To think ds doesn't have an eating disorder - or does he?

[looseddaughter]

He's 11 and has always been skinny - unlike ds2 who I described as 'sturdy' when he was younger little. He's slim now but always fills out a bit before a growth spurt, while ds2 just grows steadily and never fills out. His ribs have always been visible but I must admit recently more of his bones are more prominent on his frame. He wears clothes in his age range and they fit well. His face isn't gaunt and he has a lot of energy.

He has always been quite a fussy eater when compared to ds1, who will pretty much eat anything. Ds2 likes pasta of most kinds, can be fussy about the type of bread he'll eat and leave crusts etc. Loves all fruit and limited veg. Loves the usual sweets/crisps, and likes crackers. I would say his eating has got more fussy lately and it's not unusual for him to leave most of his packed lunch, even if I know it's items he likes.

He can be fussy about eating dinner, but then often I put it down to him having crackers, cuppa-soups, fruit etc before tea. Even meals he likes (beige teas, minced beef based meals or pasta) he'll often leave a fair bit but I tend to give portions of the same size for all of us. Can usually be relied upon to eat fruit with yoghurt after. Always has cereal for breakfast with fruit and has 2 weetbix - always eaten.

Ex and I are divorced and ex is a vegan (but eats fish) who does a lot of home-cooking and bread-baking, a lot of which ds has told me he doesn't like and won't eat. In the past ds has been upset by ex's family calling him skinny and lately it seems to be coming more from ex himself. I tend to think ex should cater more for ds's likes, even if they're irritating to him.

Tonight ds2 rang me in tears as ex has told him he's anorexic. I'm livid - surely you shouldn't say that to a child? Apparently tea was a homemade pizza with anchovies, wihich ex knows ds won't eat! Why?? He loves pizza - why not just leave it with cheese?

Now ex has texted me saying he's worried about ds2 as he's 'painfully thin' and 'hardly eats with [him]' and we should see someone?

What do I reply? I admit I have noticed him being pickier and a bit thinner than he was, but I also think ex seems to make no attempt whatsoever to cater to his tastes, which doesn't help.

Any advice would be great - I'm churning here.

ARFID is definitely worth considering by the sound of it. It's not anorexia but can lead to loss of weight and other knock on effects.

Losing weight / getting thinner coupled with 'fussy' eating /change in eating pattern should concern you.

Well hell no, they shouldn’t have told ds he was anorexic. How people are going on about a fish etc I don’t know .

How often does he go to his dad’s? If it’s say twice a week and he’s not eating properly during that time, that’s quite a lot?
I think you need to tread carefully here, he’s already upset about being accused of being anorexic. Now when he comes home you want to measure him and weigh him? could that cause more of an issue. You don’t want to trigger a problem if there isn’t one, possibly creating a problem surrounding food. Some people are just skinny, I was one of them. I would fluctuate between skinny and very skinny. No eating disorder, just picky and very energetic. No pressure from my parents (thank god).
I’d wait and provide lots of reassurance. Im not saying ignore it, quietly monitor what’s being eaten. Don’t make a big deal of it.... he is 11.

My DS doesn't have an awareness of calories or any desire to look a certain way but his eating pattern was very similar to your sons and his BMI is 14 (he's 17 and weighs just over 6st). We've had two years of dieticians and a year with the eating disorders service with no actual diagnosis. He's still managed to maintain concentration and good marks at school so that's no indication.

Our starting point was the GP.

Could you secretly log how much he’s eating into a calorie counting app? Just to monitor how much he is eating. Many people are naturally slim, but they eat large meals and enough calories for their activity level. However, if your DS isn’t eating enough calories then he will get skinnier. This can stunt his growth and cause all sorts of long term health issues. He should be eating around 2,300 calories unless he’s very active.

www.nhs.uk/common-health-questions/childrens-health/how-many-calories-do-teenagers-need/

www.google.co.uk/amp/s/childmind.org/article/boys-and-eating-disorders/amp/

You do need to weigh him.
However some teens and pre teens are very lanky (for years). Boys until they're about 21!
See the gp if you're concerned.

When my DH got it into his head that DD8 was too skinny, and started making comments in front of her about eating I leapt into action. Took her straight to her doctor, who did all the checks and plotted her on the graph against the ‘norms’ for her age. Slapped the graph down in front of DH and said ‘Right, one more peep out of you about weight or food that stresses her out, and you’ll be the one on starvation rations.’

I’d still let the GP help your cause, then I’d prolly turn it around on ExP & family and accuse them of projecting their own health and diet problems onto others. Tell DS all about projecting, and train him to ignore them or leave the room when it happens. By all means get him a counsellor, and say that the counsellor has prohibited commenting on his food.

My DD has mild emetophobia (fear of throwing up) and while it’s not an ED, it can be associated after time. First thing they say is to treat food as fuel only and not link it to anxiety by commenting on it negatively in any way. If your inlaws really think DS has an ED, the last thing they should be doing is throwing that at him in person and publicly. I’d be asking them all ‘So which is it?’ in a very don’t-fuck-with-me tone.

Maybe I should be straight with ds to an extent - or would that be a disaster? And say something like, 'We all know you have been a bit fussy lately so we need to check you are okay.' I mean I'm not sure about whipping out scales tomorrow but I'll have to speak to him before going to the GP.

@BeBraveAndBeKind

My DS doesn't have an awareness of calories or any desire to look a certain way but his eating pattern was very similar to your sons and his BMI is 14 (he's 17 and weighs just over 6st). We've had two years of dieticians and a year with the eating disorders service with no actual diagnosis. He's still managed to maintain concentration and good marks at school so that's no indication.

Our starting point was the GP.

It sounds like he’s trying to hide it. Has the dietician upped his calories and created meal plans? If he’s not gaining on 3000 or so calories then it’ll be another health issue. However, if he’s not eating enough then he’ll remain skinny. A bmi of 14 isn’t healthy.

Anorexics often do very well academically so doing well at school isn’t an indication that he’s healthy and well.

As a recovered and occasional relapsing bulimic who was a fussy eater and super skinny as a child....no he doesn’t sound like he’s got an eating disorder.

If he did it’s more mental, anorexia is not wanting to eat due to the fear of calories and getting fat. Your child sound more like me when I was young and I had a fear of the unknown and had to gag. I felt like everyone would watch me if I tried something new and it put loads of pressure on the situation. Worst thing is to make it a big deal.

I would try to broaden your kids eating habits if possible. Always give them something they will like to eat and one new thing at a time. Give your other child lots of praise for eating their food and then have a normal conversation about anything other than the food in front of them. They might surprise you.

As for the ex you need to be on the same page, never get upset or annoyed and state it’s peas or carrots this week he’s having on this plate as his potential food to try

I work with young people and do eating disorder triage forms and sorry to pitch in with another one saying you need to know his BMI. If you self referred to a mental health service they might also want you to get some blood tests done at the GP. However, they will ask lots of questions and either decide that your boy needs to go to the eating disorder clinic, or if it is more disordered eating they might suggest some emotional support, or if it is nothing they can reassure you.

Good luck OP I find eating and my kids one of the most stressful situations ever.

It sounds to me like there was no problem until your ex made it one! Sounds like your ex was frustrated at DS not liking his homemade food and said something stupid.

Obviously none of us can rule out an ED on the internet, but I would be wary of letting this thread worry you into rushing in and turning it into an issue.

My DD1 is similar - quite fussy, and won't eat if she isn't hungry. We deal with this by giving her food we know she likes, and it takes all the stress out of it. If someone said to her "you must eat this home made gubbins" she would just refuse.

Also sometimes mine are ravenous after school and end up filling up on (healthy ish) snacks and not being hungry for tea later - but this isn't the end of the world!

I think my reply to ex would be something like, I know it's frustrating when DS is fussy but that does not mean he is anorexic - please NEVER say that to him again.

You could always tell him he’s just reached an age where general health checks become normal, making sure he’s on track for things like height/weight, etc. You could even loop in the idea that once he’s reassured about things like that, he can more confidently deflect any future comments from ExP’s family. ‘Well, my doctor says I’m just fine, and I imagine he/she’s had a fair bit more training in these things than you’ for example.

@looseddaughter

Maybe I should be straight with ds to an extent - or would that be a disaster? And say something like, 'We all know you have been a bit fussy lately so we need to check you are okay.' I mean I'm not sure about whipping out scales tomorrow but I'll have to speak to him before going to the GP.

Op that’s not going to work I think. If he has got a disorder then he will lie about it, ans he will start throwing his lunch out rather than bring it home. Start saying he’s eaten when he hasn’t. If he thinks you’re on to it, he will just start to hide it,

The poster who suggested you all weigh yourselves had a good idea. Make it light hearted. Don’t single him out.

Everyone’s reactions would be different if he wasn’t visibly loosing weight and regularly skipping meals, and other times eating greatly reduced portions, even when it’s stuff he does like, that’s at its core is disordered eating, particularly in an eleven year old lad.

hi @looseddaughter. I have two 11 year old boys - they've always been on the slim side - esp DTS2 - since birth as they were tiny and very skinny. They've filled out over lockdown for sure though.

I have to say, based on my experience with my two and my (now adult) DSS, I've never known an 11 year old not be an almost constant eater. We regularly joke that DTS2 must have hollow legs! It worries me from that perspective if he's not eating all his lunch, but at the same time, if he's active and not tired and his clothes fit then I would keep an eye on it. It might help (if he doesn't already) to have a bike ride or run every day, just to keep his metabolism up and increase his hunger levels.

I weighed all and measured all my boys about a month ago as I was worried they had gained weight over lockdown - they haven't, they are 50th centile, but I did us all and said we've all been a bit lazy so let's start walking more often.

I think your ex needs to start feeding his child stuff he likes and not trying to force things he doesn't like on him, and then making ridiculous proclamations about anorexia.

I think is sounds like ARFID as well which has its causes in sensory issues or problems with the mechanics of chewing and swallowing rather than concerns over weight or appearance.

It can be serious but there is lots of help available for children with eating clinics.

My dad.. Was a* pupil and playing County level hockey, training in the gym, horse riding and running every day... While surviving on about 300 calories a day.
We are two yrs on from her diagnosis of anorexia.
I wish so much I had acted the tear before when her picky eating became more restricted, when she started to lose weight etc.
At her ED hospital they took children as young as 8...its a rapidly rising problem in boys and younger ages.
Act now.. Better be overly worried for nothing than be were we are now

Sorry my dsd

ARFID is a serious medical condition and isn't diagnosed readily. DD1 is 164cm and 37.6kg (BMI 13.9) and hasn't been given an ARFID dx.

Having said that, his diet is poor. He may be losing weight, so you need to see someone. DD1 is just starting supplements because she's lost weight over the last 3 months. She isn't deliberately restricting, just poor appetite and mood.

The trouble is that as people eat less, appetite decreases. Then they eat even less and still get the full signal. Viscious circle.

Sounds like a Concern to me.
And I don't adhere to this 'being able to see their ribs is healthy' mantra.
Going to the GP, and being weighed shouldn't be such a big deal: 'just to get you checked'.

Your ex calling Ds anorexic rather than admit he gave him pizza with anchovies on us disgraceful.

If ex genuinely thinks there is a problem, then he went about addressing it in just about the worst possible way.

But it is worth gentle probing about why he doesn’t eat his lunch. Is he embarrassed about his lunch? Being bullied? Have nowhere to sit?

A snack when secondary school kids come in is fine, but I would look for something with more nutrition, especially protein. Would they put a sandwich of whole meal bread and cheese in a sandwich toaster? Homemade humous? Chicken drumsticks? With some cherry toms and carrot sticks and maybe cheese?

I would ask your Ds how he feels about what his Dad says: say do YOU think you have a problem? And in an encouraging way “great, explain to me why you think that”. Get him to own his own view of himself and advocate for himself.

Your ex calling Ds anorexic rather than admit he gave him pizza with anchovies on us disgraceful

I don’t think this is about not eating pizza one night, although I understand that’s how it’s been positioned. The op said the father said he was really worried about him, and that he hardly eats when there. And that he was desperately thin. So it seems it’s wider. I don’t understand why if he was worried he’d knowingly give him something he doesn’t like, so something is amiss there. Potentially the anchovies is not true,

But the op and the father are adrift. He is seeing is son as worryingly thin and hardly eating, and thinks they need to seek help, the op just thinks he’s a bit thinner than he was and picky. They need to understand his bmi to get a better grasp on this. Because they are poles apart.

Ultimately though she admits he is skipping meals, reducing portions sizes and dropping weight. So it seems there is something behind the fathers concern.

An eating disorder doesn’t just go away. It’s not a phase. So if something is going on here they need to get to the bottom of it fast. Becayse once it takes hold, it’s hard to come back from, and it will be indisputable.

Why not take him to gp today and get him properly assessed? No one here can tell you for sure if there's a problem or not. He does sound as if he eats very little - and fact that you have noticed an already thin child is noticeably thinner and eating less suggests you should find out for sure and quickly.

I think given his dad is concerned and you have no objective measures to base your reply off, you need to weigh him. That's the first step. Take your emotions out if it and look at the facts.