Nutrition / eating advice please for DD taking Methylphenidate for ADHD

[NotDonna]

Ive a 12 yr old DD with ADHD who takes concerta (12 hour release methylphenidate), which works well but has seriously reduced her appetite. She eats next to nothing. She will have a bite of something for bfast. And I mean one bite/mouthful. No lunch usually. Then maybe four five mouthfuls of whatever for dinner. I’m adding cream/cheese etc to keep up the calories but concerned regarding general nutrition. I’ve got her vitamin tablets but I’m still concerned as they’ll not be well absorbed.
We were told a side effect of the medication could be reduced appetite but also that she’d be hungry in the evening when the meds wear off. She’s really not hungry. Im struggling what to offer her. I had thought about protein bars for school but nuts aren’t allowed and they all seem to contain nuts! Does anyone have any suggestions for nutritious compact foods please? Or how you’re coping with the loss of appetite?

It might be worth exploring with your consultant about trying other meds. We had issues with DS appetite when he was on methylphenidate (although different brand). He was moved onto different medications after a dosage increase had the side effect of making him depressed.

We have been through a number of different meds and DS has been on Elvanse for about 3 years. It does reduce his appetite when it is in his system but he is ravenous in the evening so we don't stress too much about lunch (he takes his meds at breakfast so is usually OK although easily distracted!).

My DS’s don’t have ADHD, but do have a condition meaning they need high calorie/fat/protein diet but sometimes have poor appetites.

Would DD drink smoothies, hot chocolates and milk? With milk you can add skimmed milk powder and some cream to it. Or even supplement drinks?

Will DD eat eggs? If so, look at duck eggs nearly double the calories and have more protein and fat.

Croissants can be relatively easy to eat for their nutritional density. With added butter and jam. DS are allergic to nuts but it not a nut butter would work instead of jam.

Avocado? Avocado oil works well added to some meals.

I'd have a chat to your consultant. In our experience meds stay in the system way longer than advertised - my son's is supposed to be a 6-8 hour release and is still clearly in his system 12 hours later. We manage this by getting him to drink a lot of full fat milk and basically he eats non-stop in the evenings, 2 full meals between 5 and 8pm.

We had read some stuff on the internet about combining a non-stimulant medication with the stimulant but our consultant drew a bit of a blank on that. I think the docs in the US mix and match meds in a way they're not really allowed to in the UK.

Just thinking about your daughter - what about distraction? If she was allowed to just watch TV or something whilst eating maybe that would distract her from not being hungry and she could get more in.

Oh and what @Imitatingdory said - higher sugar stuff like croissants and jam can be easier to get down than high fat stuff if one isn't hungry. Just think all the stuff you get told not to eat on a diet like really sugary snacks and things. It's dreadful from a nutrition perspective but we've had to put the 5 a day on the backburner for now.

all the stuff you get told not to eat on a diet

Sigh. This is why I need to lose a few stone. I comfort eat all the high calorie/fat food meant for DS’s.

Croissants are actually high in fat.

Is your DD. Taking it 7 days a week? Or skipping at the weekend

I’ve a DD and a DS on it at high doses, DS particularly is a poor eater and wasn’t taking at the weekend and would then get the munchies but afterwards didn’t want much to eat during the week

DD takes hers every day with no breaks, she felt that when she took breaks it affected her appetite more but when she took it continuously her body settled and her appetite improved

We finally persuaded DS to try this approach and he has conceded that his appetite and side effects have improved.

Both are still very much grazers so I make sure that there are plenty of high calorie dense foods available, full fat milk etc

They’ve always been low weight (also coeliacs) but they are stable and the team they are under are happy with our approach

Thank you for your suggestions. She takes it everyday.

@Tomnooktoldmeto what high calorie dense foods to you keep available please?

@NotDonna for DS who is underweight we encourage supper as well as other meals, he’s a very fussy eater anyway so food tends to be cake, biscuits, chocolate,crisps, milkshakes, pizza etc and full fat milk

DD is more of a grazer but I keep fruit yoghurts cheese portions again milk shakes and biscuits available. DD is more controllable as she goes to school from home so I can monitor and prompt through the day

We are all coeliacs and vegetarian so most of our food is from scratch and DH’s natural build which the DC inherited is like Rodney from Only fools and horses so I have to convince health professionals that they’re naturally built skinny

DS has just increased his dose so is not eating particularly well but gets the evening munchies still so will have a big mug of milk, crisps and maybe a muffin for supper no doubt