It's not me. It's my son.

WinKitty

And he doesn't need to lose weight. He needs to gain it.

Background info: He'll be 12 in a few months, and he weighs 75 pounds. He's weighed 75 pounds for over 2 years. He gained 2 in the last year. It's muscle weight. He's a (very good) swimmer, and swims 1.5 hours a day, 5 days a week, and loves it. He has a 6-pack, he's that athletic. I know this burns a lot of calories, but it's the only thing he truly loves to do, and it's a good habit to get into. I don't want him to be fat like me. He's a little short for his age, but that will change soon (puberty), and I expect him to sprout up, but not gain any weight. He has ADD and he takes a stimulant medication called Focalin to help him focus in school. I know this can stunt growth, but he's still growing upwards at a normal rate for his growth history. Also, he is not hyperactive and doesn't have behavioral problems. The doctors are slightly concerned but can't really do too much for him because by definition, he's not "underweight" (he's getting ever closer though) or failing to thrive. They won't refer me to a nutritionist. They just tell me to have him eat more, more often, but they're not telling me what KINDS of foods to feed him. Some say more fat, some say healthy snacks. When he eats, he EATS. Makes me wonder where all that food could possibly go! But there are just some days that he has no appetite (I suspect the medication, but this medication is the only one that works for him, with the fewest side effects). This whole, "feed him more food" thing is not working.

Questions: Should I cut back his swimming? Should I introduce more fats? Should I introduce protein? Should he be doing a different kind of activity/exercise?

pretentiouskate

I would say that if his current doctors wont refer you to a dietician (which is, I suspect, what you want, rather than a nutritionist, as a dietician is licensed), either a) find a new doctor or b) find the dietician yourself and, if you can afford it, pay out of pocket/try to get insurance to cover it without the referal.

emilex

I guess I am wondering why you feel like he needs to gain? If he isn't under weight.. and his doctors are not concerned...what makes you want to have him gaining?
I have 2 daughters who are both very small, naturally. As long as they are eating healthy and they don't have any complicating health problems....I think it's ok. They are who they are.

Tzavush

Do the doctors feel he is unhealthy?
Are you concerned that he is not healthy?

Remember the scale is just a number.
Sometimes I think that we can obsess too much on either side.

If the doctors are concerned that he is not meeting the developmental milestones/growth milestones for his age they should make more definitive recommendations.
If you are very concerned I would highly recommend seeing a Registered Dietician who can help add in the necessary things to his diet that may be needed.

pyro13g

Protein and Fats. Give him one more meal a day. There are also drinks(last resort) for weight gain. I had to drink a few in the hospital once. Do not reduce his swimming. wrong message.

Vick_MN

My son is 15 and also takes meds for ADD. My son also is not hyperactive and does not have behavioral problems so what we do is on weekends and anytime he has a break from school (including the entire summer) we do NOT have him take any meds. I also make sure that he has a big breakfast in the morning before he takes his meds, Also, around 6:00 pm or so when the meds to wear off, it seems like he wants to eat non stop so we have moved our dinner time back so that he eats a good supper. He then snacks pretty much all evening long. He is still rather thin but this has helped him quite a bit. When he was younger, I also used to make milk shakes using Boost so at least I knew he was getting good nutrients.

kacarter1017

I would say that if his current doctors wont refer you to a dietician (which is, I suspect, what you want, rather than a nutritionist, as a dietician is licensed), either a) find a new doctor or b) find the dietician yourself and, if you can afford it, pay out of pocket/try to get insurance to cover it without the referal.

Yep. Dietician, not nutritionist. You want to keep his calorie intake much like on this site- 40/30/30, but just more of them. Keep it healthy foods and as little processed stuff as possible. At the end of 7th grade (age 12), my son was 4'9" and 80 pounds. he ran cross country, played basketball, and ran long distance track. He was healthy, doing well in school, etc. Just kept an eye on him and made sure he had plenty of healthy choices for snacks/meals. He is now end of 9th grade, 14, 5'10" and 114 pounds. STILL skinny, but healthy, doing well in school, etc. His growth has continued to track as would be expected. This, combined with school performance, athletic performance, sleep, are very good indicators of the overall health of your child. Getting some input from a dietician may give you ideas to help feed his furnace!

Lizzy_Sunflower

I have the same problem with my boys... What I have been doing is giving them tons of food before the meds kick in (in the morning including smoothies packed with fruit, protein powder yogurt whatever...or even just carnation instant breakfast added to their whole milk) and after they wear off (evenings). Also it helps for me to pack lunch instead of having them eat school lunch (I found our they weren't eating lunch cos they didn't like what they served). So I buy high density foods for them (light bread for me, rich wole grains for them, full fat dairy fir them lower fat for me...etc...). So yeah, high calorie....mixing it up (higher fats or high protein. Just high calorie in general)
Good luck!! And keep me posted

diaryoffatdad

Do not reduce his activity levels, if anything we should be encouraging our children to be more active.
Never Never tell a kid they are being too active

try seeking out a dietitian on your own, seek out another doctor if you need the refferal, perhaps it might be worth looking into a doctor with a sports medicine background (i know in my experience they are much much better at understanding activity levels and nutrition and would probably be more inclined to help your son before he hits the 'underweight' level.)

the problem with north american medical systems is that there is very very little emphasis placed on prevention, the doctors won't help you untill you have a medical condition, even if you are approaching the condition and they can clearly see that.

So perhaps you increse his portions a little, encourage healthy snacking, increase protein, and perhaps there are other medical alternatives to his medication, i know nothing about it but is there other drug options that might not stunt his growth or effect his appitite? just a thought.....

emilex

The more I think about this, the more I want to stress a couple things that I didn't in my first response. As a therapist...I think the worst thing you can do for people/kids who have ADD or ADHD (or any brain disorder for that matter) is cut out or reduce their physical activity. Particularly for ADD or ADHD children or adults, physical activity and sports are a really important and appropriate outlet. Michael Phelps is a good example of this. Again, I am not sure what the reason for your concern is, but if his weight is negatively impacting his health I think other posters are right in that a registered dietitian might be helpful however, reducing his activity level is not a good idea.

WinKitty

Thank you all for your feedback. It is much appreciated.

FairyMiss

when my son adhd was on focalin he was thin, and even worse when he was on concerta (though it worked great til he started getting ticks). his doctor was not worried about the thinnes. mainly because he knew why he was not gaining i would take him off the meds in summer to let him 'catch up'. now on adderall he is holding his weight wll

bcweisen

You can't take him away from something he loves. Maybe try Boost shakes. They are the balanced nutrition used in hospitals and healthcare for patients who are not eating enough "real" food or are under-nourished. I think pushing too much fat or too much protein at his pre-pubescent body could interfere with his metabolism. Try the healthy snacks and balanced calories. But even if he's not hungry, it's pretty easy to get a shake down.

monkeybelle83

Whatever you do, do NOT just feed him junk food. My cousin had ADD and was on medication. His doctor told his mom to just let him eat whatever he wanted, however much he wanted. He now struggles with obesity and changing his eating habits.

glamazonjenn

I too have an almost 12 year old son...he is adhd...he too is very thin. Not so thin that the docs worry. I try to feed him whenever he is hungry...the meds take the hunger away. I have pushed some fatty foods but more good fats like nuts...peanut butter...he even likes to snack on slim jims. Bars are another way to get calories in but not junk food. I don't think you should stop the sports at all! I think our boys will put weight on eventually. I am trying to ween down the meds with my son. He and I are hoping to have him off meds in high school. Not sure that will happen but hoping so. Eating is a stuggle for him at times though for sure....even tonight he said I put to much on his plate...not true...however I just asked him to make himself eat 6 more bites. He did and then later tonight I asked him if he would like some pretzels and he ate. I just keep asking. I know it is tough and if you ever want an ear..shoot me an email. I know how it feels.
On a side note...I wasn't on meds as a kid...I was a swimmer and played other sports too...I ate like a freakin horse... almost always whole and good foods...and people still accused my parents of not feeding me enough or would tell them to have me checked for eating disorders....and here I am...battling the bulge....kids that are athletic and don't sit around and eat and don't have a bunch of junk food around are just thin sometimes!!!