Extremely fussy eating teenager

[therunningman]

Hello, I am actually a Dad posting here but through word of mouth I know I can expect some helpful advice for which I would be very grateful.

My teenage son (now 15) is an extremely fussy/picky eater, which is putting it mildly I think, and has been for several years (ie. this has developed as some new "lockdown induced" problem)
His diet/habits I have watched over this time are:

• Never eats breakfast.
• Lunch weekends at home is typically a plain cheese sandwich white bread, provided that the bread is the "right kind" (no, I don't know what that means), and which is always unfinished. More often than not he sits at the table and just eats nothing.
• Dinner is normally just a plate of pasta (he will also eat pizza (Dominos), noodles/stir fry), there is absolutely no variation here so eg. last Christmas dinner was also a plate of pasta for him, roast for the rest of us.
• He refuses to try anything else - meat eg, chicken, ham, beef, sausages, burgers - vegetables eg. potatoes, greens - soup
• As far as I know he eats pasta pots and paninis for school lunches.
• Between mealtimes he will snack on biscuits, and give him a tenner for trips out he will fill up on the usual junk - crisps, chocolate, sweets, fizzy drinks
• Eats small amounts of fruit under duress
• Drinks sparkling water

My second teenage son (13), on the other hand, is eating as one might expect - anything and everything (bar a few exceptions) at all times.

Understandably, this is extremely frustrating to see as a parent. I fear his diet/habits have now passed the point of no return in the time left before he leaves home (3 years), and the usual recommendations I read are geared towards younger children and won't help here - reward charts, involvement in meal preparation, explanation of diets/health, even bribery etc.

On the one hand I think, so what? He's being fed and watered at home is most likely not malnourished, and it will be his problem to live with and figure out soon enough. Peer pressure perhaps will change his habits in the future.

But on the other hand I do wonder if we have missed something, and feel responsibility to investigate in that time left. I have had a nagging feeling for some time his diet/habits may be symptomatic of another problem, but I can't put my finger on anything specific - he is a model student and happy at school, engages with his friends online, is not consuming anything illicit, and isn't (it seems) anorexic. So this isn't something I want to leave unchecked. I suppose my first question is an obvious one - could this reasonably be described as an "Eating Disorder"? And if so, where next?

Any advice, gratefully received!

Oops I meant to write: (ie. this has not developed as some new "lockdown induced" problem)

I'm in no way experienced in this area, but I suggest you Google ARFID and see if it rings any bells.

I’m exactly the same. So is my son (age 17) We both have hyper sensitive taste buds and can taste small differences that others may not.

In addition Ds is autistic and has sensory food issues, especially regarding texture.

Dd and dh on the other hand eat anything & everything.

Just don’t make a big issue out of it.

What kind of paninis does he have --only cheese?

Lunch weekends at home is typically -- so what else is possible, if not typical?

Does he only eat marguerita pizza, or will he have any other pizza toppings?

Does he eat chips, nuggets,sausage rolls, burgers or hot dogs?

Is he a healthy weight? Do you know roughly how many calories he would be getting on average in a typical day?

My teen dd has an ED so these threads always get my spidery senses tingling!

It might be worth getting a Dr to give him a once over, check his bloods, pulse, bp etc.

That sounds like a fairly major issue. I wouldn’t know where to start. Could you get him to take a daily multivitamin with iron (you can get chewy sweet style ones) and ask him to find a protein bar he likes (as he’ll eat sweets, chocolate and crisps)? Then at least you be confident that his body is getting what it needs even if he exists on pasta and junk food.

I wouldn’t count on him not being malnourished. If you think he would be willing to engage with it then I’d try and get a referral to a dietician via the NHS (very long wait times) or privately if you can afford it, which tends to give you more scope to find someone who you think might be a good fit for him.

It may be that an external person clarifying the short and long term consequences of nutrient and vitamin deficiency might hit home more than either parent (which at 15 may be perceived as you nagging or interfering, plus of course at 15 you’ve just worked out you know everything about everything and your parents know nothing because they are soooo old and the world has changed beyond recognition since ‘the olden days’ or similar!).

Just to clarify his current diet could increase his risk of various chronic diseases, lower his immune system, make him more prone to depression, cause skin and hair problems, bowel issues, fatigue & mood imbalance. Also with a diet made up of almost exclusively white carbs he is at risk of developing type 2 diabetes at some point regardless of his size (not to mention specific vitamin deficiency issues such as scurvy with no vit c, permanent vision issues if his diet has no vitamin a etc).

It’s great that you are concerned enough to post & I hope you can find a way to sensitively approach it & help him moving forward.

@itssquidstella

I'm in no way experienced in this area, but I suggest you Google ARFID and see if it rings any bells.

Thanks, yes I had read about ARFID before posting here and there are certainly some signs that can be ticked off eg. not liking texture of mousse and ice cream iirc. I'm a little uncomfortable its described as a mental health condition, I'd prefer to believe its just a lack of interest in eating and a teenage phase he may emerge from.

@lljkk

What kind of paninis does he have --only cheese?

Lunch weekends at home is typically -- so what else is possible, if not typical?

Does he only eat marguerita pizza, or will he have any other pizza toppings?

Does he eat chips, nuggets,sausage rolls, burgers or hot dogs?

Pizza often with some pepperoni toppings, but usually a few are then picked off and not eaten! He won't touch chips, nuggets, sausage rolls, burgers or hot dogs at all.

@Girliefriendlikespuppies

Is he a healthy weight? Do you know roughly how many calories he would be getting on average in a typical day?

My teen dd has an ED so these threads always get my spidery senses tingling!

It might be worth getting a Dr to give him a once over, check his bloods, pulse, bp etc.

About 6 3/4 stone which is the lighter end of BMI healthy weight range for his height 5'3" and still growing. I'm not too worried about that. He's also fit and active, does a six mile round trip bike ride to school every day. I see involving a Dr or nutritionist as a last resort really.

@Nightbear

That sounds like a fairly major issue. I wouldn’t know where to start. Could you get him to take a daily multivitamin with iron (you can get chewy sweet style ones) and ask him to find a protein bar he likes (as he’ll eat sweets, chocolate and crisps)? Then at least you be confident that his body is getting what it needs even if he exists on pasta and junk food.

Yes he has a multivitamin daily, and my wife is quite good at smuggling in other foods eg. banana cake.

@chipsandgin

I wouldn’t count on him not being malnourished. If you think he would be willing to engage with it then I’d try and get a referral to a dietician via the NHS (very long wait times) or privately if you can afford it, which tends to give you more scope to find someone who you think might be a good fit for him.

It may be that an external person clarifying the short and long term consequences of nutrient and vitamin deficiency might hit home more than either parent (which at 15 may be perceived as you nagging or interfering, plus of course at 15 you’ve just worked out you know everything about everything and your parents know nothing because they are soooo old and the world has changed beyond recognition since ‘the olden days’ or similar!).

Just to clarify his current diet could increase his risk of various chronic diseases, lower his immune system, make him more prone to depression, cause skin and hair problems, bowel issues, fatigue & mood imbalance. Also with a diet made up of almost exclusively white carbs he is at risk of developing type 2 diabetes at some point regardless of his size (not to mention specific vitamin deficiency issues such as scurvy with no vit c, permanent vision issues if his diet has no vitamin a etc).

It’s great that you are concerned enough to post & I hope you can find a way to sensitively approach it & help him moving forward.

Well a lot of that is worrying, but thank you, and reinforces why I wanted to post in the first place. I had no idea of the link between pasta and diabetes - I do now!

I completely agree with you re an external person who is not a parent. Sadly lockdown for the last year put an end to school trips, visits to friends' houses etc. all situations where he would have less say over what he is given to eat.

My sons diet was extremely limited from being a toddler until he left school. I was extremely worried about his growth and overall health. Since then he has gradually improved, the main breakthrough was when he wanted to add muscle and now his diet although still limited in the variety he eats, is quiet healthy. It seems it only changed when he wanted too and nothing we said or tried over the years really helped. He's now a strapping 6 foot.

@Bigpinkslippers

My sons diet was extremely limited from being a toddler until he left school. I was extremely worried about his growth and overall health. Since then he has gradually improved, the main breakthrough was when he wanted to add muscle and now his diet although still limited in the variety he eats, is quiet healthy. It seems it only changed when he wanted too and nothing we said or tried over the years really helped. He's now a strapping 6 foot.

Good to hear!

My teenage Ds has probable ARFID ( he can't access anyone to get an actual diagnosis). We have been told that eating anything is better than nothing at all.

Ds is severely restricted. I have found it impossible to get any kind of outside support. Our local eating disorders team can't help and a specialist referral to a feeding team has recently been rejected. He saw a dietitian once and was discharged as they can't offer any more appointments. He is very underweight but I'm pretty much at the stage of giving up asking anyone to help.

All Ds has eaten today is a bowl of pasta.... nothing else.

I would just encourage your Ds to eat what he can and if you are at all concerned to ask the GP for a physical check, sadly beyond a quick check in primary care the NHS are utterly useless in dealing with this.

@Punxsutawney

My teenage Ds has probable ARFID ( he can't access anyone to get an actual diagnosis). We have been told that eating anything is better than nothing at all.

Ds is severely restricted. I have found it impossible to get any kind of outside support. Our local eating disorders team can't help and a specialist referral to a feeding team has recently been rejected. He saw a dietitian once and was discharged as they can't offer any more appointments. He is very underweight but I'm pretty much at the stage of giving up asking anyone to help.

All Ds has eaten today is a bowl of pasta.... nothing else.

I would just encourage your Ds to eat what he can and if you are at all concerned to ask the GP for a physical check, sadly beyond a quick check in primary care the NHS are utterly useless in dealing with this.

Thanks, it's a relief to read it's not just us. Snap, just one bowl of pasta today, half an apple, and some cake. If he's been snaffling any biscuits in the meantime I haven't noticed. As I wrote at the moment I see the NHS as a last resort on addressing this. We are planning to get him to a GP this year on a separate matter (missed HPV jab) so that might be a chance to ask them to do some additional checks too.

Being under 7stone at age 15yo does ring a few alarm bells tbh, there's a teen ED thread which you're welcome to pop over on to. One of the regular posters could work out your sons weight for height which gives a more accurate indication if he's under weight than BMI does.

He needs calories so if he eats biscuits or snacks then definitely encourage this.

I would avoid making any moral judgments around food being healthy or unhealthy tbh.

DD 16 eats more or less the same as your son. She went veggie quite a few years ago and it went down hill from there. She loves chocolate but other than that its crisps, cake, certain biscuits, occasionally chips, pasta, margarita pizza and noodles. She also picks any topping off pizza (and will only eat certain pizza’s).

She has stopped eating breakfast and I have no idea what she eats at school. Her skin has lots of spots on, she isn’t as slim as your son. But she is also extremely awkward and moody. I also worry her diet is so bad that I am sure her periods have also stopped. She won’t conceive of going to the doctors. I am at my wits end with her.

I have a fussy 12 year old, although he will eat a range of processed meats and chips so he isn't as limited as your boy. We are working on spicy tastes as he likes chilli etc. and can occasionally be persuaded to try tiny tastes of things in curry sauce. Very very slow progress but I think we will crack it in the end. Chinese and Indian takeaway snacks worked well as a bridge to this because some of them are so close to crisps which my boy likes. Would your son puck the pastry off a pork pie or a sausage roll?

Cake is really good if you can make it with plenty of eggs. It's not great for him to have tonnes of sugar but a generous slice of cake can have the equivalent of a whole egg in it, which is a good dose of nutrients compared to a bowl of pasta.

Would you get away with switching some of the cake flour for gram flour which would increase cake protein further (best disguised in a moist chocolate cake)?

What does he drink? Again fruit smoothies are a bad idea for most people but if he can help his fruit intake this way, it'll be worth it

That’s quite short for a 15 year old, isn’t it? There’s a big variation in when teenage boys (and girls) have their growth spurts but unless you mad his mum are very petite it sounds like more is still to come.

Just checked on the CDC growth charts - height is between the 3-10th centile. If he’s still early in puberty and there’s a proper growth spurt to come he should get very hungry soon in which case you could subtlety widen his food range?

Hi I am returning after I see 3 years later to happily report that this phase has passed and my (now 18 year old) son is eating anything and everything, and is regularly cooking for himself. I think the key advice I can offer is just keep putting food in front of them and if they refuse it they refuse it, don't make an issue of it or pander. It's extremely dispiriting hard work and seems endless but just keep doing it. Get them out of the house on their own as much as possible eating with friends / other adults where they may be less inclined to make a scene over it.
Good luck!

Thanks for the update :)