How to increase calorie intake in 11yo DS on ADHD meds who is losing weight

[AuADHD]

DS is 11 and has been on Elvanse since August. He’s lost around 1.8kg since he was weighed prior to starting medication. He is a tricky eater as it is and has autism too. He eats well but needs to eat more to counteract the weight loss. He’s happy and healthy so I’m not concerned particularly but as he was very slim to start with I don’t want him to lose anymore.

He’s just started secondary school and is doing great. He has ‘proper’ porridge for breakfast with chia seeds mixed in and a load of syrup. He’ll drink a big glass of milk with that. At break he has a babybel. Lunch is usually a jacket potato and beans. He has a second babybel a couple of hours after lunch. Dinner is usually homemade soup and baguette with butter, homemade pizza, veggie sausages, mash and Yorkshire puddings, macaroni cheese, or his favourite baguette with Primula cheese spread or Leerdammer cheese. He eats crisps and chocolate, biscuits and sweets but far less than he used to which is great on one hand but has decreased his overall calorie intake.

I’ve said we will start eating more puddings after dinner. He likes apple crumble and custard so I’ll make this today. I’m going to make some high protein chocolate chip muffins for snacks but he might not like them knowing him. He’s not much of a cake person. He’ll eat my homemade oatmeal cookies sometimes. Flapjacks are hit and miss.

I could start making him a hot chocolate each day although he already has a lot of milk, but I could maybe add some double cream to it. I already add double cream to mashed potatoes if I make them but dd doesn’t when she does. I’ll ask her to do so.

He has full fat cheese, semi-skimmed milk, proper butter but doesn’t like butter on his sandwiches. He’ll eat small amounts of peanut butter. He’s funny about eggs but will eat the white of a hard boiled egg.

Does anyone have any advice for getting more calories into his diet
please?

Hi, my daughter is on Elvanse and this definitely used to be an issue. We took breaks in the holidays to fatten her up! Christmas is great for that… how does he manage with breaks?

Do you notice his appetite returning more in the late evening?

Looking at fortifying what DS eats, you could make porridge with cream and add skimmed milk powder too if DS would accept that. Would he add peanut butter or other nut butter, or actual nuts, to the porridge? Swap the milk for a milkshake. If he won’t drink a milkshake, swap the milk to jersey milk/gold top milk or at least full fat milk. Can DS add cheese (and butter if he isn’t already having that and will have it on jacket potatoes) to his jacket potato? Are the soups creamy soups? You can add things like cream, butter, olive oil, cheese to mash potato to add calories. A babybel isn’t much of a snack when you are looking at increasing calorie intake. Would DS add something to his snacks? Does DS have a third snack a day? If not, add one in.

We had this with our daughter from 5 years old.... she was the shape of a toothpick! How we managed it was fat all the way.....before anything else. Chocolate spread, butter, double cream, nuts, chocolate mousse.... calorie dense. Really it's all the food that we wouldn't suggest that people ate constantly!

It sounds like you are already doing a lot.

My daughter had a few 'well meaning ' TAs comment on her chocolate milk, chocolate sandwich and custard pots 'unhealthy' lunch. In the end I spoke to the SENCo and said without it all she'll be taken off her medication. Noone said anything after that

Could you try mixing an egg into the porridge once cooked? A good way to get extra protein in.

Could you try mixing an egg into the porridge once cooked? A good way to get extra protein in.

OP, I wonder whether a referral to the dietitians at the nearest hospital via your GP would be a good idea.

I can’t imagine eggs in porridge. It would taste eggy and therefore be rejected.
I’ve bought double cream today and will add some to his porridge, I'm
making the high protein muffins tomorrow, and a veggie roast dinner.

He didn’t have his medication today and was actually ok but the only other time without it was a nightmare weekend. He’s running low generally needs it to function well in all areas. His appetite remains constant throughout the day.

I don’t think school allow two toppings on their jacket potatoes so I’ll send him in with a little pot of cheese to put on it himself. I don’t know if they have butter on them but I hope not as it will not be actual butter.

I’ve asked him to think what snacks he might like to add. A snickers is the best I’ve got that has some protein and fat rather than just a sugary cereal bar that’s mainly air and sugar.

I’ll experiment with some different soups that I can add cream to and add some to his favourite broccoli and cheddar when I make some tomorrow. He’ll eat a tiny amount of peanut butter or chocolate hazelnut spread. I don’t think he’d eat it in porridge but might eat a spoonful on its own.

He takes babybels because they give the medication a boost due to the protein.