Underweight teen?

[Anonymous]

My 13 year old son has BMI of 15 which I believe puts him as underweight. His pediatrician said he is mid-puberty and due for his growth spurt soon. She really wants him to try to eat as much as he can so he can achieve his growth potential. He eats 3 normal size meals a day with all the food groups and has a snack or two- but never the ravenous appetite I hear teenage boys having. Never getting seconds. I try to give him smoothies with protein, nuts etc. Many times he’s filled from last meal/snack. Anyone else in same boat? Do some boys just not get a crazy big appetite? If not, will it affect growth?

[Anonymous]

Give it time. Also, does your kid have a sport that he likes? Encourage him to play, practice and get to the gym to lift.

My DS was in the same place, tho his BMI was usually lower. We always had a party when he was actually on the weight chart! We made sure to feed him good foods that appealed to him. (He was a peanut butter fiend, still is) I tried to keep ice cream in the house for dessert because it was a high fat food that had some dairy, calcium, etc in it. Chees itz were another good one. If he likes particular things around, like eggs or rotisserie chickens, I have them.

He started really growing at the tail end of being 14. His appetite increased, but not dramatically until he was a solid 15 and playing his sport A LOT. He realized that practice and meets were better when he was well fed, which led to more weight/muscle, which led to better performance. This kid is a senior now and almost 18. He spends (way too much) time in the gym and at practice, but he needs fuel to do it. He's now 6'2 and 155, which he considers a huge achievement.

[Anonymous]

Is he otherwise healthy OP?
If he is I would keep doing what you’re doing

[Anonymous]

What does your son like to eat? Whatever his favorites are, make sure to keep those around. I have 2 skinny, athletic teens and there’s a shelf in my pantry with their favorites - chocolate peanut butter, granola, cheese popcorn, certain ice cream toppings, these weird little round wheat crackers one of them likes, a certain brand of protein bar, etc. They know they can grab what they want from that shelf whenever they want.

Also - milkshakes. Sometimes it is easier to drink calories. We do protein shakes too but frequently I’ll make my 13 year old a milkshake in the window between getting home from school and having to leave for practice. She would never be able to eat a sandwich or meal equivalent at that time but can manage a milkshake.

What is your son eating at school? Can you maybe figure out a way to get him to eat more at lunch?

[Anonymous]

Yes, my son is this way. He is currently 5’6”-5’7”, 108lbs or so. Mid puberty. Not technically underweight but very skinny for sure. He was more average weight/build before he started puberty- some boys get really skinny during puberty as they start growing in height.

I’ve had to throw a lot of food “rules” out the window the last year or two. I let him have pretty much whatever he wants to eat as long as it is actual food (milkshakes and cheeseburgers great, Cheetos etc no). He does a lot of ice cream, milkshakes, whole chocolate milk, hamburgers, heavy breakfast foods (hash browns eggs and sausage etc), snacks on chicken nuggets and chicken tenders etc. Yesterday he requested pie when I went on a grocery run, and then ate half of a small apple pie piled with whipped cream for dessert.

I realize this sounds terrible in a way…but honestly it is the only way to keep weight on him. He is very active and plays a lot of sports. He isn’t a particularly picky eater but has never had a huge appetite either.

[Anonymous]

We were and sort of still are in the same situation. DS just turned 14 but up until a couple months ago he hadn't grown much in a couple years and was really underweight. Barely any appetite. This summer he grew several inches and while he's eating slightly more, still does not have the ravenous teen boy appetite I keep hearing about. His doctor kept suggesting he needed to eat well but he ate what he ate and that was better than nothing to me. He's also gained weight but is still really skinny and will gladly skip meals if allowed and will rarely say he's hungry. BUT he's growing so I'd say give it time if he is otherwise healthy.

[Anonymous]

We are in this situation. I have found that liquids are much easier for him to get in at high calorie levels than solid food. He regularly has milkshakes that include heavy cream, and each shake is about 600-700 calories. If you're looking for ultra-high-calorie foods whipping cream is pretty incredible (every ounce is 100 calories) and can be added to many things. Our ped GI has said not to worry about protein because most kids get more than enough, and to focus on fat.

[Anonymous]

It sounds like you are using the adult BMI criteria for being underweight. Kids/teens are considered underweight if their BMI “percentile” is less than 5th, when compared to other kids the same age, gender, and height.

Here is the calculator to see if your son is in fact underweight:

https://www.cdc.gov/healthyweight/bmi/calculator.html

[Anonymous]

Same, OP. 13 year old who has dipped on the weight/height chart multiple times over the past few years and we end up back at the ped for 6mth check-ups almost every year. My kid is VERY active, plays a ton of sports, but is a little picky and doesn't have a good appetite. He needs to be very intentional about how he chooses to fuel his body (and we provide all the high protein/calorie options, but left to his own devices he gravitates towards cheez-its and candy) and some days are better than others. He'll rock it for like a week and then get sick of XYZ and only want bananas and chocolate milk. Then I'll find something new and he'll want it every day, and then never again.

His lack of growth started affecting his mental health in middle school. To make sure we turned every stone we got the bone age x-ray through the ped and took him to a pediatric endocrinologist. Bone age showed a year behind (good news, supports late bloomer theory), but his bloodwork through the endocrinologist was a little wonky so he's scheduled for another test. I suspect it'll ultimately be fine and the "answer" will be late bloomer, but we're going to see it through.

[Anonymous]

Anonymous wrote:It sounds like you are using the adult BMI criteria for being underweight. Kids/teens are considered underweight if their BMI “percentile” is less than 5th, when compared to other kids the same age, gender, and height.

Here is the calculator to see if your son is in fact underweight:

https://www.cdc.gov/healthyweight/bmi/calculator.html

OP here, thanks. he’s 2nd percentile for BMI.

[Anonymous]

Anonymous wrote:We are in this situation. I have found that liquids are much easier for him to get in at high calorie levels than solid food. He regularly has milkshakes that include heavy cream, and each shake is about 600-700 calories. If you're looking for ultra-high-calorie foods whipping cream is pretty incredible (every ounce is 100 calories) and can be added to many things. Our ped GI has said not to worry about protein because most kids get more than enough, and to focus on fat.

Thank you for this info! I didn’t know cream had that many calories!

[Anonymous]

Anonymous wrote:Same, OP. 13 year old who has dipped on the weight/height chart multiple times over the past few years and we end up back at the ped for 6mth check-ups almost every year. My kid is VERY active, plays a ton of sports, but is a little picky and doesn't have a good appetite. He needs to be very intentional about how he chooses to fuel his body (and we provide all the high protein/calorie options, but left to his own devices he gravitates towards cheez-its and candy) and some days are better than others. He'll rock it for like a week and then get sick of XYZ and only want bananas and chocolate milk. Then I'll find something new and he'll want it every day, and then never again.

His lack of growth started affecting his mental health in middle school. To make sure we turned every stone we got the bone age x-ray through the ped and took him to a pediatric endocrinologist. Bone age showed a year behind (good news, supports late bloomer theory), but his bloodwork through the endocrinologist was a little wonky so he's scheduled for another test. I suspect it'll ultimately be fine and the "answer" will be late bloomer, but we're going to see it through.

Do you mind me asking what the percentages are? My 14 year old son is typically around 10-15% BMI and between 35-45% height. Our pediatrician says this is not enough to do testing for but he has not grown much in the past few months and I'm wondering if we need to look into things while we still can. He's currently 5'4". Like your child, his appetite isn't great and he's a very inconsistent eater. He does stay fit and goes through spurts of trying to get more protein in but they don't last.

[Anonymous]

We have girls both with bmi % as 3-4%. They haven't hit puberty yet, and one is being overseen by an endocrinologist every 6 months. They both do sports (part of the issue - I think they just burn at a high rate). We try to do 3 meals + 2 snacks. It's a lot of cajoling but the Olean protein shakes (after school) and protein bars (during 3rd period) were really helpful. Our older one was actually losing weight but now she is gaining again (slowly). We also offer milk at bkfast/dinner as opposed to water. I make a huge snack for after school (benefits of telework!) at 5, and then dinner is at 8. I find this gets more calories in overall. After school is when they are hungriest.

[Anonymous]

Coconut oil is the answer. The filtered 'refined' version is flavorless. Melt 3 tablespoons in the microwave and add to a smoothie for 360 undetectable calories. If you do that twice a day it really adds up.

[Anonymous]

My son is similar. 120 at 5'9'' and has always been 20-40%ile. I think he's had his biggest growth spurt but will probably grow a few inches more.

He loves fruits and veggies and will choose them almost every time he cooks or snacks. Doesn't love dairy or meat. Which is challenging.

He also loves junk food. I just went to the TJs and got him: pomegranates, pears, mango fruit snacks and bars, buttered popcorn, chips and salsa, mini chocolate chip cookies, peanut butter cups, and butter chicken to microwave. We keep peanut butter and crackers, ramen (so much ramen, to which he usually adds corn, green onions, cilantro, and cucumber), all kinds of potato chips, hummus and pita or chips, we have tons of candy, and lots of drinks (though he doesn't drink much soda). He goes through tons of ice cream.

Playing a sport year round is challenging. Last night I was waiting in the car after practice and he wasn't coming. When he finally came he said "oh sorry I was late, my friend and I were trying to run a 6 minute mile after practice. we did it before practice too." I was like "cool - WHAT DO YOU WANT TO EAT?"