<p>DH and I are trying to decide if S2 has an eating disorder, or a feeding problem, or what the heck is going on. He has significant health challenges and has undergone numerous invasive and semi-traumatic hospital procedures as an elementary age boy. He is now nearly 22. </p>
<p>He has never weighed enough, and I assumed that in time his body would generate hunger, etc. and it would solve itself. That is not happening. At 5’ 11’ he claims to weigh 130 (which would be a record high) but I am guessing he’s more like 126 soaking wet with clothes. He is seen by his specialist twice a year and has regular labwork which indicates his health is generally speaking normal. Not anemic, not vit D deficient, etc. His doctor is aware of my concern but shrugs it off. S2 is nearly 25 lbs underweight. That seems like a lot to me. </p>
<p>He’ll eat one egg or one donut and a glass of milk for breakfast, for example. He’ll eat a couple tablespoons of peanut butter and pretzels for “lunch”. He does not snack much. He does not drink soda, and has food allergies that prohibit most empty carbs. And then I started thinking, if he were a GIRL, someone would have mentioned anorexia. Or at least a counselor. This is a trend that has persisted for years, btw. </p>
<p>He is aware of our concerns and while I’ve tried to not concentrate too much attention on it, when he is home from college these first few weeks are always stressful as I watch just how little he eats, in person. So I’m looking for anything to help me understand what is going on. </p>
<p>I agree that if your son was a girl there would be more discussion. I’ve had several friends with kids with anorexia. And yes boys can have it too. How does he react when you suggest he eats more. Anorexia is not necessarily a problem about weight but it is how an individual controls themselves. Often food is the only thing they have control of. If you suggested that he make fruit smoothies with protein powder in them several times a day - do you think he would do it. If he is willing to try something like this than it just may be that he doesn’t like to eat. If not, then it might be psychological. Goodluck</p>
<p>Hey green button. I can see why you are worried about your son even though his Dr is not too concerned.</p>
<p>My good friends daughter had pretty severe GERD while in college. She was on the highest dose of preventative medicine she could be but was still having problems. </p>
<p>When her mom finally saw her in a swimsuit she was shocked at how frighteningly thin her daughter had become.
In talking with her it became apparent that she basically stopped eating in order not to feel so bad. Her GERD was eventually found to be stress based and she was able to get a handle on it.</p>
<p>So my first thought in your sons case would be if his food allergies cause him enough discomfort that its just easier for him not to eat. </p>
<p>Iis he showing any signs of malnourishment? </p>
<p>One of my sons guy friends was hospitalized in high school for anorexia - so yes, boys do get it. Dh’s sister is also a lifelong anorexic - she goes in and out of it. I think it’s such a complex issue about control. I know her “anorexia” diet - watermelon by the truckload and tuna out of the can. In fact she ate so much tuna she got mercury poisoning. The hard part is actually how many compliments extremely thin people will get or how much attention they’ll get over it. She was quite crafty and got her masters in nutrition. So now she pretty much just lives on handfuls of vitamins. It’s frustrating to sit by and watch and I know her mom took her to a doctor who pretty much ignored how little she weighed. Does he believe he’s too thin?</p>
<p>He is clinically stable and sound, but of course food is tricky and sometimes downright dangerous so I don’t blame him for not just stuffing things into his mouth. Intellectually, he seems to understand he needs to eat more, but when it comes to the moment of choosing to eat every couple hours (a strategy once suggested that has failed every attempt) he just doesn’t commit. Or whatever. It doesn’t help that you really don’t get much sympathy in life when you are complaining that “Man, I have to go finish the cookies” or “wow, I forgot to go eat ice cream, I’m in trouble now”. </p>
<p>I suggested maybe he would want to see a counselor, and he was horrified and angry. Sigh. </p>
<p>Does he have any interest in exercising? My son works out with a strength and conditioning coach who is very health/diet conscious. He has the kids keep food diaries at times, requires them to try a new food periodically and report back and generally encourages healthy living. Maybe your son would be more apt to listen to someone like this.</p>
<p>So he is not going to want to talk with you about this which leaves you in a lousy place. As you know, anorexia is about control. So where does this leave you?</p>
<p>I would call and discuss your concern with his specialist. You can get around HPPA laws by just talking to his Dr . Dr. can talk to you in general terms. I would want to know at what point Dr. would be worried.</p>
<p>What are his health challenges? Thyroid, diabetes can take a toll on weight.<br>
Loss of appetite can take main stage—GERD, medication that changes taste perceptions, types of food (he has allergies), stress, discomfort after eating (a particular food(s) or physical discomfort–esophageal problems, hiatal hernia).</p>
<p>The real question is how healthy he is. How is his energy level? Is HE worried about it? Or not willing to talk about it? Surprised at the amount of weight he has lost–what period of time?
Just an example but a friend of my son’s was diagnosed with diabetes–he joined a team, lost a bunch of weight (looking great actually) but the weight loss was from undiagnosed diabetes–not the physical exercise that everyone first attributed the weight loss to.
Another example–a girl I worked with was ready to undergo surgery–major stomach cramps etc. She couldn’t afford the surgery so put it off. Guess what? After extensive quizzing about what she ate and her symptoms it turned out she didn’t do well with salad which she ate all the time in an attempt to diet. None of her x-rays showed anything (she didn’t eat during them obviously). Cut out salad–problem solved. The doctors weren’t asking the right questions.</p>
<p>If his diet is devoid of what might be considered “empty calories” that might be enough to keep him way underweight. Not exactly anorexia but a lot of “healthy” foods (veggies, fruits, low fat protein) doesn’t have the requisite number of calories to keep an active person going. You need carbs to burn.</p>
<p>If you can strike up a conversation about it without any accusatory overtones (easier said than done I know), you may find out a reason. Or get a grasp of his reasoning behind how he eats. A doctor doesn’t have the time nor inclination to hold a long interview about diet that may actually pinpoint a problem (or its solution).</p>
<p>Totally different track:
Does he fix his own meals (breakfast, lunch if not dinner) when he’s at home? Is it just easier not to eat?
Does he not eat ALL the time? Or are there times he’ll chow down? Favorite meals?</p>
<p>Greenbutton- Is it possible that he feels physically sick when he eats? Perhaps he is having symptoms of whatever his illness is and doesn’t want to become a “patient” again. Perhaps the underlying reasons for not eating are physical. A friend’s son with Crohns was having a very difficult time with eating and gaining weight. He eventually went to PT for bone density issues and
now eats more and works-out. He is still really thin, though. Is there a nutritionist that works with his doctor? I wonder why the doctor feels he is not too thin. Perhaps he is in the normal range for his illness. I think sax raises some really good points. </p>
<p>^^I would like to think he has better sense than that…he is on very good (texting) terms with his healthcare team and knows that ignoring symptoms is not going anywhere good. There is a nutritionist who works with the practice but no amount of knowledge really substitutes for execution. He does fix his own breakfast and lunch specifically so I would be further away from the whole issue, and of course when he’s at school that’s his to take care of because he needs to own it. He is age-normal in that he’s kitchen lazy. But when he graduates in a year…</p>
<p>We send a steady supply of calorie-dense supplemental food so he doesn’t lose weight. The goal during the semester is to maintain, not gain. When he’s home, we try and build up a small gain to help when he goes back. No, he doesn’t ever just sit and eat a ridiculous amount (although he really likes ice cream). He’s not diabetic, and thyroid is normal. (we thought of that too)</p>
<p>Is being thin common for his illness? If you feel he is too thin perhaps the doctor might agree to a bone density test which if abnormal could encourage him to work-out and build muscle mass. I think it is really great that he is on good terms with his medical team. I can’t imagine they would ignore a sign if they felt he had an eating disorder. </p>
<p>“He is very good (texting) with his healthcare team”…but execution as you say trumps all.
Why is him fixing his meals and making you further away from that issue an issue? I can imagine that as a problem with major health problems. It could become a daily battle (not to say it was–but I get it.)</p>
<p>Maybe what your son needs is another tack depending on his current health (not far from what others have already suggested).
A nutritionist/exercise expert rather than hospital based expert. There are different things that get focused on and their expertise lays in different areas. Maybe its time to focus strictly on health.
He needs to learn to cook for himself and make it fun. Not only for himself but for his friends and family. He obviously can’t eat everything and that is a social drawback. Learning to cook the foods he can eat and enjoy will free him in a myriad of ways. Next time he comes home–party time–and he cooks. Works great at college too.</p>
<p>“Knows ignoring symptoms is not going anywhere good”-- the whole world needs that advice!</p>
<p>You say: “When he’s home, we try and build up a small gain”–Does he gain at home? Analyze it.
Easier to eat because you fixed the meal? Fixing meals is a big issue–no matter the small amount of time involved, it can sometimes be an emotional drain. Just ask the fast food industry about that. They make tons of money because of that fact.
Better food?
Easier access? ( getting to the grocery store? Willingness to pay for better produce/meat?)
Mom and Dad spring for more expensive supplements/ice cream (love it but I don’t have a freezer)?
(“Can’t wait to get home–ice cream in the fridge, ready to go, and chocolate sauce too!”)
Just more time to relax ?.</p>
<p>I have a kid with some pretty significant health challenges. They started at age 19.</p>
<p>It has been extremely difficult to try and help her with this when normal kids at this age are trying very hard to be independent and pull away from their parents ( especially mom).</p>
<p>I have watched her struggle, watched her purposefully ignore her health in an attempt to be a normal kid, watched her fall apart with the consequences.</p>
<p>As much as I wish I had been able to have more influence I knew the timing was totally off. I knew there was no way she was going to consider my ideas on many things. I had to learn to just let go. She did eventually come around for help on her terms.</p>
<p>As she has become older and more mature it has gotten easier but she, and only, she is in control of her health.</p>
<p>When she lived home I would leave reading material around hoping she might pick it up. Obvious…yes but ya can’t blame a mom for trying.</p>
<p>The best thing, green button, is that he knows you are there for him and he can come to you for help if he needs to.</p>
<p>If he’s always been a small eater his stomach may be accustomed to small volume. I had this issue with my daughter who needed to gain weight. She also has food allergies so she decreased the number of things she ate and just got used to smaller portions. </p>
<p>We met with a sports nutritionist who explained that she had to retrain her stomach and brain to eat more. She was not anorexic but she appeared to be. Big difference. She wanted to gain weight but had to learn strategies. </p>
<p>Luckily she wanted to play tennis so there was an incentive there to see the RD. Otherwise she would not be cleared to play. </p>
<p>Also anxiety can factor into eating issues. Especially with food allergies. Does he appear to have any other manifestations of anxiety? </p>
<p>One of my sons was 5’11" and 123-125 lbs throughout college. (He was 115 @ HS graduation. ) Was an extremely picky eater with many aversions. Now that he’s working at a company that provides meals, he eats more (and better). Still doesn’t eat chicken, hamburgers, fish, pizza, potatoes, etc. He is now at 140 – he went to a company health fair and they told him he was severely underweight (BMI was 17). His doc was never terribly concerned as S was growing up.</p>
<p>OP — discovered some food hidden today (hidden so I wouldn’t discover he hadn’t eaten it) and asked him to stand on the scale to see his weight (which he told me yesterday was 128) . I typically don’t second guess his reports, which I also don’t ask for. Lest anyone think I’m following him around. </p>
<p>He weighs 123. I was incredibly calm . He said " so,what do you want to do" and I just said he would have to think about what he wanted to do, and tell me how we could help make it happen. After he left for work I had a nice cry and then went for a walk. </p>