“My 16 year old old daughter hardly ever has an appetite?”
My 16 year old daughter hardly ever has an appetite. She's stuck at 80lbs, 5’0". No energy. Blood panel and thyroid tested normal. The 16 year old is a step-daughter (mom is bio-mom, I'm step-dad).
-Feels full quickly (after 2 or 3 bites of food).
-Weight seems steady at 80lbs.
-This has been going on for a few years (she's petite, so we were not too concerned when she was 13 or 14).
-A pediatrician has evaluated a complete blood panel and separate thyroid tests and found no issues.
-Workout/exercise - none. due to her procrastination (see below) if she were to workout, she'd complain she's falling behind in her studies due to the time spent working out.
-Depression - none that's obvious
-Substance abuse - none
-Anxiety - yes. On a scale of 1-10, maybe 3 or 4. Mostly anxious over completing school assignments.
-Current medications - birth control. was on accutane last year for about 6 months.
-Fainting spells - twice in her life
-Does she eat healthily? - In general, yes. There are very few fresh vegetables in her diet. The veggies that are present are usually things like peas and carrots that have been simmering in oil and placed in rice. She'll sometimes have soups with vegetables in them. But things like - a side of grilled asparagus or a spinach/kale salad are not a part of the diet. Meats are generally fried in a pan until well-done. She'll consume some fruit - maybe an apple every couple of days, or a berry smoothie for breakfast; but nothing consistent.
-Extreme procrastinator - As an example: if an assignment is due at 11 pm, she'll begin to panic at 9 pm even though she's had 3 days to start the assignment.
Frequently skips lunch and does not eat to finish homework.
-Anorexia? - Not sure. She doesn't have a poor body image, does not exclaim she's "fat" in certain areas, in fact, she acknowledges her lack of weight and appetite.
emotional issues - unknown. She's one of those people that's immediately likable by new friends. She's playful, funny, and makes jokes. Aside from what I would consider normal teenage outbursts concerning cleaning her room, bathroom, or doing laundry - there seem to be no emotional issues. The emotional issues of the divorce (8 years ago) seem long gone, and in fact, she really doesn't feel like being around bio-dad too much (as in - they have nothing in common, not that he’s mean or anything)
I'm not sure what else to add.
Here are my wife's and my current thoughts medically:
-see a nutritionist
-see the same pediatrician again
-see a different pediatrician for a 2nd opinion.
Here are my wife's and my current thoughts non-medically:
-Figure out the procrastination
-Get her to do regular exercises.
Conclusion - we don't know what to do next.
Thank you!
UPDATE: from another "ask a doctor" website, the thought was this may be a psychological issue, and she is anorexic (but in the classic "eating disorder" definition)
-Feels full quickly (after 2 or 3 bites of food).
-Weight seems steady at 80lbs.
-This has been going on for a few years (she's petite, so we were not too concerned when she was 13 or 14).
-A pediatrician has evaluated a complete blood panel and separate thyroid tests and found no issues.
-Workout/exercise - none. due to her procrastination (see below) if she were to workout, she'd complain she's falling behind in her studies due to the time spent working out.
-Depression - none that's obvious
-Substance abuse - none
-Anxiety - yes. On a scale of 1-10, maybe 3 or 4. Mostly anxious over completing school assignments.
-Current medications - birth control. was on accutane last year for about 6 months.
-Fainting spells - twice in her life
-Does she eat healthily? - In general, yes. There are very few fresh vegetables in her diet. The veggies that are present are usually things like peas and carrots that have been simmering in oil and placed in rice. She'll sometimes have soups with vegetables in them. But things like - a side of grilled asparagus or a spinach/kale salad are not a part of the diet. Meats are generally fried in a pan until well-done. She'll consume some fruit - maybe an apple every couple of days, or a berry smoothie for breakfast; but nothing consistent.
-Extreme procrastinator - As an example: if an assignment is due at 11 pm, she'll begin to panic at 9 pm even though she's had 3 days to start the assignment.
Frequently skips lunch and does not eat to finish homework.
-Anorexia? - Not sure. She doesn't have a poor body image, does not exclaim she's "fat" in certain areas, in fact, she acknowledges her lack of weight and appetite.
emotional issues - unknown. She's one of those people that's immediately likable by new friends. She's playful, funny, and makes jokes. Aside from what I would consider normal teenage outbursts concerning cleaning her room, bathroom, or doing laundry - there seem to be no emotional issues. The emotional issues of the divorce (8 years ago) seem long gone, and in fact, she really doesn't feel like being around bio-dad too much (as in - they have nothing in common, not that he’s mean or anything)
I'm not sure what else to add.
Here are my wife's and my current thoughts medically:
-see a nutritionist
-see the same pediatrician again
-see a different pediatrician for a 2nd opinion.
Here are my wife's and my current thoughts non-medically:
-Figure out the procrastination
-Get her to do regular exercises.
Conclusion - we don't know what to do next.
Thank you!
UPDATE: from another "ask a doctor" website, the thought was this may be a psychological issue, and she is anorexic (but in the classic "eating disorder" definition)
Female | 16 years old
Complaint duration: 2
Conditions: minimal appetite
6 Answers
It's important to remember that consulting with a healthcare professional, especially a pediatrician and possibly a mental health specialist, is crucial for a proper evaluation and diagnosis.
Here are some considerations and steps you can take:
1. **Consult with a Pediatrician:** It's a good idea to revisit your daughter's pediatrician, and possibly seek a second opinion, to further investigate her lack of appetite and weight concerns. While her blood panel and thyroid tests were normal, it's important to continue monitoring her health and explore potential underlying medical issues that may not have been identified initially.
2. **Consult with a Mental Health Professional:** Given her history of anxiety and the possibility of an eating disorder, it's essential to consult with a mental health professional who specializes in adolescent mental health and eating disorders. Eating disorders can have complex psychological components, and a thorough assessment is necessary.
3. **Nutritionist Consultation:** Consulting with a registered dietitian or nutritionist can help create a balanced and nutritious meal plan that accommodates her limited appetite and food preferences. They can provide guidance on how to increase nutrient intake while addressing her concerns about feeling full quickly.
4. **Address Procrastination:** Procrastination can be a significant contributor to her overall stress and anxiety, which may further affect her appetite. Consider working with her on time management and organizational skills to help her reduce academic stress and allocate more time for meals.
5. **Promote Regular Physical Activity:** Encouraging regular physical activity can have multiple benefits, including improving appetite, reducing stress, and enhancing overall well-being. Encourage her to engage in activities she enjoys, even if they are not formal workouts.
6. **Open Communication:** Maintain open and non-judgmental communication with your daughter. Let her know that you are there to support her, both physically and emotionally. Listen to her concerns and feelings without pressuring her about eating.
7. **Consider Family Counseling:** Family counseling can be helpful in addressing both the individual's and the family's concerns and dynamics. It can provide a supportive environment for discussions and problem-solving.
8. **Monitor for Warning Signs:** Be vigilant for any signs of deteriorating physical or emotional health, such as significant weight loss, isolation, or an increase in anxiety or depression symptoms. Seek professional help promptly if any concerning signs arise.
Remember that eating disorders, including atypical presentations like avoidant/restrictive food intake disorder (ARFID), can be challenging to diagnose and treat. Early intervention and a multidisciplinary approach that includes medical, nutritional, and mental health components can be most effective.
Ultimately, it's crucial to work closely with healthcare professionals who specialize in adolescent health and eating disorders to determine the most appropriate course of action for your daughter's specific situation.
Here are some considerations and steps you can take:
1. **Consult with a Pediatrician:** It's a good idea to revisit your daughter's pediatrician, and possibly seek a second opinion, to further investigate her lack of appetite and weight concerns. While her blood panel and thyroid tests were normal, it's important to continue monitoring her health and explore potential underlying medical issues that may not have been identified initially.
2. **Consult with a Mental Health Professional:** Given her history of anxiety and the possibility of an eating disorder, it's essential to consult with a mental health professional who specializes in adolescent mental health and eating disorders. Eating disorders can have complex psychological components, and a thorough assessment is necessary.
3. **Nutritionist Consultation:** Consulting with a registered dietitian or nutritionist can help create a balanced and nutritious meal plan that accommodates her limited appetite and food preferences. They can provide guidance on how to increase nutrient intake while addressing her concerns about feeling full quickly.
4. **Address Procrastination:** Procrastination can be a significant contributor to her overall stress and anxiety, which may further affect her appetite. Consider working with her on time management and organizational skills to help her reduce academic stress and allocate more time for meals.
5. **Promote Regular Physical Activity:** Encouraging regular physical activity can have multiple benefits, including improving appetite, reducing stress, and enhancing overall well-being. Encourage her to engage in activities she enjoys, even if they are not formal workouts.
6. **Open Communication:** Maintain open and non-judgmental communication with your daughter. Let her know that you are there to support her, both physically and emotionally. Listen to her concerns and feelings without pressuring her about eating.
7. **Consider Family Counseling:** Family counseling can be helpful in addressing both the individual's and the family's concerns and dynamics. It can provide a supportive environment for discussions and problem-solving.
8. **Monitor for Warning Signs:** Be vigilant for any signs of deteriorating physical or emotional health, such as significant weight loss, isolation, or an increase in anxiety or depression symptoms. Seek professional help promptly if any concerning signs arise.
Remember that eating disorders, including atypical presentations like avoidant/restrictive food intake disorder (ARFID), can be challenging to diagnose and treat. Early intervention and a multidisciplinary approach that includes medical, nutritional, and mental health components can be most effective.
Ultimately, it's crucial to work closely with healthcare professionals who specialize in adolescent health and eating disorders to determine the most appropriate course of action for your daughter's specific situation.
I am not a pediatric gastroenterologist but the eating problem in your step-daughter is most likely the result of anxiety and a hypersenstive stomach. The treatment of choice from a GI standpoint is neuromodulator medication. Of course anxiety should also be treated. See a good pediatric GI doctor to get her feeling better.
Your ideas on how to help her seem reasonable. It might be helpful for her to see a psychiatrist.
Absolutely need to evaluate for anorexia. Another issue to rule out first is gastric outlet obstruction/gastroparesis — screen can be with upper GI series and evaluate gastric emptying. They need to also look at ESR and CRP to see if there is any inflammation. Lastly need to look for systemic disease processes even malignancy in this setting. A pediatric GI should help coordinate all of the above.
Hi, take a look at these links:https://www.healthline.com/health/fatigue-and-loss-of-appetite and https://www.healthline.com/health/appetite-decreased and https://www.buoyhealth.com/learn/loss-of-appetiteand then see a specialist in eating disorders.
I am no pediatrician but I have seen young adults like your stepdaughter. She most likely has an eating disorder. She should see an expert in adolescent eating disorders for an assessment. Physiological tests are usually abnormal with eating disorders so distinguishing one issue from another is difficult. Good luck with this very troubling challenge for this young girl.
