks, image, and thinness. Help them to notice special qualities in themselves like compassion and humor as well as things that interest them beyond their appearance. Teach them that they are enough just by being who they are — on the inside. (While you’re at it, think about yourself that way, too!)

• Do de-stressing activities together, like: listening to music, walking, spending time in nature, playing games, doing a hobby or craft, or reading and discussing a particular book.

• Help them to foster love for themselves when they look in the mirror. Teach them to “see” themselves with the same love that they feel for other people or animals in their lives.

• Make a list together of all the things that our bodies do for us. Help them to appreciate their various body parts rather than criticize them.

• Talk about what makes a good role model. Ask for an example of a person who seems to be a healthy, balanced eater with a positive body image. Discuss what qualities that person has that demonstrate good health. Ask your child to imagine having those same qualities inside.

• Teach your child that weight fluctuations are normal and healthy and that we all have a natural weight range just like we have a natural eye and hair color. Help them prepare for weight changes, especially girls approaching puberty.

• Role model and practice all of these things along with your child so they can experience you as a healthy eater with loving body image!


For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on FacebookTwitter, and Instagram.

To visit or tour a Clementine location with one of our clinical leaders, please reach out to a Clementine Admissions Specialist at 855.900.2221.

5 Keys to Coping with the Holidays



Dr. Stacey Rosenfeld is a licensed psychologist, certified group psychotherapist, certified eating disorder specialist, and the author of Does Every Woman Have an Eating Disorder? Challenging Our Nation’s Fixation with Food and Weight. Her work focuses on substance use disorders, anxiety and mood disorders, fertility challenges, relationship concerns, and sport and exercise psychology. In addition to directing Gatewell Therapy Center in Miami, she is a co-occurring (eating disorders and addictions) consultant at Oliver-Pyatt Centers. Dr. Rosenfeld works with individuals, couples, families, and groups, using cognitive-behavioral therapy (CBT), dialectical-behavioral (DBT), psychodynamic therapy, and motivational interviewing approaches. In this week’s blog post, Dr. Rosenfeld shares strategies to help cope with the upcoming holidays while in eating disorder recovery.

Despite its festivities, the holiday season can present a number of challenges for those in eating disorder recovery. For some, family time can be stressful. Food is often abundant and not on a regular schedule. In many cases, individuals leave the comforts of their homes and routines in order to celebrate with others. Those with co-occurring illness, such as alcohol/substance use disorders, depression, anxiety, or trauma may face additional challenges during this time.

Toward the goal of relapse prevention, a little planning can go a long way. As the holiday season approaches, consider these five “S”s that can help reduce the likelihood of symptoms escalating or re-emerging:


Going into the holidays, take a personal inventory. How have you been doing? What has been challenging for you recently? What have you learned from past events? What types of triggers do you anticipate going into the holidays this year?


Planning is the enemy of relapse. While it might be impossible to predict every potential scenario, strategizing certain situations can go a long way. For instance, if you’re attending a holiday gathering, discuss with one of your treatment professionals how you’ll approach food before, during, and after this event. How will you respond if someone comments on what you’re eating or your weight? If you’re sober, assume someone will offer you a drink; have a response ready to go. Have some topics in mind to discuss if the conversation turns sour (e.g., when the inevitable New Year’s diet talk ensues).


Think about who your supports are and reach out before the holidays approach to see if they’re on board to provide you help if needed. Your interpersonal arsenal might include specific family members, friends, treating professionals, peers from treatment, or others who have identified themselves as healthy supports. Ask your supports if they’ll be available to talk/message at designated times. See if you can check in before and after specific events that you anticipate to be particularly challenging, a practice referred to as “bookending.”


Knowing that the holidays can create additional stress necessitates a ramping up of your standard self-care routine. What can you do that calms you/centers you in preparation for this time? Now is the time to be particularly gentle with yourself. During a stressful situation, are there specific tools you can use to help you through? Do you have an escape strategy ready to go? If something triggers you, and you’re at an event, can you step outside and get some fresh air or contact one of your supports? Are there any pleasurable activities you can get on your calendar following your holiday commitments?


Recognize that, despite your best efforts, setbacks can happen. How you respond to potential setbacks can influence their duration and severity. Recovery is a process of learning from experience, maintaining motivation and commitment, and cultivating self-compassion.


For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on FacebookTwitter, and Instagram.

To visit or tour a Clementine location with one of our clinical leaders, please reach out to a Clementine Admissions Specialist at 855.900.2221.

The Moment of Discovery



Nancy Mensch Turett is the founder of WholeView, a consultancy to empower leaders to generate health across their personal, professional, and public life-spheres through holistic thinking and action. She will be contributing a series of blogs sharing her personal story of supporting her daughter on her journey to being fully recovered.  In part one of her series, she tells of the “Moment of Discovery”.

When colleagues invited me to offer my perspectives about eating disorders (ED) publicly, my immediate reaction was sure, this makes sense. I’m a professional communicator. I help other leaders find their holistic voice and share their insights broadly to generate health and well-being. I should follow my own advice. And it’s certainly true that ED demands a WholeView — it develops from a perfect storm of factors, manifests in several forms, and can be cured only through a holistic approach to treatment.

Before I jump in, given that there were many dark and difficult times, you should know that there’s a happy ending: my daughter is well. Thriving. As is the whole family. More on all that in future postings. Also, importantly, with her crisis behind us, my daughter is in favor of my sharing experiences and insights that might be helpful to other families. Her only caveat: that I use just my nickname for her, “Rosie.”

OK, so I resolved to share my story. But how to tell it? Where to begin? Like every family’s, our ED odyssey is long and winding. In some ways, it started at the start of Rosie’s life. It definitely continued through most of high school.

There’s so much to share. So my story will be told in chapters, with a different installment each month until I’ve filled in the chapters from beginning and end. Today, however, I start in the middle, at the Moment of Discovery, for the many other moms and dads out there who are sitting there right now, disbelieving, shell-shocked, and terrified. That fateful time when you suddenly realize that your lovely, loving, and “healthy” child is in fact terribly ill.

Discovery for me happened on a sparkling, below-freezing day in January 2010. I’d been looking forward to a “girl’s day out” – a special time when Rosie and I say bye to all the “boys” (3 brothers, one dad) to follow our own agenda, i.e., Shop. Lunch. Shop. Chick Flick or maybe Mani Pedi. Deliciously mother/daughter.

It couldn’t have been more than 11 AM when the day started to sour. In the car with Rosie, I was enjoying the bright snow and munching on a protein bar. When I offered Rosie a bite she turned to me from the passenger seat of the car and screamed NO. And a minute later she told me to stop chewing – that it sounded disgusting. Telling myself Rosie was just behaving the way 12 year olds are supposed to behave, I tried not to be alarmed.

But the first stop of the day was a wreck. We had planned to design stationery together. Parking the car and brightly cautioning Rosie to watch out for the ice, I got no lighthearted “ok mom” or even a “you don’t have to tell me that any more.” Rosie turned away and walked to the door of the shop. Once inside, Rosie refused to speak with the salesperson offering options for custom cards and simply glared at me. Feigning cheer, I excused us and promised to come back another time soon.

Having jettisoned the first part of the day’s plan, I suggested we move on to lunch. Silence. OK, let’s listen to music rather than chat en route to the deli.

Our easy tradition was to order a couple of items together to split. This time, no such thing. Not only didn’t Rosie want to share, she couldn’t even decide what she wanted. Conscious of the line of customers waiting behind us, after just a bit more cajoling, I put in an order. Something easy, like a turkey sandwich and a bag of those salt and vinegar chips Rosie favors. At the table, she couldn’t manage to take a bite. Actually, she couldn’t manage to stay seated. Pacing around the little restaurant, Rosie was clearly uncomfortable with the simple concept of eating lunch. I felt sick but smiled and ate and didn’t make a big deal of it when Rosie consumed nothing but a few chips and a can of Diet Coke. But still tried to file it away in my brain as just one of those tween things… no big deal.

Next up was to be the highlight of the day: Shopping for a special-occasion dress for Rosie. Given how much she loves dressing up, I anticipated our both having a great time while Rosie tried on a variety of frothy numbers. This was our first time clothes shopping together since before Thanksgiving, and Rosie, at 12 and a half, was clearly getting taller and I figured, developing a woman’s shape. Having mentioned her desire to lose her “baby fat” over the summer, and just having gotten her first bra, I hadn’t thought it odd that I hadn’t seen her undressed for a few months. Rosie was just private about her body as I was too on the cusp of adolescence. Totally normal.

With a few items she and the salesperson selected, Rosie went into the dressing room to try on the first dress. What transpired next was surreal: A young girl came out in a form-fitting dress. With Rosie’s face but a stranger’s body. Thin. Very thin.

As I’m telling myself this is not good, others in the store, staff and customers alike, ooh’ed and ahh’ed at Rosie’s appearance, saying things like “you look amazing” and “you should be a model.” No she didn’t and no she shouldn’t.

I slipped outside to call my husband. I did my best not to break down right there on the sidewalk when telling him that something was very, very wrong. Our Rosie – our healthy, smiling, never-complaining, lovely child was not well. How could she — seemingly overnight – morph into a too-thin, very-tense, and apparently humorless pre-teen? What did we do wrong? What should we do now?

And then I got a grip. I told myself that my daughter is sick. That I don’t know how or why it happened but it was important that her mom and dad keep as calm and steady as possible. I cannot say we always achieved this goal, but keeping in mind that our behavior would affect her sense of things helped a lot.

Driving home in the car together, it was already dark at 5:00 so there was nothing to look at but the lights on the highway ahead of us. I didn’t know what to say. Rosie filled the space easily. While she didn’t mention the new dress, or the shoes, or the special event it was all for, she spoke with elation about now “being” a “2” or maybe even a “0” (a size I hadn’t known existed). Any spark of hope I had that she wasn’t sick was extinguished.

I was frightened about what would lay ahead for Rosie. But resolved that we would get her well, ASAP.

That evening, we called an eating disorders specialist and the next day, my husband and I were sitting in her office. The doctor asked many questions, and as we answered each with a “yes” I began to weep with fear and worry. At that meeting on that Sunday, we learned four important things:

  1. Our daughter was suffering from anorexia nervosa.
  2. With specialized care including parental commitment to participating fully, this potentially fatal disease was curable.
  3. That time was of the essence. We needed to do all possible to keep the disease from taking deeper hold in her brain. No more dismissing her withdrawn mood, weird eating habits, and baggy clothes as nothing more than ordinary tween stuff.
  4. That ASAP is the right thought for accepting the diagnosis and getting going on treatment, but not a realistic mindset for time to full recovery. We had a long haul ahead of us and life for our entire family would never be the same.

The sooner we accepted the enormity of this, the better for Rosie. It felt like the nadir of our lives. How could it not? But in retrospect, I see that it was the beginning of our facing the truth and getting Rosie the help she needed for a real chance at a full life.

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