How to talk to teen son

[Forestgarden]

Hi there, this is my first post on this forum, apologies for the length! My 16 year old son has been below the 1st centile for bmi for several years. A few years ago (4?) he was seen by a paediatric consultant who concluded there was nothing physically wrong, he just needed to eat more. We've struggled on. His height has shot up, but his weight has not. He eats very little during the day. He does not eat breakfast but recently has managed a glass of oatmilk before school. In the last couple of weeks he has started to take a chicken sandwich to school because he doesn't like the ones in the shops. He doesn't always eat it though. After school he often won't eat until dinner. He's started waiting to eat until after the rest of the family have finished. He has a reasonable portion. Then, late evening 10/11pm and later he will snack (meat pie, ham roll, vegan yogurt). Dairy makes him constipated, so he mostly tries to avoid it. He seems to go between bouts of diarrhoea and constipation. He avoids onions and artificial sweeteners, but we haven't figured out what else affects him. These intolerances are presumably ibs symptoms. I think he was tested for coeliac, and was negative. His sleep routine is atrocious. At weekends he will game all night, going to bed at 4 or 5am, sleep all day, then be a zombie for half the week when he has to get up at 7am for school. We have now put some controls on his pc to shut it down at a more reasonable hour as he seems to not be able to do that himself. Obviously this has not gone down well. He's intelligent and we've talked about routine for sleep as well as eating regularly, and he understands, but can't seem to follow through. He says he never feels hungry. Body image: he's obviously more self aware now and has started going to the gym with friends, and has bought some protein powder mix. He obviously wants to increase his muscle, not least because he has a pigeon chest (pectus carinatum) which he wears a brace for at home (never out of the house). How do I get him into a proper sleeping and eating routine? I believe his lack of hunger is due to him not recognising the signals. What to do?? How do we sort this mess out?

[LoveforAll41]

Hi Forestgarden... there aren't many posts in this forum so I haven't checked it in some time. I have binge eating issues so kind of on the other side of the spectrum. I feel like almost always where there is an eating disorder or disordered eating that there are some psychological issues. Children are resilient and can cope with stuff in interesting ways. It sounds like he has friends and goes out, so it doesn't sound like he is depressed. I would guess he has some anxiety. I did all through highschool and was pretty high-achieving, then crapped out after highschool in college. I would imagine that much of the IBS symptoms are caused by anxiety.

I am not sure how you would get him to see a therapist... maybe a kind of performance coach person could work with him. Anxiety for me in HS was really apparent in the mornings, I was anxious and did not want to go to school and was grumpy, but I did not realize it was anxiety. I had sweaty armpits all the time too from anxiety, didn't know what that was about. I hope you can find an open and loving, understanding way to talk about these things.

There is a book intuitive eating my therapist recommended, I haven't gotten to it yet. There is a podcast with Dr. Nina about eating disorders and why we have them. You have to get to the root cause. I wish you both peace, hope, strength, and gains😅☮️