Tall skinny teenagers

[Citygirlrurallife]

DS is 6’4.5” and I weighed him today and he’s just shy of 60kg (sorry for mixed measurements!)

he seems to have a healthy enough appetite but certainly isn’t as hollow legged as I’d been led to expect teen boys to be - at what point would you be worried about his BMI? He’s 15

What’s that in sizing, like a 28/30 waist?

Teens grow in spurts and found my string bean ate like a horse for some time and then stopped scoffing for awhile. Also seemed to leave on nonsense for some time.

if he is healthy, happy eating sensibly and doesn’t have any major food aversions then he’s just skinny build and there seems to be a jump in teen heights with this generation so going by BMI scales that were created decades ago isn’t ideal.

I would not worry unless there is illness, but I think he’s old enough to have a chat about general fitness and should be doing it exercise to bolster his legs, core and back muscles for the future. Make sure he has good posture, footwear and understands that he’s probably not made for contact sports like boxing and rugby. Running, football, tennis, badminton, squash swimming, ballroom dancing, horse riding, basketball, volleyball, yoga etc would be good for him.

The trouble is I worry that sometimes he does have some issues around food but I don’t know if I’m seeing something that isn’t there? He’s under 2 percentile of weight for his age which is underweight according to the NHS

DH is genuinely very worried about him and we have aCAHMS appt next week for mental health issues so we think maybe we should bring up his weight as well?

I would definitely mention it to CAMHS. He could just be built that way, or it could be something else, like an ED. The fact that he is already under the care of CAMHS and you have concerns would make me think he is intentionally restricting his intake. (I'm not an expert but have been through this with DD)

My son is 16, 6ft 1.5 and 8st4. He’s always been skinny so I’m not massively concerned. Has yours always been slim? Recently he’s started to eat a lot more to bulk out. He probably eats twice as much as everyone else, but mainly at main meals, he only wants good food and is very anti junk foods, upf etc.

That’s very normal for teenage boys - they grow up, before they grow out. Half of DS’s class were beanpoles and are naturally filling out now they are turning 17. At 15, I would have zero concerns and would not mention it to avoid him becoming self-conscious/developing a complex.

That's a skinny kid. Is he energetic & happy & active in other ways?

Ds17 is very tall and slim. He did have issues with eating very little when he was younger and was under the consultant. It is only in the last few months that he eats more. When people talk about teenage boys raiding the cupboards, he never has. He eats 3 meals and few snacks, he also does a lot of sports. Recently he is beginning to eat more. As your ds has issues with his mental health then not eating could certainly be part of it so I would mention it. Just encourage healthy eating so eating together when possible and have his favourite foods in. Chocolate milk has proved a great hit here and is calorie rich.

He’s underweight, he has mental health issues, he has some food issues. Of course you mention it.

I’d bet my house if it was a daughter you would. Boys get ED too. It needs mentioning as he’s not deemed healthy.

What are the issues around food?

Has his build changed or has he always been skinny? I had 2 very skinny teens but they were very skinny children. Hollow legs happened periodically and only meant they were growing up, not out 🙄

My dd is tall and underweight and I’ve had a query from the school about it in the past. She doesn’t have any issues with food however. I was the same as a teen and so was her father. However if you have noticed some issues then of course you should talk to camhs about it. I imagine they will ask anyway.

well this is the thing, DH was the same as a teenager, tall (not as tall) and skinny (though I don't think quite as skinny). DS has always been a skinny kid as well, I think the only time he was truly chubby was that gap between going onto solids and starting to crawl.

Potential issues around food are we know he sometimes doesn't eat in front of his friends at school (we've seen messages and they've gone so far as to tell us they think he has an eating disorder) but as that only happens at school we think it's part of other attention seeking behaviour - he has never refused to eat at home though will never eat beyond what he says is fullness. But then will often come back to food he's eaten a while later.

DH is concerned that DS goes to the loo very frequently during or immediately after meals though I don't think there is any evidence that he's vomitting.

I'm wondering if the initial approach should just be us saying according to the guidelines he's underweight, he only actually needs to put on about 2.5kg to be on the 5th centile which seems manageable, and a way of bringing it up with him without saying he has an ED - I don't want to create an issue where there might not actually be one. And he will shut down at any sign of it becoming a serious conversation around his mental health

to strangers yes but there are multiple mental health issues he covers up very effectively (hence having our first appointment with CAHMS next week)

Not wanting to eat in front of people is incredibly common. It can be an indicator of something worse than just simple anxiety and hypervigilence or those symptoms can be part of a picture of an eating disorder.

You should aim to contact the service prior to the appointment to raise things that you feel might embarrass him or cause him to clam up, email them and confirm that the clinician has seen the email prior to the appointment

Thanks @soupfiend thats very helpful advice

I have a similarly tall and skinny 19yo DS (approx 6'2 and 60kg). Has always been skinny, despite having two porky parents and unlimited access to chocolate, cake etc throughout his teenage years. (We do actually provide healthy meals as well, but he can snack anytime on anything.)

He has ASD and I suspect this is a factor. Doesn't seem to have any ED or eating restrictions as such; in fact he eats a very wide range of foods considering he has ASD. However, he dislikes eating in public (dislikes doing lots of things in public) and can go long periods of time without eating - I think he isn't always aware of when he feels hungry (has a similar problem with not noticing when he's too hot or cold).

Obviously your DS may be completely different, but if this rings any bells then it may be worth thinking about.

Thankyou @TinyThing

our DS doesn’t appear to have any problem eating in public (he does eat incredibly slowly) and the messages we saw back and forth between friends seemed more of the attention seeking variety (I don’t mean that in a bad way - I think there’s a big difference between hiding an eating disorder and making it clear to your friends you’re not eating, and he engages in other attention seeking behaviour that I wonder is part of him not really knowing how to engage with people on an emotional level)

i did a kind of test over the last few days and made his absolute favourite meals and cooked a load of flapjacks and he’s gobbled everything up so I think we’re going to mention to CAHMS we’re concerned about his weight and ask if they will weigh him in an all round assessment - then they can effectively be the baddies if he does need to put on weight rather than us. Family mealtimes are lovely for us and I really don’t want them to become an another of contention if there’s no need for it

Joining this thread. DS is 15. He is quite tall, 1,76 and weights 52 kg. He eats a lot and is healthy (blood and urine tests are fine). We took him to the doctor because everyone around us kept saying he was too skinny but there is nothing wrong with him. He recently told me he goes many times to the toilet, 3-4 times a day but that it's not diarrhoea. He had this issue 4 years ago and he had all sorts of tests and was checked by a gastroenterologist and they couldn't find anything. Since it's been happening for 4 years but he feels fine, grows and wins weight (slowly, but he does) his doctor thinks there is no reason to be worried.
I am a worrier and I'm getting anxious whenever I hear him going to the toilet, wondering if this is the reason why he is so skinny and that we might be overlooking something. But like I said, all the allergy tests and food intolerances came back negative. A colleague at work told me that boys have a much faster metabolism and digestion and that her sons also go a lot but still... I can't help wondering. Does it happen to teenage boys?

Finding clothes is challenging because his waist is to tinny in spite of his height so we always buy 2 specific brands and models of trousers that fit him. He says he would like to be wider and stronger like his friends and feels a bit self conscious. I think the more he worries about his weight the more he goes to the toilet and that it might be psychosomatic, it's like a vicious circle...

From personal experience with my ds, now 18, if you suspect your sons are overdoing the exercise and not eating enough they are in danger of getting RED.

There's a difference between being naturally skinny despite eating well, and plenty, versus not getting enough calories in to maintain health, which can then spiral into an eating disorder.