Is it possible that my 7.5yo DS has an eating disorder?

[GoBrazil]

I've been at the end of my tether (it seems like forever) with my DS. Whenever I mention it to his paediatrician he says that as long as he is healthy (which he is) then not to worry too much about it.

These are my problems:-

1. When we sit down to eat he immediately starts drinking water, he completely fills himself up with water and then only eats a few mouthfuls before declaring himself full. I have tried saying no drinks til the end or just a few sips but somehow he manages to have enough water to make himself full. And if he is genuinely thirsty what can I do to deny him a drink?
   

1. He will regularly come home from school (we live abroad where we have two 'snack' breaks rather than a proper lunch hour) having eaten two cherry tomatoes or 2 carrots. His packed lunch will otherwise be intact and he won't eat when we get home. :(
   

1. He is NEVER hungry. He is so thin and it's the first thing anyone says to him (i.e me!)
   

1. A new thing which has started this week is gagging when he is eating. 2 or 3 times I have heard him gagging and I've run to see if he's choking and he says something (like a stringy part of cheese) has gone down his throat so he had to gag. I don't know, I just feel like this is part of something that is going to get worse :(
   

1. Every single meal time is a huge drama, I feel he is using it to get attention. I really, really try not to make issues about eating, to talk about it excessively etc, but it's so frustrating having spent hours cooking and getting everything on the table and he just picks at everything. I am not joking when I say he will sit and eat one grain of rice at a time until I am just driven round the bend!!!
   

1. If by chance he does have a good proper meal, he'll lift up his tshirt (skin and bone!!) and say look how fat my tummy is. I don't know where he gets this from, both DH and I love our food and eat well, healthily, the odd takeaway etc - we don't make a big deal of our weight or anything.
   

I just never feel like he has had a good meal or has enough to last him for the day. he is SO SO active so is always burning more than he is taking in - I just would love him to come running in one day and say 'mum i'm starving, ooh is that spaghetti bolognese, my favourite!' and scoff it all down.

Does anyone have any tips?
Sorry for the long post. :(

[WaitingForMe]

Until I read about him saying he was fat I thought it might be something else but that does sound worrying.

Does he have any SN? DSS1 is diagnosed as dyspraxic (but we think other stuff is going on) and had a lot if problems with tastes, textures, recognising certain feelings as hunger or thirst and so on. Left to his own devices he'd never eat or drink and when he was younger (a similar age to your son), he'd claim to feel sick or that things hurt his mouth. His mum is a fussy eater and he jumped on the fact she doesn't like spicy food, claiming what we served was too spicy (it wasn't).

It has been pretty worrying and DSS1 is very small (he was premature and just never seemed to close the gap) and incredibly thin. He's regularly lethargic and can be quite a dull, flat child compared to DSS2 and DS.

He's getting better now. Things that have helped have been involving him I'm meal planning and cooking but mostly it was something he needed to grow out of a bit. He's now nine and can understand that feeling sick and unwell is something he can control by eating or drinking but when he was seven there seemed like nothing we could do.

[mummytime]

Okay - first does he have any other issues?
For the water question, I would encourage him to drink 1/2 hour or more before each meal, then not allow drinking until he has eaten a certain amount. Also use smaller glasses at meal times.
I would also try to ensure he has more "snacks".
However if he is not underweight then you don't have that much to worry about.
Children can quite often become less hungry than you might expect between the ages of about 2 to about 10/11.

The gagging thing could be an issue and might be worth discussing with the doctor. But first I would keep (and not let your son know about), a food diary. See which foods cause him to gag, if there are patterns. Do you give him a lot of dairy foods, a lot of wheat/gluten, or could it be linked to texture?

[GoBrazil]

Sorry to hear you had problems too. No, no SN. He is otherwise a bright, happy, active child - it's just that whenever food is involved he is just not interested! I also forgot to say before that he doesn't like any junk food (!) so will turn down doughnuts, cakes, chocolate etc in favour of a carrot!

Which I guess is good but it means he is eating nothing that puts any meat on his bones.

[Delphiniumsblue]

I am at a bit of a loss and not sure if my general advice is appropriate. I would say get him checked out, but you have done that to no avail.
It does seem it is psychological and not necessarily about food- more a control issue.
He is getting tremendous attention from it and he will know from your body language how worried you are.
I would try an experiment before you go further. Take all the drama and attention out of it.
Keep water and all drinks off the table.
Serve the food and eat it yourself. Do not comment on what he is doing - either way. When you have finished ask him if he has finished and clear it away without comment.
Keep the school snacks and if he mentions being hungry later remind him that he still has them.
Don't comment on what he has not eaten at school- just have it available in case he wants it.
When he lifts his shirt just make a bland comment like 'really' in a bored tone and change the subject.
If it makes no difference I would go back to his paediatrician.

[GoBrazil]

He is on or under the 5th percentile for weight since he was about 3...

[PenelopePitstops]

I think you need to take the drama away from meals like delphin suggested.

[GoBrazil]

Thank you all. Yes I agree it is attention related Delphiniumsblue and I really like your advice. I have tried doing what you've suggested but it is so hard when I know all he's had all day is a slice or two of toast for breakfast, a couple of tomatoes then if I clear dinner away that's it! It's so frustrating.

Another thing he does is we go through all this drama then just as he is about to drop off at bedtime he'll say, mum I'm hungry (again, I think he knows the reaction he'll get) and I say no, you had your chance to eat and you didn't, you are not starting picnicking now!! and he'll keep saying he's hungry and can't sleep so I end up giving him milk and a biscuit (sometimes, not always) - but I feel it's just for the drama factor.

[mummytime]

If that is his natural weight that is fine. However I would probably encourage him to eat healthy but more calorie dense foods.
Also, with my DD I have tended to incorporate more of her favourite dishes into the meal rotation. So maybe have pasta with her. Favourite sauce a little more frequently or chicken the way she likes it more.

[PenelopePitstops]

If he's hungry at bed time, whip out leftovers from tea. No drama, just 'OK here's what you left earlier' put it in front of him and ignore ignore ignore. Don't mention what or the amount he eats at ALL.

Same at dinner, put it out, ignore what he eats, put in fridge for later. Get the message through that you aren't falling for the drama.

[GoBrazil]

Thank you all so much. I just had to get it all out of my system.

I'll try out all of your tips. In a few years I'll probably be posting saying he's eating me out of house and home, lol.
Thanks so much x

[Delphiniumsblue]

I like PenelopePitstop's solution to the bedtime hunger.

[Delphiniumsblue]

Good luck!

[MerryMarigold]

I am in a v similar situation. I still post when I'm not on my phone. just tagging. My ds is 8.

[WhereTheWildlingsAre]

My kids do the look how fat my tummy is thing after a big meal. Their tone is totally innocent about it and they will often do 'look how thin I can make my tummy' too.

What's his tone as he says it?

[unrealhousewife]

My niece had a problem and the consultant told my brother that he should lether eat what she wants. This did actually work.

You are placing too much emphasis on the meal you cook for him, how about getting him to prepare meals for you? It doesn't matter what it is.

You should also question how this has happened. If he has been underweight try to identify the cause of this. It could be the natural food caution that children develop naturally (to prevent poisoning) at about 2, has developed into an eating disorder.

This happens usually when parents panic about food refusal at this stage and it means food becomes associated with stress.

I would say he definitely has an eating disorder and you need to find ways of helping him to make him want to eat, rather than forcing him.

Often the cause is tied up with a confused understanding of dirty/clean. Does he hate getting his hands dirty? Often it is tied up with hypersensitivity, often it is tied up with undiagnosed food intolerance or a bowel problem.

Could these be an issue?

[GoBrazil]

He's just had food intolerance tests as part of something else (unrelated) and everything came back fine.

I can honestly say he has no other issues with anything, he's a happy, busy boy - gets as grubby as little boys do and no issues about being overly clean.

I am just not sure how I can make him 'want' to eat. I have tried involving him with food prep - a couple of weeks ago we blitzed bananas and made a banana cake etc, he wouldn't even sample a piece of it!

[MerryMarigold]

Ok, now I am on the computer, I can write my long post. I think there are similarities with my ds1. He was a fussy eater from about 9 months. I remember he'd eat everything when he was a baby and then started refusing various things as he got older. I 'gave in' (not wanting to make food a big deal) so he had a lot of fish fingers and chicken curry and rarely ate the same food as us. I remember distinctly a holiday when he was 1.5, and stressing a bit about food, taking the ingredients for chicken curry. And another holiday when he was 2.5 where I took loads of tuna and cous cous (had to be Ainsley spicey!). He had a fairly wide range of 'favourites' which has gradually narrowed over the years. I have noticed with my ds that he is a lot worse when he is stressed about things, his appetite totally diminishes. Is it possible your ds is stressed. Does he ever increase his appetite? My ds is definitely a lot better in the holidays and also after doing running about. Winter is hard as there is a lot less running about and I think his mood may be lower (monitoring that one).

During the January/ Feb term, I realised he had not been eating dinner at school for a long time. (He managed for the whole of Y2 which was a happy year for him, and even the first term of Y3, but apparently they changed the dinners plus he was having difficulties in his friendship group). I only realised this when I gave him a packed lunch instead and it was coming back virtually uneaten and also saw just how much weight he'd lost (at this point his pelvis was protruding from his back). School were great and came up with a plan with me. I give him fruit, sandwich, yoghurt drink, snack (eg. raisins, rice cake, crackers). He had the fruit at morning, sandwich and yoghurt drink at lunch and snack in the afternoon. The teacher got someone to monitor him. It made a huge difference. He has put a fair bit of weight on. I have also started this thing where we all have a 'meal of the week' where we get to choose a meal and pudding. I wanted my other kids to be involved as I don't feel it's fair on them for us to always eat only what he will eat. For the sake of this, I sometimes give him something else (he likes omelette).

He tends to sit in front of food for a good 10 minutes. I now ignore this. Often, once he's tasted it, he likes it, and eats it. It's a really fine balance between pushing him to expand his boundaries and not creating an issue. You just need a lot of wisdom there. Often, once he's started he does like it. But I also try and cater to other needs, eg. putting sauce in a bowl on the side, not mixing veg into food (has to be separate, sometimes also on a separate plate). He likes plain food mostly, plain pasta, plain rice.

I think an eating disorder is a mental health issue. It usually goes along with unhappiness, isolating self, depression. I don't think your ds would be happy and busy if he had an eating disorder. I think he has some food hang ups, which is different. How are his friendships? How is his anxiety? I was worried about my ds (and still am) as his is always triggered to be worse by emotional problems. I have been to the doctor, but she just said to monitor it for the moment. At least it is logged that I have concerns about his eating.

The one saving factor for my ds is that he has a good breakfast. His favourite is Greek yoghurt, fruit and granola. He has always loved this. I also make honey bran muffins sometimes and there is a Sri Lankan breakfast with rice flour and coconut that he eats. He also eats omelettes. But, if he is unhappy or stressed, he would even be able to eat these.

From what you've said, I would...
Offer him plenty of drinks after school, including half an hour before food. Do this yourself too. Then no drinks on the table, as others have said.
Get him to pick a menu a few times a week.
Try as much as you can not to get upset about it. Sometimes I have to leave the room. It is so sad to see my 5yo eating double what his brother eats at times.
Definitely no biscuit and milk when he's hungry. Why don't you come up with a list of some healthy things he can have when he's hungry eg. nuts, granola (loads of calories in that) or the snacks from school or more of his dinner?
Try and get into his head a bit and whether he is really all that happy. My ds can be busy on his own or with his siblings but lots of stuff happening at school.

[MerryMarigold]

Oh yes, also he eats better 'out of context' eg. if we have a picnic on the living room floor, he will eat things like houmous which he would never eat if we were at the table!!

[GoBrazil]

Wow, thanks so much for the long post. ((hugs)) to you too and I hope things get better.

With mine, it is not actually the type of food served that's the issue. There is not much he doesn't like actually, (apart from cake etc!) - he'll eat anything as long as it doesn't have black olives or green peppers in it. It's that he says he is not hungry and just doesn't WANT to eat.

So encouraging him to eat his favourite meal won't really make a difference, as when it's put down he will still pick at it!!

He is very popular at school and has lots of nice friends. His best friend moved away last year which did affect him a lot (they sat together for 3 years and he's an only child so it seemed to affect him more) but I couldn't even say it was that as he has always been the same!!!

Thanks for all your advice, I really appreciate it x

[lljkk]

My cousin had something wrapped around her osophogas that interfered with her swallowing. Not discovered until she became drastically underweight in her 30s but had certain been there for life & always given her a light appetite. Required major surgery to resolve & I'm not a fan of interventions that aren't strictly necessary, either. Cousin was hassled so often about anorexia that she became incapable of eating in front of other people sometimes, which only made things worse. And she loves her food as much as anyone.

I guess what I'm saying is you could get him checked out, or just work with how he is & keep encouraging him without making it into an issue.

[GoBrazil]

Very interesting....thank you.

[unrealhousewife]

You said he gets hungry later if he doesn't eat.

You said that even when you put down his favourite food he doesn't eat it.

I think this indicates that he needs to choose his food and also when he eats. It's important to deal with the psychological issues first because. The body can go into shutdown mode if they get too used to being hungry and once hunger becomes their friend there is a dangerous downward spiral.

Medical issues may be underlying but be very careful not to verbalise this as it could add another layer to his issues.

The simplest thing is to let him eat what he wants, for him to prepare his own food, even if it's cerebral and crisps. Sit him down for main meals and put some on his plate as the smell of the food might encourage his appetite and he might just try it.

[unrealhousewife]

*cereal not cerebral!

[GoBrazil]

Thanks, all good ideas. i'm just remembering now when he was a baby, i had a terrible time getting him to stop drinking milk and eat food instead! When I think about it, he's just never had that food interest.

Maybe some people are just like that, I certainly know one or two adults (with no eating disorders) who are just not that interested in food, can take it or leave it sort of thing.

Thank you everyone.

[unrealhousewife]

It's not really normal as a child,it's a basic human instinct to want to eat enough for nutritional health. It gets messed up by things like sugar and processed carbs, medical issues and psychological issues. Aversions are normal at a young age as the olfactory system kicks in and children are working out whether food is safe. The trouble is adults think their healthy diet is should be the same but they have very different needs.

If he couldn't get used to textures in his mouth when tiny that may have been enough to put him out of kilter, even a little thing like a burn could do put him off. It largely depends on how he felt about it afterwards. Kids are weird and wonderful!