Appetite and Nighttime Eating

[IrishEyes1]

My 7 yo is currently on 15 mg of Focalin daily. I know the medication suppresses appetite during the day, but in the evening he eats enough food for a grown man. Does anyone else have this experience?

We try to not let him eat snacks when he comes home from his after school program (around 5:30) so that he’ll eat dinner. We’re not always successful. He does have snacks while at the program so it is not as though he goes without any food after school.

He’ll eat dinner and say he’s full but then come back within an hour to have more. Additionally, nightly when it is time for bed, he’ll say he is hungry. At that time he tends to want 'snack' like things such as applesauce, graham or animal crackers. He does not like sweets - so that is in our favor.

I struggle with the bedtime eating as I don’t know if it is a stalling tactic. He will eat though, so it makes me believe he truly was hungry. Ideally I would not have him eat right before bed so he has time to digest, but he has not complained.

He is thin, but the doctors are not concerned about growth or weight gain. I am struggling with letting things remain as it or trying to enforce a better eating schedule.

[STEM_Dad]

Stimulants reduce appetite in a lot of people who take them. When the medication wears off, if the person hasn't eaten adequately, they will probably be as hungry as if they completely skipped a meal (and possibly they did).

Some strategies that might help:

1. Food that contains protein, and food that contains fiber. (Both are more fulfilling than carbs.)

2. Let him have some say in what he eats. (Giving him a sense of efficacy can help him to be more motivated and interested in eating adequately.

With reduced appetite, one strategy is to add a little protein to meals and snacks. (e.g. meat, eggs, cheese, nuts, peanut butter, beans)

• I usually start my day with a bowl of cereal. I put a spoonful of peanut butter into the bowl before pouring the cereal, which helps me last until lunch so that I don't start snacking.

Dietary fiber sources can include whole grains (e.g. old fashioned oatmeal, whole wheat bread), fresh fruit, and certain vegetables (e.g. carrot sticks).

MAKING IT A ROUTINE

Another part of of is getting your son into a routine. You are there to make sure he eats breakfast, so you can ensure that at least he starts the day off well. While he's away at school, make sure that he knows he needs to eat his lunch.*

Let him have a small, healthy snack when he gets home. e.g. A piece of fruit (or maybe just half), a cheese stick or yogurt cup, or a peanut butter spoon.

GIVE SOME CHOICE

My kids live with their mom during the school week, and if they don't like what's on the school's hot lunch menu for that day, she sends them to school with bento box style lunches. They get some say in what they pack, but they have to choose from the options that she gives them. (Every month of two, she changes some option. She might change back, if they don't like the new option.)

e.g. A sandwich, D'animals (yogurt drink), some apple slices with peanut butter, and a treat like a cookie.

e.g. Crackers with cheese slices and pepperoni, Capri Sun, carrot sticks, and gummi fruit snacks.

*SET EXPECTATIONS

Make sure your son knows what he's expected to eat of his lunch, at the least. (i.e. he has to half of each of the things, before he can eat the treat or go to lunch recess).

Figure out what will work for your son's taste, as well as your family's lifestyle & budget.

{Note: My kids aren't diagnosed with ADHD, though they clearly have some traits. So, they've never been on stimulants. But I have an ADHD diagnosis, and I have been on stimulant medication, before changing to non-stimulants. - When I was on stimulants, they didn't affect my appetite much, but the daily letdown from the meds made me irritable and my ADHD symptoms would return in full. So, I do understand having to deal with the medication wearing off, but in a different way.}

[Alt49]

exact same issue here and we let him eat to ensure he is making up calories from the day. My son usually doesn’t eat a bite between bfast and 4/5pm which is something we are working on improving. Our dr said it’s fine to do this but to ensure he is not binging because that obviously creates an unhealthy habit. I’m not exactly sure the line for binging tbh. My son eats dinner around 5 then eats almost a 2nd dinner around 7. At that time I make sure it’s relatively healthy (yogurt, oatmeal, fruit, peanut butter) and I do try to make sure to set a boundary that this is it. Very rarely he does eat more after he is in bed and when I allow this I truly believe he is very hungry. It’s all definitely not ideal and I wish this wasn’t the case but for us the benefits of the meds definitely outweigh this side effect.

[MomofADHDBoy6]

Hi there. We experience the same thing. I try to do a very filling breakfast and stress that he eats at least some lunch, which he eats a little of. Then he eats dinner, and I have changed our dinner time to 5 so he’s not totally starving and trying to fill on snacks before dinner. Then about an hour after dinner he will want snacks. For us, as long as it’s not sugar snacks I let him eat to make up the calories. Some nights it’s a lot and some nights it’s just a little, but he skips both daytime snacks and most lunch so we are fine with it. I brought it up with his doctor and he said let him eat. It threw me off at first when he started taking his meds, but has become a new eating routine and we have all adjusted pretty well. Hope this helps!

[Mamamichl]

you’re doing great! The only thing I would add is a meal replacer like ensure (or a protein shake) in the morning to keep up calories for the day.

[SurvivorFan]

Yes, same for both my boys. They eat dinner but are really hungry again around 7. We let them eat until 7:45 and then teeth brushed and bed time. That is when they are most hungry and they are on the thin side as well. As long as it's not only unhealthy snacks then why not?

[L26vb]

Same situation- very little or no breakfast, same at lunch and dinner, then around 8pm absolutely starving. Our ADHD Consultant advised to let her eat whatever she wants whenever she wants . Currently that's usually McDonald's or other fast food, chocolate, boiled rice and plain pasta. Her weight and height are measured every 3 months and she has gained a tiny amount. If that changes her Consultant will consider a change of medication. It's not worth setting rules, or being strict or stressed as its beyond the child's control and not their fault. Work with the medical profession and it will help.

[MyWanderfulBoy]

First off, you’re doing great! One thing to consider as time goes on maybe is a different stimulant if you feel he may need to try something else at the time. I believe that if things are fine, don’t rock the boat. But their needs change along the way with medications as they grow. My son was on adderall XR for 2 years and it really kept him from wanting to eat during the day and the effects of the medication eventually weren’t helping as much as they once had, along with some other things that weren’t doing him good. So we started seeing a child psychiatrist who prescribed him Azstarys. It’s in the same family as Focalin. It’s timed release throughout the day in small increments rather than half of the pill being released 30 min after taking it and then another half being released about 4 hrs later like the adderall did which coincided with lunchtime. The new medication has helped him eat throughout the day more than he did before and without the pushback. He still definitely gets distracted from eating but can get back on track with being reminded vs a full refusal to eat.