At what point does calorie restriction become dangerous in a 13/14 year old

[Purpler5]

I don't want to give too many details, but can anyone tell me at what point calorie restriction becomes harmful/dangerous and also what the first signs of trouble would be?

The teenager in question is underweight (ie below 2nd centile) and skips meals/restricts calories.

Apart from this, they seem fit/healthy/active.

Op

It’s gone beyond the “first sign”

Fairly significantly

Sorry, I don’t mean first sign of a problem. I mean first sign of serious physical harm (requiring medical intervention fairly quickly)

that already sounds worrying.
why does the youngster skip meals, what do they say about it.
are you the parent.

They are supposed to be growing, restricted calories will impact that.

Thank you all, I know it’s worrying and I know it will be having an impact.

Is anyone able to tell me more medically/precisely the physical harm that calorie restriction/being underweight will have?

Being permanently tired / cold
Periods stopping
Extra body hair
Heart palpitations

They would be my first stab at a list of physical symptoms that your body is in trouble.

I'm not medical at all but eventually if you run out of fat your body uses muscle as fuel.

The heart is a muscle so eventually will get damaged.

But I would imagine that severe mineral deficiencies would cause issues before that - I seem to remember potassium / magnesium being particularly relevant with eating disorders.

Why are you so focussed on the physical side OP? The serious mental illness is usually in play well before getting to that stage...

Oh yeah - long term danger of osteoporosis, not reaching 'proper' height, further mental problems from depriving the brain of fuel during puberty.

A lot of restrictive eaters do a lot of activity in a bid to burn through more calories.

It's not healthy.

Thanks @FusionChefGeoff, that’s useful.

I’m already clued up on the mental illness side, it’s the physical things I was wanting to find out about.

If you're concerned (and it sounds like there is reason to be) about a child of yours then ask for a phone call with your family GP so they can signpost you to services and support.

Also contact this charity for some initial advice and guidance https://www.beateatingdisorders.org.uk

I was anorexic and can't believe how manipulative and good at lying about food and exercise habits I was. I wish someone had pursued help for me before I got so deep into it.

I was dancing hours and hours a day and all weekend while anorexic. I was incredibly ill but justified it with well I can still exercise so I must be fine. That's why it's so important to get professional, external support as soon as possible.

Does any of that feel like stuff you can do initially OP?

I started with anerexia at 13, physical side was periods stopping, dizziness/ fainting, you can stop feeling hungry ( then use that as an excuse, your stomachs not rumbling so you must be eating enough ect.
I grew loads of downy hair, constantly cold, also started with bad bloating when I did eat, this has never gone.

are you the one restricting your intake, OP ?

Underweight and restricting it’s already dangerous.

Thanks everyone, I’m really touched by people’s kind replies. Especially those who’ve shared the personal experiences.

Sorry I was cryptic. It’s my DS that I’m concerned about. I’ve already spoken with GP (it’ll probably take more appointments, as their threshold for ED/MH is high, and despite how my post appears my DS is not a severe case). I’ll take a look at the beat website too.

Thanks again

What a worry for you. I hope you are able to find some help.

The Junior marzipan guideines classify children into red, amber, green and these cover physical symptoms and mental/behavioural issues.

www.paediatricpearls.co.uk/wp-content/uploads/2020/04/MARSIPAN-risk-assessment.pdf

I would advise you see your gp and get a sitting and standing blood pressure to look for a drop when they stand.
Also watch for other symptoms such as hair loss, passing urine more often, burping, self har and persistant standing/walking.

Good luck, it is a difficult path to walk but the sooner the better. The GP may not be fully conversant in these guidelines so I would be tempted to print them out and see where you think your son lies. It's currently amber from what you have said - alert to high concern

sorry about spellings
self HARM and persistent

You’re at the point now OP you need help immediately
I have an asd dd who has arfid and presented as anorexic and was very unwell you need to see the gp and get an urgent referral x

I think officially in my area your BMI has to be below a specific range for help. So unfortunately you get told you're too fat for help which is great! There's lots of charities that may be able to offer you support.

Hello OP. I am sorry to hear about your son . We had similar issues with our 12 year old son that began in March . He began running and it became clear he was addicted to it .
He lost about a stone and ended up less than the first percentile for weight . He was 4 stone 4 on admission to hospital.
His heart rate was down to 27 beats per minute at night , his blood pressure was very low .
His electrolytes were all over the place . He was at constant risk of a heart attack . Every organ in his body was under strain .
We spent two months in hospital. He has now made a full recovery .
I am posting to point out that very low body weight can have extremely serious consequences, even death .
Also note we had our son at the GP four days before admission to hospital and he said he was fine , just a bit thin ......
I don’t mean to scare you but I would probably go to the ED. This was what we did and they were horrified by his physical condition.
I hope you get the help you need and please PM me if you wish .

Hi @Purpler5 - there is also the risk of 're-feeding syndrome' - whereby un-managed food intake can cause all sorts of problems as foodie outlines (electrolytes, organ damage, coma etc)

Please do join us on the teen eating disorder support thread if you'd like a space to let off steam, shout into the wind, sob, congratulate each others successes and a huge amount of other support.

Thanks for info myrtle and foodie, and sorry to hear that your DC are struggling with this so very difficult illness. I'll check out the support thread now.