Adult son barely eating

[BlueLoris]

DS was diagnosed with inattentive ADHD aged 18. His struggles have worsened as he’s got older and he is now NEET. Aside from the difficulties we’re having with helping him find employment and his increasingly nocturnal living, we’re getting really worried about his eating.
He’s never had a huge appetite and maybe slightly fussy but he’s now hardly eating. We sit down for a meal as a family in the evening, when he’s often not eaten all day and it’s clear to see that he’s struggling to eat, I find it painful to watch. We are pretty good cooks and make an effort with providing food the dcs will like, so it’s not that we’re serving him something awful. We’ve found he actually seems to eat more when he takes his medication because he’s able to come out of his room and make himself something. Today he’s not had medication, not eaten all day and couldn’t eat a roast dinner at 7pm. He’s had one cup of coffee.
when everyone else is asleep tonight, he’ll probably come downstairs and get crisps, chocolate and coffee.
He is now so thin that his collar bones are visible jutting through his T shirt. He weighs less than me (he’s about 5’7”) and I’m 5’1” and size 10.
We’ve asked him so many times but he denies there’s a problem and will not open up.
I’d like to take him to the GP but he refuses.
any ideas what might be going on? Anyone else experienced this?

Op can you look at him having things like yoghurts and fruit instead, and things like beans on toast, toasted cheese sandwiches, chicken nuggets (healthier ones that you can find in the supermarket) etc- a roast at 7 sounds very non young adulty if you know what I mean, some would jump for it, others like picky things that time of the evening. Also finding work sounds hard, is he volunteering or could he volunteer? Could you tempt him out of his room with family time of board games or just pop up to chat/ share a joke (I google jokes my kids will love so I’m armed).

I wonder if he might have a bit of ARFID going on @BlueLoris

Would he drinks a high calorie smoothie (if you have a liquidiser you can make it yourself).

I was going to say ARFID too.

Ds struggles to eat with the medication, he’ll often come off it to eat - he’s very aware it has this affect on him.

I have exactly this with DS (24). His medication is not for ADHD (tho he does have it) it's for mood stabilising/ personality disorder/ anxiety/ psychosis.....He rarely eats all day but there's a window of time just after he takes his meds at 10pm where he is able to eat. He will then shovel in a load of rubbish. I always try and get healthier things for him and always leave a giant portion of our evening meal- which he doesn't mind eating cold.
I tried, for the first time in our family, NOT having tea round the table together. It was too big a pressure for him ... so now we eat in front of the TV (Police Interceptors!!!!!!!!- there's just me and 2 DSs!!! ). I always thought it was a non- negotiable that we all ate together and chatted about our day but its too intense for him and he doesn't like being watched while he's eating so this has become our compromise )
He takes in just enough calories this way but is on the skinny side...

I’ve had very similar with my autistic son, things that helped for him were high protein shakes and other snacks that he could just grab and go. M&S near the chilled pizzas do burrito wraps that can be air fryed in a few minutes, they’ve been popular. Individual pots of prepared fruit, sausage rolls, anything you can get in at this stage will help increase his appetite. My son started going to the gym with his mentor, this helped him focus on cleaner eating and increased his appetite. Good luck

My son went through a similar phase at that age. He is AnDHD and was going through a very difficult time. An eating disorder specialust told me it was something he coukd control, when the rest of his life felt out of control.

I remember discussing nutrition with him. How essential vitamins and nutrients are for oyr mental and physical health, and how important it is to take good care of ourselves when going through a tough stage in life.

He agreed to a milk shake in the morning, which I made with full cream milk, a banana and a scoop of protein powder. And a fizzy berroca drink for the vitamins. Then a few mouthfuls of the most nutritious, calorific thing I could tempt him with. I made brownies with almond flour, fresh pesto with loads od ground cashews and pinenuts, olive oil and cheese, so even a few bites helped. We chatted about the need for protein, calcium etc. I gave him very small portions so as not to daunt him.

We made efforts to make his life more fun, just listening to music, watching comedies. We chatted about his dreams so he had something worth getting fit and strong for and devised really small easy immediate things and outrageously bold things he could do to achieve them. I encouraged him to do some.

Very slowly, he got out of it. If your son is ND and NEET he might well feel a bit pointless. It's important he develops some purpose. It doesn't have to be work. Creativity, volunteering, fitness plans etc could help. I feel for you and him. It was one of the darkest times of my life.

I wonder this too. DS had severe ARFID until aged 8 then seemed much better. But late teens stress made it so hard for him to eat again. It can come and go.

Agree with all this. Sometimes ready meals tempt them more.

DD1 has inattentive ADHD - she says living away from home she had this just forgot to eat. She was on low dose anti depressant while she waiting for ADHD medication to final get perscribed - so that may be affecting it.

DS seemed to be going down similar lines after being home summer after year 1 of uni - he was hungry but often not remembering to eat till 4 or alter or after then not wanting tea and a very messed up sleep cycle. He eats anything and everything and always has.

He did eat anything quick or any left overs in fridge - air fryer also seemed to help as it's quick for a lot more things - same with microwave. I think as soon as he remembered to eat he wanted to do it quickly.

Both have always struggled with interoception- body singals- I think home routine with someone calling you for meals was masking it a lot for them - so livinga way made problems clearer.

The eating isn't the problem, it's the symptom. He eats more on his meds, so why is he skipping them? And why is he allowed to be nocturnal?

Is there a fixed wake time, chores, anything expected of him during the day? No structure means no hunger cues, so the 3am crisps and coffee is dopamine-seeking, not fussy eating.

Stop counting his calories and start counting his hours: up at a set time, meds taken, something to do, real stakes if that doesn't happen.

He won't see the GP, so make it a condition of living there. He's an adult under your roof on your money; the deal can be treatment, a wake time, and something to do, or the arrangement changes. You're allowed to stop funding a lifestyle that's making him ill.

I can only assume you have no experience of living with a neurodivergent person. You can’t just impose a sleep/wake schedule. My son has had over a decade of medication, strict routine, exercise, holistic treatments, he is beyond desperate to be able to sleep at night in order that he can function during the day with his peers. Absolutely nothing has worked for him. He’s now holding down a day time job and college while functioning on virtually no sleep, as despite a full life and busy schedule, he still can’t switch his brain off and rest at a conventional time.

I knew someone was going to say this so I should have put it in my original reply but I AM neurodivergent with ADHD and autism
So yes indeed I do live with it every single day of my life

Your complete lack of empathy and understanding is even more astounding then. Every neurodivergent is different, what works for you is unlikely to work for others.

Sounds a bit like our DC2 who has ARFID. Similar in the way that it’s definitely not Anorexia because if there is a food that they like they’ll eat the all of it and not worry about weight gain.

One thing that really helped us was them having a back up supply of food. They used to get really anxious about the evening meal so I started giving them a small budget and taking them to Iceland. Their frozen food was kept separately and they knew that if the evening meal we provided was too overwhelming they could cook their own food. This seemed to take the pressure off and they actually started to eat more of the meals that we provided.

Do you think the tics might be linked to Tourette’s? Has he tried anything like DBT?

That’s not true about it definitely not being anorexia. I said up thread it sounds like ARFID, which may have tipped into anorectic behaviours. It is possible to have anorexia ride on the back of ARFID. This is exactly what happened to my dd.

The NHS like to put things into neat boxes as either / or, but it can be both. We are using a very experienced coach and former in patient ED mental health nurse to get dd to eat. At once stage, she was nil by mouth. Then would eat just 5 foods. Well 3 foods and the 2 others were a ‘treat’ day once a week to once every 10 days.

My dd does not eat just because there is food there that she can and will eat. It is far more complex than that.

It’s good your ds is eating a nutritious meal most days @BlueLoris. And that he cooked himself pizza. It at least has some tomato and protein. It’s interesting that you say he eats the vegetables first. My dd eats loads of grapes. And when she’s eating snacks (crisps, biscuits etc), she eats them first. I can’t make out why tbh. But there has to be a reason.

Good luck with the GP. If your ds does refuse to engage, you can go into the GP and get a form that you fill out for him to sign to confirm that you can advocate on his behalf. I got dd to sign it when she was 16/17. And I checked recently to see if it is still in place now she’s 18. It is.

Obviously with your ds, you’re talking adult services rather than CAMHS, which is a lot more difficult to get seen than CAMHS. However, it is worth talking to your GP at the very least. Do be aware that every post I’ve read on here about adult services says they discharge you if you don’t engage. But even if this happens, it is still worth trying, because it is doing something. And it’s all the doing somethings, which elicit change.

The advice to give your ds as much control as possible is good with you just nudging him along like you did with the pizza. And having a range of things, which are ready made / cooked and easy to grab and eat. Things like melon or pineapple ready chopped, grapes, cooked chicken breast / chunks of chicken (or even a whole chicken ready cooked in the supermarket if he will pick at that), ham slices, individually wrapped cheese eg babybel or sliced cheese, roasted vegetables that he can eat cold (preferably cooked in butter if he will eat that), potato salad (use a recipe with crème fraîche for the brain feeding dairy fats) steam fresh vegetables that he just needs to microwave as well as crisps, biscuits and chocolate etc.

The doctor put my son on Mirtazapine. It transformed him and his eating well and working out. He does weights three times a week now.

An ambulance?!?!? Don’t be so utterly ridiculous. This isn’t an emergency

If someone has a very low BMI (it needs to be a particular level) and is eating less than a certain number of calories for their need (in the cases Ive worked with it was less than around 600 a day), it is life threatening and they should be admitted for re feeding. We have had this a number of times at work and the instruction is to get them to A+E.

I dont know his height and weight but its usually around 70-80% centile (they do it differently for young people) for weight and the proportion of calories at a guess for a young man would be around less than 800 a day.

Underfeeding in that way for prolongued periods (not starving out right) can cause brain dysfunction and organ damage.

Sorry o was talking about my own experience, I definitely wasn’t referring to any other posters. It’s not Anorexia in our case as DD has never shown the slightest interest in losing weight and given her safe foods she will happily eat and eat and eat. Never any binge eating either which I have watched for and no signs of orthorexia either.

And every neurodivergent person is not like your son either
Believe it or not we're not a monolith

At no point have I suggested anyone else is like my son, quite the opposite.

Agreed. And the suggestion to make going to the GP or into treatment a stipulation of continuing to live with op is misguided. He may not be able to go to see them. And therapy is a big ask. I’m not saying op’s ds definitely has an ED. However, someone in the grip of an ED may need no incentive to leave. It’s what the ED wants: to split up families. Never try to control Eating Disorders, you will always lose.