Endocronologist (Pediatric) Questions Metabolic Disorders

How can I help my son gain weight?

My 11-year-old son is so thin, and it seems like no matter what he eats he stays the same size. Could it be a medical problem, like with his hormones? What should we do?

7 Answers

Yes, he could. It could be hormonal, digestive, or neuropsychiatric. You need to go to a pediatrician!
Take him to a pediatric endocrinologist to have a complete evaluation.
Yes it could be hormones but it could be other things. He may be normal but has genetics for thinness or he may just be a little late for entering the growth spurt that comes next before puberty. A lack of growth hormone could also be the cause.Take him to a pediatric endocrinologist to have him evaluated. He can be tested for hormone lack & this can be treated.
Your concern is quite common among parents and care givers. I will assume you have had this child taken to the paediatrician who has said he is doing well.
For most part children have a high rate of metabolism and are still in a growth phase. They will grow slim and this can be quite normal and healthy. He will grow vertical until age 17 /18 years then after this he will be putting on weight or "go side ways". You have various flow charts of weight vs. height / age that can be easily accessed on the web which will tell you the expected weight for his age / height.. check them out..

Michael James
Thinness or failure to thrive could be due to inadequate weight gain or inappropriate weight loss. These conditions may be due to poor appetite, poor calorie intake, malabsorption or excessive calorie expenditure.
Many children with poor appetite due to various reasons, may have failure to thrive. Failure to thrive may also take place while appetite is normal. In this scenario the child may have either malabsorption or excessive calories expenditure. Malabsorption may be due to gastrointestinal issues such as celiac disease, lactose intolerance, protein allergy etc. And excessive calories expenditure could be due to hyperthyroid, anemia, heart disease, cystic fibrosis, diabetes and other diseases that reguire more calories expenditure. Some children who have good appetite may not gain optimum weight as these children may have constitutional underweight which is a normal variant of growth.
Most children gain weight in a predictable fashion. A new born child baby is about 7.5 pounds at birth. Birth weight is doubled at 3 months and tripled at one year. At age 5 years the average child is 40 pounds in weight. Thereafter the child (boys) gains about 5 pounds untill the age of puberty 12 years. After the age of 12 years the average child gains about 9 pounds per year until adulthood. A simple formula could be also used to calculate the weight of a child after the age of 1 year. (age x 4.4 pounds +18 pounds = average weight of a child at that age). Linear height growth also follows a predictable process. The formula for height after the age of 1 year is as follows: age x 5cm + 80 cm = the height in centimeter of the average child for that age. To covert this to inches, simply divide it by 2.54.
Children who have poor appetite and or have failure to thrive, those children whose weight is less than 20% of thier hieght or those who fell 2 or more centiles of the wieght growth curve or the ones whose weight is below the 3rd percentile, need proper evaluation by an expert. Medical, hormonal genetic, psychological and environmental factors should be ruled out.
Children who have poor appetite and those who are picky and Small eaters and those with failure to thrive need to be provided with high calorie foods. They need to eat more frequently and should always have bedtime snacks. Calories can be fortified with cheese, creams, peanut butter, butter and oil. Seeing a good nutritionist will also be very important. Nutritional consultation will help in understanding of nutritional values of different foods and micronutrients. If indicated some children can benefit from apettite stimulating agents. Cyproheptadine is commonly used for this purpose. 2-4 mg three times a day half hour before meals may help. Oxandrolone 5-10 mg can be considered for some children. Progesterone base medications ( such as megace) are reserved for serious illnesses such as cystic fibrosis and wasting syndromes. These things should be discussed with the physician if they are ever indicated. The most important thing is optimizing calorie intake.
Going back to your question: If your son have a normal linear hieght growth but his weight is low or has poor appetite, he may have a constitutional underweight which is a normal variation. But if linear hieght growth is affected, he may have more issues going on. If your son has a good appetite and is not a small or a picky eater and, his height is normal that is likely his genetic program. It is important that you have him see his doctor and have him proper evaluation and get referral if indicated. Basic work up should be performed to rule out hormonal and medical conditions. You should also see a good nutritionist to help you appreciate different foods and nutrients. You should optimize calorie intake as much as you can. Add Cheese, butter, oil etc to his food. Let him eat high calorie foods more frequently at least 6 times (three meals and three snacks) a day and remember to provide him with high calorie bedtime snacks. Ask your doctor if he can benefit from weight promoting agents if indicated. The most important thing is to work with your doctor closely.
Good luck.
If you truly have given your son more than enough to eat and he hasn't gained weight then your son should be checked for any underlying disorders that may prevent him from gaining weight. I would take him to his doctor if he is not gaining any weight or even losing weight.
Has he always been thin but steadily gaining? Is he getting the calories he needs? Try adding vitamins. If he has not been gaining further workup is needed