National Eating Disorders Association

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Nervously awaiting treatment for 9-yr-old restricting food intake--what can I do to help?

My daughter turns 9 this month. She has been deeply depressed by isolation and changes during COVID. Over the last few months, she started expressing unhappiness with her body image. This past summer, she developed a habit of collecting saliva in her mouth and not swallowing. Her pediatrician suspected it was a medical issue. We went through an endoscopy and a hospital visit, and after we came home from the hospital it became clear that she was deliberately restricting her food intake. I'm awaiting her initial visit with a counselor. Until then, my fear is that she will get too weak and I will have to take her to an emergency room. I'm worried that it is affecting her cognitive function; it's like she's often in a fog. She simply isn't the same girl that she was earlier in the year. I already consider this a crisis situation--at what point does it become an emergency?

Medical symptoms

Hi amandaleigh, welcome to the forums. We’re very sorry to hear about how what’s been going on with your daughter recently. The following are just some of the signs of a serious problem that demands immediate medical attention:

  • accidentally or deliberately caused themselves a physical injury
  • become suicidal
  • confused thinking and is not making any sense
  • delusions (false beliefs) or hallucinations (experiencing things that aren’t there)
  • disoriented; doesn’t know what day it is, where they are or who they are
  • vomiting several times a day or has uncontrollable vomiting or diarrhea
  • experiencing dizziness or fainting spells
  • too weak to walk or collapses
  • painful muscle spasms
  • experience pain in the lower legs
  • complaining of chest pain or having trouble breathing
  • blood in their bowel movements, urine or vomit
  • a body mass index (BMI) of less than 16
  • an irregular heartbeat, and fast heartbeat, or very low heart beat (less than 50 beats per minute)
  • cold or clammy skin indicating a low body temperature or has a body temperature of less than 35 degrees Celsius/95 degrees Fahrenheit
  • experience dizziness, nausea, fever
  • wounds/cuts heal slowly
  • feel tingling in the hands or feet
  • blurred vision

If she experiences anything above, we highly recommend seeking help from a medical professional as soon as possible. Seek medical help soon on an outpatient basis if she:

  • have significant heartburn and/or a burning sensation after eating
  • have other gastrointestinal concerns
  • have high blood pressure
  • struggle with significant joint or muscle pain
  • have difficulty sleeping (falling and/or remaining asleep)
  • struggle with fatigue, sudden weight gain, and/or hair loss
  • have frequent urination or unquenchable thirst
  • have gained and lost significant weight repeatedly
  • have gained significant weight in a short period of time
  • struggle with chronic diarrhea or constipation

If you need assistance finding resources in your area, please feel free to contact the NEDA Helpline at 800.931.2237 M-Th 11am-9pm ET and F 11am-5pm ET. Additionally, you can chat with us online M-Th 9am-9pm ET and F 9am-5pm ET. Please don’t hesitate to reach out and take care.