13 year old son has lost so much weight

[Frownlines]

A little background about my son: he'll be 14 in December. Hes ASD and at times a little withdrawn as in all communication is on his terms (i accept this, its how its always been). He's always had a good appetite- although a little limited at times! I last weighed him during lockdown** (he wouldve been 9) and he was roughly 5lb over where the BMI chart suggested.

Anyway, since Xmas he looks like he's dropped so much weight. I've asked as subtly as I can if he's eating OK at school because I know he's skipped lunch if he hasn't felt like eating or hasn't liked what's on offer. I don't want to isolate him or push him away by asking lots of questions but I'm so worried. I know he's going through puberty but I expected him to gain weight at 13 not shed it.

When I think of how my mum would've handled it she'd have made a GP appointment and taken me along whether I wanted to go or not (lol). I'm trying to keep communication with him open and not draw attention to something which may be nothing.

When ive spoken to his Dad about it he's told me he noticed but also that he thinks he looks good for it!
If anyone can suggest ways to deal with this I'd be most grateful.

**I've never made an issue about weight or body image. I weighed my son because I weighed my younger son when I was looking at car seats and he asked to be weighed aswell.

I would be speaking to the GP if he is losing a significant amount of weight. There could be an underlying physical reason.

Children with ASD can also be more at risk of developing eating disorders. Does he exercise much? My DSS with ASD developed an eating disorder at a similar age and one of the things we noticed most was becoming obsessive about exercise.

Has he dropped weight or has he had a growth spurt and stretched? Thirteen is an age where many boys shoot up. My own son did and actually developed loads of stretch marks on his back from growing so rapidly. He went from being quite solid to being an absolute beanpole so probably looked like he’d lost weight when in actual fact he’d just shot up.

I'd get a blood test ASAP to rule out diabetes.

You say he "looks to have" shed weight - has he actually lost weight and not grown, or do you mean he's looking skinny all of a sudden? Has he had a growth spurt as well? Mine seem to grown like inchworms - they look a bit tubby for a while, and then suddenly their legs and faces look all skinny. I never think they've grown but then I hug them realise that they're closer to my height than they were before.

I don't really understand why you're pussy footing around this to be honest. I mean sure you don't want to go on about his weight constantly but you need to address it with him. Have a chat about how weight can naturally fluctuate and it might be nothing but it's best to get it checked out.

Don't suppose you have a parent pay app where you can see what he orders at school do you?

Mine went very skinny at 14 (after being puppy-chubby his whole life) and it was just the extra testosterone of puberty burning through his food consumption - he also became very tall between 15-16. He’s mid 20s now and still tall and slim but just about proportionate/healthy BMI.

did he get the standard end of year 6 weigh in with the school nurse? Letter usually comes in the post. If you have his red book you can plot his height and weight to see where it is in regards to birth weight centile.

My son is also ASD and he refused to eat secondary school dinners because he hated the push and shove and noises of the school canteen - I didn’t realise for ages but eventually noticed he wasn’t buying anything on his school dinners account. Is everything normal-looking on there when you log in? (I suspect some schools are less detailed than others but his itemised everything).

There may be nothing to worry about or there might be an easy tweak. I probably wouldn’t go the GP unless the weight loss extreme or if if was in conjunction with other stuff, lethargy or sleep problems, anxiety etc.

Is he active? Sports or other (my son hated sports but would happily cycle for transport or spend hours skateboarding in a car park).

My eldest is 13, and with probably 6 inches of growth in the last year or two he's looks like he's lost weight, but he hasn't, it's just stretched out.

Are you saying he looks too thin? Has he been growing taller though? Is there anything else changing (more lethargic or weeing more etc.)

If you have enough worries, take him to the doctor. If everything else seems fine, then I personally wouldn't - my son's perceived weightloss is entirely explainable for instance, so I'm not worried

Surely you must be aware of what he's eating at home and if it's enough.
If he's noticeably lost weight he needs to see a gp to find out what's going on.

Adolescence and ASD can combine to increase anxiety and this can affect food intake.Does he have set patterns and self imposed rules about when he eats and where he eats?
I wouldn't mess around with this if I were you as it may need some professional input.

Thank you for the replies.

R is very stubborn, he's argumentative and will shutdown completely if I ask questions about anything @Gelasring. It's not pussy footing around it - it's making sure he doesn't close up completely!

I provide him packed lunches the majority of time. For whatever reason if I haven't or if he's chosen not to take it he skips lunch.

He doesn't like sports and would rather stay home than go anywhere. He's not keen on exercise as he doesn't like sweating.

I'm aware of what he eats at home. He has breakfast and his evening meal. He used to be a snacker aswell. But, this has stopped.

No other concerns. He's healthy and no changes to other patterns.

Now, I feel really neurotic and like I'm over reacting!

Anxiety? My daughter started skipping breakfast and lunch when she got anxious at school

@ChaChaChooey he was weighed in year 6 and everything was fine.

Is he actually lighter or just taller and thinner?

Looking back at pics of my own 14yo and he's a clear foot taller now than he was in lockdown times. Slimmer too.

@Happyinarcon he does have some anxiety. The lunch line is often too long or too crowded for him. I know he struggles with moving around the school between lessons due to the amount of people in the corridors. And - he's probably worrying about moving into year 9 (choosing options)

@MassiveOvaryaction he is taller but not massively so.

Year 6 is 11yr olds
He's 13. Do you know how much he weighs and where he sits on a BMI chart?
I'd start there.

@Lifeinlists he won't be weighed. Or even weigh himself.

Was he overweight to start with? Are you buying clothes in his age range?

Then I'd be getting a gp appointment as that's a concerning sign.

The sooner you address it the better.

You should get him checked by a GP - weight, height and blood tests. He should be gaining weight at his age.

My son has the eating disorder ARFID and also has coeliac disease - both diagnosed after weight loss. He's also autistic. He's always been a selective eater, but secondary school triggered major anxiety so he stopped eating when he was there. I didn't know he wasn't eating at school until other symptoms appeared (high anxiety, feeling unreal, tiredness). And the undiagnosed coeliac meant he wasn't absorbing nutrients.

Just in case anything else is going on, get your son checked out. No harm in asking for a coeliac test to be included with the blood test as well. My son had no gastric symptoms - just weight loss.

Hopefully, everything is fine, but if there are any underlying issues it's best to get treatment ASAP.

Don’t worry, It can be really hard to know what’s ‘normal’ when you have a ND child (or any child really 😂).

If you haven’t had a 14 year old boy before (and if you don’t work with teens) why would you know that a sudden beanpole stage is a pretty common phenomenon? Average boy growth patterns are very different to our own adolescent growth patterns (hence the red book having different graphs for boys and girls).

If he was a little over a healthy BMI age 9, bang on at 11 when weighed by the school nurse and is now in his gawky-skinny-era at 14 that doesn’t seem an unusual teen-boy trajectory to me (I’m not a HCP tho!)

I’d say nothing but keep an eye on it - no point in risking his self esteem by commenting on his weight (self esteem
is usually wobbly in adolescence but often especially so for teens on the ASD spectrum).

I’d probably just keep his favourite foods well stocked and just occasionally gently probe if he hasn’t eaten lunch - secondary school can be such a minefield, finding a safe space for break sometimes takes priority over finding a space where it’s permissible to eat food from home (eg spending breaks in the library = no chance to eat).

Maybe dig out the red book and plot his height on the chart, just for your own reassurance reasons? No need to weigh him if that seems weird/will upset him in some way but measuring height against the wall is usually as much fun for teens as it is for toddlers!

Thank you @ChaChaChooey! Parents with teens who are more neurotypical appear to have much more open communication around these subjects (or any subject)

As I said communication can be difficult with him as he tends to shut down if I try to make conversation or ask what he feels are too many questions. Even gentle probing can feel too much.

I'm not overly worried about underlying conditions. I know he's anxious around people which is why he prefers his own company.

The point of my post was to see if anyone had any similar experiences and suggest ways of opening dialogue in what can be a sensitive subject for teens.

(I'm going shopping soon and have asked him to make a list of preferred foods as his preferences change pretty quick!)

Hi @Frownlines have you ever tried writing to him? My DH is late diagnosed and I’ve started emailing him instead of talking to him about issues. It’s been quite effective since he can take a longer time to think about a reply, and doesn’t feel on the spot. Have you seen the journal ‘just between us’ or maybe text or email him if he has a phone/email.

Any tummy pains or digestive issues of any kind? One of mine lost a lot of weight and a few years later developed tummy pain. Turns out it was IBD.