“My son just doesn’t feel hungry on his own. Should I get some tests done?”
My son always has to be forced to eat. He just doesn’t feel hungry on his own. I am now beginning to wonder if could it be due to some hormonal imbalance in the body?
4 Answers
Daily multivitamins and vitamin C before the meal could stimulate appetite. Also, routine time for meals is important.
Appetite is a desire to eat food. It is mostly driven by hunger. But sometimes appealing foods can trigger appetite while the person may not be hungry. Satiety or fullness lowers hunger. Hunger and satiety are mediated by hormones such as ghrelin, leptin, neuropeptide Y etc. Appetite helps us get sufficient calories to fulfill our growth, repair and metabolic needs. Poor appetite could be due to medical, psychological, gentic or environmental factors. In teens and adolescent Anaroxia Nervosa is a common cause of poor appetite. Children with Anorexia may restrict food, purge or excercise excessively because they have intense fear of weight gain or they may think they are fat though they are not.
Many children with poor appetite due to various reasons, may have failure to thrive. Failure to thrive may happen in the setting of good appetite. In this scenario the child may have either malabsorption or excessive calories expenditure. Malabsorption may be due to gastrointestinal issues such as celiac. And excessive calories expenditure could be due to hyperthyroid, anemia, heart disease, cystic fibrosis and other diseases that reguire more calories intake.
Most children gain weight in a predictable fashion. A new born child is about 7.5 pounds. 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.
Many children with poor appetite but who have reasonable linear hieght growth may have a constitutional under weight, which is a variation of normal growth. 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. 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 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. It is important that you have him see his doctor and have him proper evaluation and get referral if indicated. You should also see a good nutritionist. You should optimize calorie intake. Add Cheese, butter, oil etc to his food. Let him eat high calorie foods more frequently at least 6 times a day and provide him high calorie bedtime snacks.
Discuss with your doctor if appetite stimulating agents are indicated.
Good luck.
Many children with poor appetite due to various reasons, may have failure to thrive. Failure to thrive may happen in the setting of good appetite. In this scenario the child may have either malabsorption or excessive calories expenditure. Malabsorption may be due to gastrointestinal issues such as celiac. And excessive calories expenditure could be due to hyperthyroid, anemia, heart disease, cystic fibrosis and other diseases that reguire more calories intake.
Most children gain weight in a predictable fashion. A new born child is about 7.5 pounds. 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.
Many children with poor appetite but who have reasonable linear hieght growth may have a constitutional under weight, which is a variation of normal growth. 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. 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 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. It is important that you have him see his doctor and have him proper evaluation and get referral if indicated. You should also see a good nutritionist. You should optimize calorie intake. Add Cheese, butter, oil etc to his food. Let him eat high calorie foods more frequently at least 6 times a day and provide him high calorie bedtime snacks.
Discuss with your doctor if appetite stimulating agents are indicated.
Good luck.
As long his weight and height are appropriate for his age you don't need to be concerned about it.
If your son is normal height and weight, this may not be a problem. However, it sounds like he should be seen by a physician. Most hormone problems do not cause a problem with not feeling hungry. I would think of a gastrointestinal problem more likely.
