Help please - should I be concerned re DS eating habits?

[BeTaupeBird]

Hi all,

Really can't work out if I am being over cautious having had anorexia myself or whether I should be concerned.

I would really appreciate any advice please.

I'll give details below including some positives so to speak for a more balanced view. He is early teens.

Mental health: some history of being worried about how he looks in terms of weight eg worried about 'chubby face', physique generally (also though worries about appearance generally eg clothes and hair). He is generally fairly happy in himself but has had some low periods in the past, can lack confidence etc

Eating habits: previously a pretty good eater, some changes corresponding to life changes eg changing schools and becoming fussier/less appetite. Historically we have gone with it and appetite improved. This has now though been quite a long period of: minimising what and when he eats: avoiding breakfast (partly maybe because takes too long to get ready); sporadic eating meals at school - reasons for this are apparently big queues etc; picking at dinner at home (very slow eating but slightly better if something he loves eg Indian takeaway); used to have a big ish snack mid evening with his parents but now rarely does this and says he's not hungry. That said, does sometimes eat big junky type snacks he buys with friends after school but not often

Weight: previously pretty average weight in terms of centiles. I haven't weighed him recently (am not keen on scales/drawing attention to weight) but I would say he is definitely noticeably lower bmi/weight centile wise - feels pretty bony through school blazer/wears joggers under school trousers (poss they all do this as a fashion thing but my trousers would not fit me if I had another pair under)

Possibly unrelated and maybe just constitutional growth delay but he is pretty behind most of his peers in terms of puberty. It may be that hitting this will be our saving grace and a growth spurt will boost his appetite but just another worry at the mo.

Thinking I may call the GP next week but I'd really appreciate any advice in the meantime

Thanks v much x

Sorry maybe should have added a typical ish day food wise:

Breakfast: either nothing or one chocolate brioche; lunch: at school, relatively often skips, sometimes something like a bacon sandwich but obviously don't definitely know if he eats it we can just sse he has paid for it; usually brings a kitkat and crisps which he appears to eat but sometimes not; sometimes has a snack of something like crisps or biscuit coming home from school or sometimes has some sweets he has bought; eats a small dinner (usually smaller than his younger siblings far, far slower than anyone else at the table); usually no snack in the evening but sometimes will if we encourage it more strongly. Eats far, far less than any of his friends visiting but they are taller/further through puberty

The more I think of it, the more I think his weight has decreased relative to his height as he almost looks gangly but he hasn't had growth spurt so I think it must be that he has gotten skinnier. Hip bones noticeable now and weren't before (not significantly but a difference), collar bones also more prominent.

Feeling stupid for not having recognised before 😞😞

I know you don't want to weigh him but it has been proven parents are not very good at determining if their child is a healthy weight from looking at them. I also think any chat with the Dr is not going to get very far without them knowing his weight and height. How old is he?

Obviously that's not a great diet food wise but are you sure there is nothing else? Teenagers (assuming he is a teenager) can often be eating things you are not even aware of.

Thanks very much for your response and that makes sense re the doctor. He is almost 14. He would likely allow us to weigh him but he would no doubt suspect that we're doing it from concern. I don't suppose you have any tips as to whether we try and fudge it that it's eg for government records or something or better to just be honest-ish and just say worried he's not eating enough? Thanks again

Writing his food down has made me realise that he has become quite a lot fussier over time and has to be more cajoled to eat anything nutritious - probably have I have let it become worse out of a desire to not make food good and bad/to not make food related stuff a big issue. Dinner is ok but breakfast/lunch and snacks pretty rubbish as compared to when he was younger/ his siblings but maybe it's a teenage thing

I can be almost 100% confident that he isn't eating any more than above since I know what I have in the cupboards and we can see what he spends on his school lunch card/bank card

The amount your ds is eating is very concerning. My 16 yo dd ate like this for a protracted period, slowly loosing weight. I thought it was a phase as I didn’t eat much when I was 15/16 and shed loads of weight myself, never becoming mentally ill. Then there was an incident and she all but stopped eating and it has been very hard.

The quicker you address this, the quicker you will get it turned around. Imo your ds needs to be referred on to an eating disorder clinic asap. As in Monday. If you can’t go in, set up a phone call with the GP and explain the situation.

Yes, definitely get him to weigh himself and get his height if you can. If he has siblings everyone should just do it so he doesn’t feel singled out. From there you can look where he is on the centiles for height and weight to get an idea of the difference between the two. Someone may be able to give a weight for height. If you post on the main support thread someone will work it out.

Anorexia has a genetic component and some people are more prone than others. As your ds is restricting not just his food but also variety, they may have difficulty diagnosing. This was the case with my dd. She doesn’t present as typical anorexic as she will eat high calorie, high processed foods. My dd has no diagnosis but her eating behaviours are also ARFID like - avoidant restrictive food intake disorder. Someone with ARFID may be so selective in what they eat that they have may all but stop eating. It is more common with people, who are neurodivergent. I say she has anorexia for ease of purpose as people understand that.

Is your ds neurodivergent or have you suspected that he is?

The gold standard treatment for an eating disorder is 3 meals 3 snacks spread evenly throughout the day. It is very very common to eat little or nothing until the evening then binge. People with ED have a lot of noise going on in their heads and it’s difficult to concentrate but by the end of the day if they still have hunger cues, they can tend to be ravenous and over eat. Eating 3 meals 3 snacks then prevents a binge eating disorder from developing.

The biggest indicator of an eating disorder btw is skipping lunch. Wish I’d known that before we got so far down the rabbit hole.