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Boys and Eating Disorders

Expert Q&A

By Vincent Iannelli, M.D., About.com

Updated: January 23, 2005

About.com Health's Disease and Condition content is reviewed by Kate Grossman, MD

Q. My son is 13 1/2 years old. He was always very overweight and ate mostly junk food like Mcdonalds or pizza most of his life. As he started going through puberty, he grew 4 inches and lost 25 pounds. The problem is he has become obsessed with his weight and continues to lose more and more weight. His highest weight was 169 and now he is down to 117 pounds. He has also changed his diet completely. He has become a health nut and exercises all the time. I have no problem with that part. I am very worried since he is all skin and bones and seems to be very happy about the weight loss. He says he can't get skinny enough. What can I do? All of his relatives keep telling him that he is now "too skinny" including his pediatrician. He only eats healthy foods, but maybe not enough. How can I get him to gain some weight back? Isn't 117 pounds too thin? Meryl, Brooklyn, NY

A. At his age, 117 pounds is actually just above average. That doesn't mean it is a healthy weight for him though. Instead of just looking at a child's weight, it is more important to know what their body mass index is.

Children with a BMI that is below the 5th percentile for their age are usually thought to be underweight. For his weight, he would already have to be over 6 feet tall to have a BMI below the 5th percentile though, so his weight may be okay.

Is he that tall? Since you describe him as being so skinny, he may very well be...

It is important to keep in mind that you can have a normal weight and normal BMI and still have an eating disorder. And you mention may of the common signs and symptoms that would raise some concern that your son has or is developing an eating disorder, including that he:

  • has continued to lose weight, even though he is now 'too skinny'
  • has an obsession with his weight
  • exercises all of the time
  • may not be eating enough food and getting enough calories
Although some of what you mention might be normal, especially that he wants to exercise, eat healthy foods, and be a 'health nut,' the fact that he feels that 'he can't get skinny enough' should probably be considered to be a big warning sign.

At this point, he likely needs a further evaluation from a health professional that has experience treating teens with eating disorders. A registered dietician might be a good place to start. If he really wants to be healthy and not just thin, they might be able to help him plan a healthy diet and make sure he is getting enough calories, vitamins, and other nutrients, to be healthy and continue to grow normally.

A counselor, psychologist, or psychiatrist might also be helpful, as can your Pediatrician, especially if they have developed a good relationship together.

If you are not sure where to take your child, the National Eating Disorder Association offers a referral service and can provide you with 'a list of doctors, nutritionists, counselors, and inpatient and/or outpatient facilities in your area.'

Boys and Eating Disorders

Although eating disorders are more common in teen girls and young women, males can also develop an eating disorder. The incidence of eating disorders in males also seems to be rising, so it is important to also think about eating disorders in teen boys and young men.

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