Son seems very underweight

[Sonya007]

my 13 year old Son is very underweight. hes about 5ft 2in and weighs around 36kg. it wasnt put forward as a problem when we had to visit hospital for a migraine, but when they weighed him i thought thats very low. anyway we went for another checkup a few months later with a cardiologist, as he had complained of getting chest pains, though by the time we saw the doc they had mostly gone, probably growing pains. anyway the dr who was with the consultant commented that we should get a full blood count and i think also test for coeliac disease.

so off to the GP who because there wasnt a letter telling them to do the tests said they wouldnt. i said about his weight so she weighed him and it was 35kg by her old scales. so she said she would refer him to a dietician, and commented to say something along the lines that we would be told what to feed him. this made me angry as we have a very good diet with all the main vegies etc, but my Son will tend to pick at food unless its junk.

he is finding secondary school very stressful because of other children's behaviour and i wonder if this is making him burn up calories?

Stress by itself won't make him burn extra calories. It might make him more likely to control his intake of food though. I think the phrase about "tell you what to feed him" to me sounds like a somewhat clumsy way of saying the dietician will be able to give you information on what high calorie but healthy things he might want to eat. The kinds of things to prioritise for weight gain.

Is the school unable/unwilling to address the issues he's experiencing?

Quite frankly I would give him whatever he wanted to eat. It's calories he needs at this point. You can give him vitamin tablets and iron tablets and so on but get some food down him.

What did you offer him to eat yesterday. What food does he have accèss to that he can help himself to

DD1 was 15, 5' 4", and 37.5kg when she was admitted to hospital. She had an eating disorder but not typical - she didn't care about her weight, she just responded to her emotions by eating less. She had grown but not put any weight on. Her weight for height was 68%. (Your DS is around 80-83% depending on how long he's been 13).

Apart from monitoring her electrolytes and getting her into CAMHS, generally the only medicine is food. DD1 did need medicines to allow her to eat but that's because she was psychiatrically unwell.

3 meals per day. Throw the healthy eating manual out the window. DD1 lived on pancakes made with duck eggs (double the calories of hens eggs) and double cream for a good while. 3 chocolate croissants for breakfast... seriously 'unhealthy' but it's what she needed.

DD1 is now a healthy weight and eats normally. She still struggles a bit at times but she eats enough to keep her going.

Yes, he's underweight - I'd be plying him with cheese slices and fried eggs

I'm not sure I'd care as much about veggies as calories

You have my sympathy as my DS is underweight (5ft10 and 48kg) and is under the care of a dietitian. We let him eat whatever he wants for snacks whilst providing healthy meals.

Despite adding lots of calorie laden foods to his diet, in the 4 months since they first weighed him he'd only managed to put on 2kg so it looks like he'll be getting persciption shakes next. He has no appetitie at all which has been put down to his Long Covid.

@WhatHaveIFound I genuinely thought that DD1 couldn't put on weight. It's amazing just how many calories some children need to gain weight that sticks, but once I upped her diet to around 3500-4000 calories per day (she needed really calorie dense foods, too, because she had such a small appetite), she gained and it stayed. Now she can eat a fairly normal diet without dropping. Having said that, she's had a few days of not eating with a tummy bug and dropped 4kg, so she does drop rapidly if I don't keep an eye on her diet.

Veggies won't put weight on. He needs foods high in calories.

Boys can be anorexic, too.

It's a devious illness (annies will be first to agree with you on that).
My friend's very unhappy teenage son has been anorexic for about 18m.
I really hope it's not anorexia but I would directly talk to him about the possibility.

Ds has ARFID and at times has been very underweight. He has been able to get specialist support at an ARFID clinic.

We were told by them that in Ds's case
"All food is good food'
And that we should not worry about a healthy food or healthy diet. As he needed lots of calories. So adding cream etc to milky drinks.

This is what we were given by the dietitian if it's of any use to you...

@Lougle Thanks, sometimes it's seemed like there's no light at the end of the tunnel so it's good to hear a positive story.

@WhatHaveIFound I'm a bit sceptical about dietician advice. When DD1 was released from hospital we were given a diet plan. 1500 calories. She lost 800g in 7 days and was almost readmitted. However, I had kept a meticulous record of her diet and had printed it out. I had deliberately gone over the plan and had managed to get 1700-1900 calories in each day. When the Paediatric Consultant saw that, he called the dietician in and she said 'oh yes, she'll need around 2000 calories to gain weight.' So why give me a 1500 calorie diet plan??

The truth is that our children need lots of fat. Animal derived fats like butter, cream, etc., because they feed the brain. Fortify everything. If they have veg, add a knob of butter. I took a standard scotch pancake recipe and modified it: duck eggs are 130 calories, hens eggs are 70 calories, so duck eggs went in. Instead of milk, I used double cream. Once cooked, each pancake had a knob of butter and then she was allowed golden syrup or Nutella on it. I could get a batch of 3 scotch pancakes up to 1500 calories doing that.

Work out what meal time works best for your child. Evening meals were a disaster for DD1, so front-loading her calories helped. If I got a really good breakfast into her, then I didn't have to stress about dinner so much.

Croissants (real butter ones) are a great breakfast. I used to give DD1 3 chocolate croissants for breakfast. 1100 calories done and dusted.

People think that they need to get better in their head before they will gain weight but the reality is that before they have gained weight, they don't have the capacity to address what's going on in their head. So rapid weight gain is the key.

DD1 went from 37.5kg, wheelchair and bed rest in January 2021 to 44.8kg and no wheelchair in April 2021, to 53kg and fully weight restored in July 2021. Since then she's bobbed around between 53-57kg, which is all perfectly normal and fine.

We haven't been given a diet plan as such, just hints on what to add. I'll have a look at pancake making this weekend as I think there's a farm locally that sells duck eggs.

He suffers from gluten intollerance so regular croissants would probably disagree with him but GF toast and chocolate spread/peanut butter always goes down well and he already has loads of butter in sandwiches.

That's great. It really doesn't matter what he has as long as across the day it's high calorie, high fat, and high protein. You can always give him a multivitamin too.

Does he go to the toilet very often? My son is 13 and he is very tall (1,66 m) but weighs only 41 kg although he eats a lot. Due to stress he suffers from mild IBS so he has a very fast bowel movement that prevents him from gaining weight. He grows fast so doctors said this is a good sign and we shouldn’t worry too much.

My son (13) was very skinny and in the end it turned out he had an overactive thyroid and basically his metabolism was too fast. He does also have coeliac disease but that was diagnosed years before and the main symptom then was he didn't grow.

Before he was on medication for hyperthyroidism he did get a lot of migraines and they thought he might be anorexic. We only found out he had an overactive thyroid after my Mum suggested it and we asked for a test. It is a very routine blood test and much easier to get from your GP than a blood test for coeliac disease. It's quite rare for a boy to have hyperthyroidism which I why I don't think they considered it but it could be worth checking.

He is quite under weight. Do you feel that he eats enough? You say you have a very healthy diet, but he only picks u less it’s junk. So does that mean that the majority of the time he only picks at his food?

of that’s the case, what with him being so under weight. I’d probably just let him have more junk. Obviously mixed with plenty of healthier choices. But I’d rather he was eating enough even if it wasn’t all super healthy.

I have a tall skinny ds not underweight but looks very thin. He makes banana and milk smoothies as he comes in from college, lots of good fats and potassium. It tastes like junk but very good for them