My skinny son

[Zanzibaragain]

Hello, hope you can help me walk through this maze with my Ds.

He is 10 years old, 152 cm and 28 kg
So a BMI of 12.

He has spent the winter in hoodies until very recently I was unaware of just how skinny he had become.
A friend had the " talk" with me and it was as if I had been blind, I just hadn't seen Him, hadn't seen how thin he had become.

So of to Drs and blood tests came back normal today.
We are getting a referral to an eating clinic!

Some signs worry me that I am now aware of.
He prevaricates a lot before meals, getting his drink just so, always the last at table to have the first mouthful, quick to clear plates.
He likes school, he has friends, and his internet time is carefully supervised.
I have no worries on those issues.

So what should we expect at an eating clinic, what happens now?

Hello. Firstly some for you. I'm sorry to hear about your DS. Ten is young, but it is so good that he has been referred for specialist help. Have they given you any indication how long the wait will be?

First of all he will have an assessment, most likely some more blood tests and an ECG, blood pressure that sort of thing. They'll ask all sorts of questions and will perhaps ask him to do a few questionnaires. These might include questions about his feelings about weight or shape and current mood.

This gives the 'team' a good starting point and help them to work out the best treatment plan for your DS. Obviously, if there is any medical concerns they will be dealt with first and foremost.

In the meantime, have you had a look at b-eat.co.uk or any books? I am happy to recommend a few if you would like?

Best of luck xxx

Will look at b-eat.
So much information is based on girls or much older men with a history of body image problems.
Just about every website I have read talks about she/ her/ your daughter so so so little about boys. I hunt through pages to find one reference that Oh boys have eating disorders too and that's it.
It's really hard to work out why my son has got so thin and its really hard not to blame myself as the food provider but my Dd only a year older has no problems with weight.
I am getting a mixed response from family, some have denied he has a problem at all, we are a skinny tall family, but a BMI of 12 is not normal, not healthy.
Others have been more supportive that yes something somewhere isn't right and then I get the little talk full of not at all helpful advice and subtle suggestions it's my fault.

He isn't trying to look like a size zero model, he isnt an athlete, he isn't body dismorphic, he isn't being bullied, he isn't living an alternate online life, he isn't even in puberty yet.
But he isn't eating enough.

So now I am trying to up his calorie count, chocolate milk and lots of snacks.

I just want to know how to make him healthy now before the teenage years start.

At 10, many children look skinny then it's not that surprising that you didn't notice this problem. Don't worry too much, maybe he will always remains skinny. One of friends was really skinny at 11 but now he is 33 years old and he is still really skinny but his health is pretty good.
Then just make sure your son eats enough that's all :)

I had a problem with a foster boy of this age. He was anaemic and that was suppressing his appetite. He was also tall and thin and had depleted his iron growing.A multivitamin with iron helped , as did milk shakes and adding supper to his meals.
He is still underweight but within his vim.

My DS is skinny and very "underfat" on those machines that measure body fat. But he doesn't have an eating disorder, just a small stomach and a genes to grow fast and tall. He now has 5 or 6 meals a day (3 with the rest of the family, plus extra toast and peanut butter or sandwiches). He gets full up too soon to be able to take in all the calories he needs in 3 meals alone.

If your DS always clears his plate is it possible he's simply not been eating enough? I'd definitely try getting more calories into him when you can. I don't know much about eating disorders but suspect a child who has one would resist the extra high calorie food.

Everyone is different. 10 is yound and it is good that it is picked up so early
A BMI of 12 is on the very serious end of low (I know what you mean about family and acceptance - we have a similar thing in our family, am not judging). They will probably offer him eith hospital addmittance (if there is space, and likely to be a waiting list) or day admittance where he it taken out of school and spenda the day at an ED unit, sleeps at home (ahagain where space) or home refeeding based on the Maudsley approach. Gtg now but will come back this eveing. Pm me with any questions. (mum of anorexic/Ednos DD)

Thank you peace don't know how to PM.

Yes his BMI is serious, it's been so frustrating dealing with family members who just want to brush it aside and say nothing is wrong but the evidence is standing right in front of them. Dh doesnt quite get it yet,he is trying but doesn't understand it's not when but how much he eats, suggested to Ds that he shouldn't snack then he would be able to finish his supper!

He is eating, very slowly but he is eating and has put on weight in the last two weeks, up to 30kg. (hang out the bunting) . Found out about the Maudsley approach which he loves, ice cream and milkshakes

Dr only made the referral on Thursday so no idea how long it will take or where we go, the idea of hospitalisation frightens me, hoping we can with support treat him at home.

I lost it a bit yesterday, cooking a big Sunday lunch, just couldn't see the point. I have always been such a big foodie, cooking everything from scratch, make my own bread, chickens in the garden, when what he needs is chips and nuggets. This thing, disease, illness really does get under your skin and challenge every thing and every way you think. My head is just spinning round and round.

So many questions but don't know where to start.
Should I tell people, how much do I say? how do I even start that conversation.

To ask your last question first: that depends on you, on your son, and on who you tell. The school has to know. Anyone who feeds him frequently needs to know. Any friends or close family of yours who can be trusted to support you need to know (in strict confidence).

Beyond that, I felt it was DD's confidential information and so I don't tell people who know her as well as they know me, I let her tell them. Or I ask her first about how to word it. She is older though, and I've made it clear that I have not kept it quiet because I'm ashamed of the mental illness etc, but because it is her thing not mine and I know I hate it if people spread this kind of personal information about me.

I have been losing it the last few days. Has been particularly difficult, had a really bad meltdown this morning. Just at the end of my tether.

DD has been dairy free for a while and we are finding that for eating out, good vegan places are best (happy cow is a good app/website to look up vegan places). She will eat meat and fish I cook though for some evening meals. Also eggs/omelettes she cooks herself. Everyone is different, your son is younger so the refeeding will need to be to your own choice of meal plans, with less of his own cooking than with a teenager. I do wish I had just tried vegan food (or 'clean eating') from the beginning though. Another of our DCs is starting to look thin as well and I've been worried about them, but they will eat up vegan food really well. It's great to see. We actually had our first happy stress free family meal out today (for about 2 years) at a vegan restaurant, I think we may have hit on something. We all said we wanted to go back there.

DD was 14/15 when ed first struck, it took 4 months before we saw anyone at the ed unit so I read about the Maudsley approach and we took tips from CAMHS and put together meal plans. DD organised her own breakfasts and snacks and she came home from school for lunches, which I prepared. (Most other parents of children with EDs have to sit in the school car park while their child eats a packed lunch. I was lucky to be able to cook things for DD.) DD now likes to bake bread, me too. We used to eat chickens as well, and I'm so happy that all our DCs will eat eggs.

Oh minimom! why did you post that?

Op's son has been referred to a clinic for eating disorders and has a bmi of 12. This is not the time to speculate that he might just be skinny.

minimom ...Just as a bit of a benchmark, DD has a BMI wavering around 16 and the ED unit are very concerned. She may not look that ill to people who don't know her, and she would say to most people that she is perfectly healthy and just thin. Tests reveal a different story. Her periods have stopped and it is affecting her memory, energy, immunity, heart rate, circulation, calcium (and other mineral) levels, and she looks thin. She is normally pretty sporty but she struggles to walk with her achool bag. She is normally top of the class and it is affecting her school work and the ED unit are talking of pulling her out of school. She struggles to maintain her body heat. I could go on. You do not mess around with EDs and put off getting help from professionals, the damage done to vital organs can be permanent.

I am 29 and have had anorexia for years. As a teenager I had a bmi of around 14, it is now only 16.9 as an adult.

I am now facing the consequences of being allowed to have a low bmi for many years, it's affect on my fertility being the main one.

Don't mess about with editing disorders. Grab any help offered before it becomes intrenched.

*eating not editing!

I think you want to be a bit wary of using a BMI measure for a ten year old. The healthy range for tall 10 year old boys will be quite different from adults or even teen girls. Better to find out how much below the healthy weight range he is.

A child who clears his plate, asks for snacks and has enthusiastically tucked into high calorie snacks and gained 2kg doesn't sound to me like he has anorexia. He sounds much more as if he's just had a growth spurt and not not adjusted his eating too match his needs. 1.52m is very tall for a 10 year old.

yellowdaisies yes, you are right and there is no need for that to be a reason to not get help. ED professionals know all that. They will give personal/custom advice on a case by case basis after assessment and in ongoing family counselling sessions. It is not a matter of one treatment fits all, far from.it.

No, of course I would absolutely suggest she gets the help that's been offered. They'll check out both physical and psychological issues I would hope, and suggest a plan to help. But some of the posts about the damage teen girls have done to themselves with BMIs of 14-16 may be alarming the OP unnecessarily. 10 year old boys aren't supposed to weigh the same as 15 year old girls, even if the are the same height

Yes I need to speak to the school.
He has always had school lunches, I need to make sure he is eating them or start packed lunches.
I have flexible work from home so maybe meeting him for lunchtime may help.

He has always been skinny and tall, but since christmas just not put on any weight. A few nasty colds and a growth spurt has just wasted him away.

But I am aware that he has some typical signs of food avoidance, small mouthfuls, very slow eating, lots of prevaricating before starting a meal. The same struggle with body heat, he has been wearing thermal leggings under his school trousers
He has an Eating Disorder of some sort, I am sure of that now.

Four months seems like a long wait to get to an ED clinic and I live in an area where I know CAHMS are stretched to the limit already, god knows how long we will have to wait.
I have read up a bit on the Maudsley approach and refeeding seems to be the way ahead at the moment. Ds is ok with it as an idea and has really tried but I think his stomach has shrunk so much he is just not that hungry and cant eat that much.

As for damage that may have been done due to malnutrition, well dont really want to go there, just hoping that as his height growth hasnt been affected its a good sign.

Thankyou so much for being here and answering me. Feeding your child and what you feed them is the most judgemental issue, knowing someone gets it somewhere is such a relief. After the holidays I need to speak to a lot of people and its not going to be easy.

I'm a CAMHS practitioner, so I feel qualified to advise the following.
If you are certain that it is CAMHS that you have been referred to (and it probably will be), then you will be able to ring them and ask how soon it is until your son will be seen. Tell them what his weight and height / BMI is, along with your concerns re his food avoidance, and ask for an urgent appointment. There will probably be a 'duty worker' that you can ask to speak to. If you don't get anywhere with the duty worker, ask to speak to the team leader.

Yes, CAMHS services in all locations are stretched to the limit (and beyond) but will still respond quickly when a patient needs to be seen urgently.

In the meantime, while you wait to be seen by CAMHS, I hope the GP is offering regular appointments to keep and eye on your son and monitor his weight, if not then please request this from your GP as soon as possible.

OP I have a 10yo DS who, when we last went to the GP for an unrelated issue became concerned about his weight. I was a bit shocked to be put under the spotlight about his diet (we have always made it a priority for him to eat well). I was told that it was a concern and that we had to prioritise 'feeding him up'.

FYI - I have just weighed and measured him and his BMI is 16.2 (145cm / 34Kg).

Honestly I had forgotten about this issue until I read your thread. So, thank you for the reminder - it is a work in progress.

It doesn't help that he obsesses about his "six-pack" (I know at 10!). He he also taken to "pumping iron" and wrestling ???

I recognise some of the things that you have said - last to start / slow eater / never finishes. Has to be cajoled along.

You sound like a great mum BTW - Good luck

Fruit juice between meals can help too, or non diet pop, or hot chocolate if he's cold. Whatever he's tempted by; tailoring it to what you see him actually eat and drink.

You're right to not worry about long term damage, zanzibar. For most, it sorts itself out once he is back up to his average weight-for-height-for-age.

Thankyou for the link to aroundthedinnertable. What a great source of information.
Getting a telephone consultation with GP tomorrow, so many questions I didn't ask last time.
Still concerned about his very pale stools, maybe something else going on as well.

I have become obsessed with checking calorie labels, reading all the youghurt pots to find the best option, hadn't really noticed before just how many shelves are full of 0% youghurts.

Yoghurts wierd spell check

Pale stools often a sign of anemia, but can be other things, which the Dr will get tests done for. Or...What colour is his pee?(doctor might ask, so ask your son before the call! )

Hope all is well op