My 11 year old son has been on medication since Feb 2021. He had his checkup last week and his doctor seemed happy that he had gained 1 lb in the past 2 months, but she didn't look at his overall weight gain, nor did I until a week later when I got copies of his medical records. He has only gained 3 lbs in 1.5 years. His dr is retiring this week and we will be transitioning to a new doctor as soon as I find one. I'll discuss this with them, but for now, I need to figure out a way to help him gain some weight.
He is a very picky eater. He doesn't really eat breakfast in the early mornings. He is more of a brunch guy. I get it. I was this way and still am to some degree. Food first thing in the morning upsets our stomachs. During the summer we fix brunch--eggs, waffles, pancakes, crepes, etc. Everyone is happy except my waistline! During the summer I also give him his meds after brunch instead of 7AM, so he has an appetite for brunch. School starts up next week and I need a new plan. I try to push waffles, toaster strudel, pop tarts--really anything to get some calories in him. He is not a morning person, so I need something quick and easy. He usually gets lunch at school, but I'm not sure how much he eats. I know last year I asked the guidance counselor to check in on him and report what he ate. There were days he didn't eat anything because the corn (& juices) touched his pizza. It drives me crazy that the school won't just give him a piece of pizza without the corn. Yeah, it is not a balanced meal, but if a kid doesn't like corn, he isn't going to eat corn just because it is on his plate. Instead, he ate nothing! I packed his lunch for the weeks he had summer camp, but he came home with half-eaten sandwiches. I need some ideas! He is a very picky eater and only likes a handful of things (Chicken nuggets, pizza, hot dogs, mac-n-cheese, peanut butter) besides snacks/sweets. I've tried protein bars, but he didn't like any of them. I even let him pick the flavors...donut, cake, etc. I need some suggestions! Does anyone else have a picky eater that is not gaining weight? I thought about making smoothies with protein powder, but not sure if that is safe for kids??
Oh, I should also note that during the summer we skipped his afternoon Ritalin most days. There were a handful of days where he took it because we had things going on that required more focus, but we tried to skip it as much as possible to increase his appetite. I'm hopeful we can continue to skip it most days this fall too. He just started running cross-country and will have practice almost daily, so this should help spend all that excess energy. It won't help with the weight gain though!
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We've found some luck with Cyproheptadine. It's an antihistamine that has a known side effect of increasing appetite. It won't help with picky eating, but it might increase overall consumption. Re: mornings, what about a protein shake? The Fairlife brand from Costco come in chocolate and are delicious. Sometimes drinking calories can be helpful. We also offer a bedtime snack, which is usually toast. Good luck!
We used to give him PediSure every morning with his meds which he loved until he all of a sudden didn't! I've been looking for an alternative, so I'll start with Fairlife if I can find it local. It is out of stock at Costco. I'll also look into Cyproheptadine. This is the first I've heard of it.
Have you thought ( or maybe you already do this) about involving him in both shopping and making his own food and snacks?Once our son learned to meet smooties it all turned around. He uses yogurt, frozen bananas, peanut butter, milk, ice and sometimes Nutella. He makes it all himself and this has helped him put in what he lIkes..
He drinks 1-2 protein shakes everyday. We insist that he eats all of his protein in order to get a treat after dinner.
There are many things he could do with peanut butter ( ants on a log, peanut butter protein balla..etc).
I've tried getting him involved in shopping & food prep, but he is LAZY, so that is hit or miss! He has sensitive ears (wears headphones when the vacuum is running, etc), so he won't run the blender, but maybe I can get him to at least put all the ingredients in so I can run it for him. Have you found a resource with good smoothie recipes as a starting point? My husband has tried making smoothies and they were awful! His ratios were off. Also, when you say protein shakes are you adding protein powder to them or just packed with protein-rich food? If powder, how much do you add for a kid?
My son struggled big time with appetite while on meds. After initially losing weight the first year the second year he did make some steady gains, but was still stick skinny. If my son didn’t wake on his own, I would need to wake him up at least 45 minutes before we had to leave for school so he could wake up a bit and then he would eat more. We always did Fairlife milk, Turkey bacon, Bagels (10g protein!), eggs, Canadian Bacon, Oatmeal with toppings, or I would make French Toast in advance and then just reheat in the morning and cut up in to strips, premake pancakes as well. You could also add whipped cream for some extra calories. Does he like breakfast sandwiches? They actually just take a few minutes to make- while the bread/bagel toasts quickly cook an egg and Canadian bacon and throw a slice of cheese on. We also did smoothies after school especially, and I would add Orgain Simple Protein Powder to it. Will he eat Greek yogurt? If so, get the full fat kind. Best of luck!
Can you give details on how you make French Toast & pancakes ahead of time? Do you freeze it or just store it in the fridge? In addition to being very picky, my kids think left-overs are disgusting, so making food in advance is tricky for us. I'd love to find a way for the french toast and pancakes to work. I can sneak extra protein into those. He won't touch oatmeal, greek yogurt or bagels. I think I'll try the breakfast sandwich again. He will eat all the pieces individually, but together?? Not in the past, but it is time to try again. Ugh. Is anyone else's kid so quirky with their food? Oh, and how much protein powder do you use in the smoothies? Is the amount different for kids?
So for the pancakes, I make a bunch and then freeze separately so they don’t stick together and then put them in a ziplock bag once frozen. My kids love the Annie’s organic confetti mix (no artificial junk). I just reheat in the microwave. You can also store in the fridge for a few days. For the French toast, I try to use a thick cut brioche and dip it in an egg/milk mixture with cinnamon, vanilla, and a little nutmeg. I just store in the fridge and they are good for about 3 days or so and reheat in the microwave, however, you could reheat in the oven for a few minutes for a crispier texture. I just put one scoop of the protein powder in the smoothies (9 grams). My son had to stop stimulants so I don’t do that anymore but did when medicated.
I feel yr pain. Our son is only 6.5 & he's also super athletic so it's sometimes painful to calculate calories out & in. It definitely seems to have improved in the summer but our Dr also assured us it was just a "calories game" at this age, anyway so he tends to make up for it a lot at dinner when the Ritalin wears off. Also, I swear he literally lived on his 2yo sister's squeezy applesauce packets for abt 4 months, so I'd always have abt 12 of them w me at all times. Idk if that helps but I feel you! I spend so much time trying to convince him to eat & joking we need to trade eating behaviors 🤔 Hang in there!
My son is living on those pre-package peanut butter crackers. It drives me crazy he won't make his own crackers, but I've come to the realization that those are better than nothing!
I give my son Cetirizine (sold under the brand name Zyrtec) because it is an antihistamine and as mentioned by other parents, antihistamines have a side effect of increased appetite. Zyrtec doesn’t interact with any other medicines and has a long standing research backed up safety in use in children. I think some of the other antihistamines can’t be used let’s say with certain antidepressants etc.I know from years ago when my younger brother used to take Zyrtec for allergies that it made him more hungry…
Otherwise I can’t comment on how to increase the range of food.
I do tricks to push food that my son doesn’t like but which I know is nutritious - I add organic and salmonella vaccinated egg yolks to his curry sauce (flavour is so strong that he doesn’t notice I added egg yolk - I add it to already heated sauce so when I mix it it cooks).
I also give him multivitamins and minerals and Omega3 capsules.
I use fatter milk for him (Jersey cow milk which is 4.5 per cent fat).
I also push a lot of bananas as they have magnesium and healthy fibre and he seems to eat them easily between the meals. I put a banana for him on his night table so when he wakes early (too early) he can have a quick snack (I told him that maybe it will help him to get back to sleep). Also say whilst we walk back from his football camp I just give him a banana and a doughnut and he just eats it without noticing. And then dinner at home. And then supper. Just to get more melas in.
Also I try to give him protein rich food because that’s what needed for growth and development. But of course carbs and are needed too!
Just to mention- my son is no longer on stimulants because they had severe side effects for him (not only lack of appetite but other severe side effects).
On Atomoxetine children suffer from poor appetite too and my son does have poor appetite on this medication, but nothing as severe as in stimulants. To be honest my son has always had a poor appetite, ever since he was a baby, he was getting full quickly and never wanted to eat much.
Mind you, now he suffers from early waking (common side effect on Atomoxetine) so really all these ADHD meds have some problems. There is no perfect medication it seems…
I had no idea Zyrtec affects the appetite! I've been taking it nightly for several years to prevent hives. I've talked to my doctor on more than one occasion about appetitive suppressants because I'm always hungry and gained a lot of weight. He has never prescribed anything because of possible side effects. Instead, he suggests a nutritionist and Noom to get to the bottom of why I'm overeating...it is usually psychological...blah...blah...blah. Not once has he mentioned Zyrtec might be the culprit! I told him I've always been able to lose weight doing the old weight watchers program (after all 4 pregnancies), but it is different this time. I'm going to try weaning myself off of it!
Anyway, back to my son. He recently started drinking milk again, so I'm definitely going to look into getting him the highest fat content. I also give him vitamins and just recently added Vitamin D. Hopefully some of this will help!
My daughter has never been a breakfast person. I started doing smoothies and she doesn’t drink much but at least it’s something. I pack it with fruit, greens, avocado, and full fat Greek yogurt. I haven’t used protein powder but I don’t think it’s necessary if you pack the smoothie with protein rich foods. I’m also trying to get back to doing warm milk before bed like I did when she was a toddler :). Good luck!
I'll have to try the milk before bed, too. My son usually eats a second dinner at bedtime, because that is the only time he is hungry. The milk will be a good addition!
Same issue here. Our now 15 year old son has been on Methylphenidate since he was 6. It’s been a constant struggle to get him to eat. We let him eat when he’s hungry (instead of on our schedule) which usually means a large afternoon snack and dinner at bedtime. He is a big fan in hamburgers and chicken fingers so that’s what I give him. On the weekends he will eat a big breakfast (before meds) so I make it count - eggs cheese bacon etc.
Here’s the good part. For years his weight gain and growth were so slow we worried he would always be smaller than the other kids but about a year ago he started growing. He is still skinny but he’s 5’9. Don’t give up hope.
So glad to hear your kid had a nice growth spurt. I worry about mine, because so far he is taking after me (5'1") and is on the low end of the growth charts. His dad is 6' so I'm hoping he will at least make it to 5'6".
Not to scare you but my 17yo daughter’s picky eating led to a diagnosis of anorexia nervosa last fall due to lack of appetite from her meds, coupled with an eating disorder called ARFID (an eating disorder that includes picky eating and/or lack of interest in food). She has been a picky eater her whole life. She is under the treatment of an eating disorder clinic at a major hospital equipped with a team of a medical doctor, social worker, and registered dietician. They don’t mess around. You don’t want to be in my position.
Here is my best advice I’ve learned from the eating disorder clinic as she has recovered over the past year:
1. Feed him his favorite foods and worry about nutrition later. At meals, hit protein, fruit or vegetables and a carb. I got one of those trays with the 3 dividers. For snacks, provide full fat milkshakes with or without protein, cut up fruit drizzled with chocolate syrup, milk and cookies. PB sandwich with chips, etc. Chicken nuggets or fried shrimp with cheese filled garlic bread and broccoli for dinner. Cheese sticks with rolled up deli meat for more snacks. Think lots of carbs. It was explained to me that the brain cannot function without calories and carbs are generally something that those with adhd love. Food is medicine the doctor tells me.
2. His meals may involve eating at unconventional times. The idea is to gain weight. Feed him at the times he is most hungry and offer snacks every three hours where possible. Don’t worry if it doesn’t coincide with regular mealtimes. My son who doesn’t have an eating disorder never ate during the school day (a tiny breakfast like an eggo). He more than made up for it in the evening and late night though when his appetite came raging back. My daughter would just never eat.
3. Ensure. If he won’t eat, give him an Ensure. Our dietician required that my daughter drink an Ensure if she just couldn’t eat a meal or snack. They make two versions and one is much higher in calories than the other.
4. Cyproheptadine. JJMom16 mentioned this already and I agree. My daughter takes 4mg at bedtime (it can make you sleepy) to increase appetite. It’s not magic but can help support the other strategies. Don’t expect him to magically just start eating.
5. Parent-led eating. This is known in the eating disorder world as the Maudsley Method. The parent is in charge of all eating and food decisions until the child is able to take it back over. You decide what his snack is (from a list he has devised) and you make it and take it to him. The same goes for meals. This 3 hour increment of meals equates to 3 meals and 2 snacks - all 3 hours apart. I have to continue this with my daughter because she just isn’t very interested in food (due to her ARFID diagnosis). I hope that one day she takes over her eating.
6. Get professional help. If his growth chart isn’t showing him thriving I would get help now. This is the measurement tool the dietician uses. He is the prime age for an eating disorder to take hold - and boys are not immune. I suggest getting professional help from an eating disorder clinic or registered dietician well versed in ARFID. Even though the method isn’t difficult, the support is what keeps one going.
I was blindsided that my daughter ended up with an eating disorder. I never thought it could happen to us but it did. You are smart to jump on this now. I’m here if you need support!
So sorry to hear what you & your daughter are going through! I hope your doctors and other caretakers are at least compassionate regarding the eating disorders. The majority of the doctors I've talked to about food/nutrition, in general, have been very dismissive about the picky eating and have actually said things like "if he lived in my house, this picky eating would have ended a long time ago!" I heard that 2 weeks ago. Hopefully, the ones working in the eating disorder clinics know better. If you and I could snap our fingers and fix the problems we would!
I'm going to try to incorporate some of your suggestions with all of my kids. They're all picky eaters, but it is more of an issue with the one on the ADHD meds.
Thank you! She is going to be okay. It’s hard, but we’re going to be okay. Going forward I am changing her regular pediatrician to one who is experienced with eating disorders. What you say about dismissive doctors is horrifying and I can relate. It’s hard to believe they could be so clueless about the damage they do with their authoritative stand and shaming demeanor. That helps no one and actually makes things worse. I appreciate your post. What a doctor specializes in or has a “special interest” in matters. We must be sure to check out their bios on their websites!
Great ideas above and great insights. Just wanted to note that bento box /multi compartment lunch boxes help too. Offering a lot of choices means something is more likely to get eaten: cubes of cheese, slices of meat, daily different variety of fresh cut fruit and veggies, hummus, boiled egg, pretzels, seeds, peanut butter crackers, trail mix, nuts, etc. You can also use silicon baking cups to make your own bento size portions. Good luck!
My grandson, who is now a high school senior and 6'3", never ate well on some medications. He was always at the bottom of the weight chart. But his pediatrician always told me he was healthy, that he saw so many overweight kids in his practice that he would much rather see this. He is still thin. Does not eat lunch at school because he doesn't like the cafeteria food and does not want to take a lunch. Also has a hang-up about eating in front of others.
He eats a huge breakfast and has an after-school snack as soon as he gets home. He is heathy and happy.
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