Should I take my DS (14) to doctor- underweight with BMI of 13

[Swarskid2184]

I am concerned about my DS (14). He has grown a lot (upwards) recently....about 8cm since Christmas. But is still only 40kg. He is literally stick thin....you can see all his ribs and he has no muscle at all. His voice has broken and he has developing body hair.

Recently he has no energy and is very lethargic a lot of the time.

He eats a good breakfast - generally 2 eggs, orange juice and some fruit. Is a bit patchy on lunch at school. Has a good supper - eg chicken breast, rice and broccoli. And then basically eats snacks all evening....until he goes to bed at about 9.30.

My DH thinks that we should take DS to the doctor....I am unsure.

Yes, he needs to seriously up his calorie intake - he's not getting anywhere near enough!

Definitely no health kick going on. I probably underplayed the evening snack thing. Tonight after supper DS has had:
A punnet of raspberries
An apple
5 rice cakes
2 iced buns
A bag of peanuts
Some ice cream

So think that he is probably getting the calories he needs- but however hard I try to feed him up during the day....always seems to be a post supper feeding frenzy!!!

None of those apart from the last two are filling or caloric

Term last three

I’d go to gp. I have a skinny son (still in normal BMI, but towards under weight), his weight goes up much more slowly than his height. He has a ‘healthy’ appetite in all senses of the word, is very active and not lacking energy.
However I could see him slipping into underweight, so am really interested to see if gp thinks you’ve made the right call going and what she said about it. Would you mind updating, afterwards?

Honestly unless he is having burger, chips, milkshake and a mars bar for his lunch he's not getting the calories a 14 year old boy needs.

Raspberries/ apples / rice cakes - all minimal calories, ice buns - if they are the ones that look like finger rolls with a blob of icing on, they are low cal for a cake .

He needs some more carbs - toast / pasta / sandwich etc

Will update after GP.

Thank you

JustDance I thought it was nearer 3000? Swars.id say that isn’t enough in snacks either. My DS eats something like beans on toast, sandwiches, a cheese and ham toasted when he gets in from school, then eats his tea an hour or two later.

What your DS is eating wouldn’t keep him going for a couple of hours.

Worth keeping a good diary for a week or so of what he eats (get him to do it) so you can show GP air dietician

Jilted depends on how active. I wouldn’t say mine was very active, more moderate. The link that someone posted above is great and gives good guidance on amounts and types of food.

nowhere near enough food for a boy his age.
Mine is also 14, 6 foot tall and about 62 kilos
he's very slim but very muscular

he has cereal for breakfast with milk
lunch is sandwiches made with 4 slices of bread, butter, meat or cheese and salad. He has fruit with that-banana especially. he will often buy a slice of pizza or a cookie at break too.
Home from school, he'll make toast usually.
Dinner has protein-chicken, beef or whatever, carbs-pasta, potatoes, rice, wraps and loads of veg. He almost always has a sweet pudding of some sort.
he is so slim and full of energy.
Your son needs way more food.

My ds (14) is very skinny but I do not obsess over what he eats, I don't fuss over what he eats - i have no idea what he has for breakfast - he makes it himself. He has a large flask of home cooked food - usually stews, curries chills etc for his lunch - no other bits and pieces. He has toast I think when he gets home, as much as he feels like and dinner is whatever and he eat till he is satisfied. He eats enough food to satisfy him.
The OP's ds has lethargy issues, these might be caused by a dietary deficiency but it might be caused by something else and it might just be caused by being a teenager.

That is a tiny amount of food.

Mind you, my son is 6 foot 1 and weighs less than 10 stones. He’s lighter than I am!

*Swarskid2184 did the GP say anything useful?

Sorry, that should have said @Swarskid2184. Total tagging fail

Appointment today was cancelled as the doctor was off sick. I could not in all honesty claim that it was urgent that he saw a dr, so now have next available appointment.....on 31st July!

Thanks for ideas though. He is now keeping a food diary (from today) and I will check calories against that....today so far:

Breakfast- 2 waffles, some raspberries, glass of grapefruit juice
Snack at break- Chocolate brownie
Lunch - Fish burger
Snack after school - Banana, flapjack and a Petit filous
About to have for supper- frittata, bean stew and salami

So sorry that the appointment got cancelled. He does seem to be eating more frequently. How does he feel about that?

A child being very lethargic and having no energy may be cause for immediate concern though. I appreciate that you don't want to panic or make a fuss, and the food diary sounds like a good idea, but I honestly wouldn't wait a week.

Call the GP, explain the situation and ask if they can fit him in sooner (they will if there are concerning symptoms ie low weight and lethargy).

Has he lost weight, do you know? Because that would definitely be cause for immediate concern.

The problem with symptoms like low energy and low body weight is that the causes can be minor or serious, and there's no way of knowing until he's properly checked out.

Are you sure it's bmi 13 or 13 percentile?
Because bmi 13 is really really underweight for a 14 year old boy.
Whats his weight?

Oh sorry, you said 40kg. That is very underweight. Hope the dr gives you some answers.

Don’t make him too body conscious- my DS is more so than my DD as he’s the slimmer one really in terms of ratio (although dd very slim she is not underweight). It’s hard to strike balance.

You should be able to take a urine sample in and they can check for diabetes (type 1) on the spot. My son did the stretching / growth but not putting on weight thing and I didn't realise he'd got so skinny he was also lethargic but again he was never very active. It was when he wet the bed that I thought it was a urine infection so took him to gp and it was diabetes. Look at diabetes uk site for the signs but I would ask the gp surgery to test his wee to rule it out as if it is diabetes his pancreas is not releasing insulin and his blood is turning acidic and could end up in coma. My son was able to walk into hospital but they told us most kids with type 1 come in in wheelchairs as the signs are subtle and they end up collapsing. Drinking and weeing lots is a key sign. I imagine even a pharmacy would do able to check. The weight loss is because without insulin the body isn't able to get energy from food and so the body breaks down fat cells to release energy instead. its literally a dipstick test that needs be done initially and if that's ok will then do blood tests etc but if you are worried just get his wee tested don't wait another week.