Weight

  My daughter is 13 years old. She is 4'7'' and weighs 60 pounds. She is extremely active in dance. A year ago I consulted our pediatrician about her failure to grow/develop, as I was afraid she may be anorexic. After consultation, he decided she was not, and really needed to add more calories to her diet. By last spring, she had gained a few pounds, but now has lost them again. She has not grown in height, and of course, with no body fat, there are no signs of development. She has no aversion to food, is always willing to eat meals, and will readily admit that she is too thin, and looks "gross." The pediatrician thought she needed about 1500 calories -- I'm thinking she needs about 2500. She eats throughout the day, not just at mealtime. The females on my husband's side are very petite--average adult between 4'10'' and 5'2'' - very few weight problems (only after age 50). Should I be consulting the doctor again?? What will help safely put on weight?

[HVM Ph.D. - KDK]

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Dear Carol,
Anorexia is defined by several criteria: (a) refusal to maintain body weight over a minimal normal weight for age and height, or failure to make expected weight gain during period of growth, leading to body weight 15% below what would be expected; (b) intense fear of gaining weight or becoming fat, even though underweight; (c) disturbance in the way in which one's body weight, size, or shape is experienced; and (d) in females, absence of at least three consecutive menstrual cycles when otherwise expected to occur. As your note indicates, your daughter is certainly not developing physically (re: weight and pubertal onset) in the way that would normally be expected. You would be wise to consult your physician again, particularly since the last consult was about one year ago and the past year would have been a time when, normally, some weight gain and development could reasonably have been expected. I am not qualified to answer your question about what might be a sensible plan to help your daughter safely put on weight. A consultation with a nutritionist might be very useful to you - perhaps your physician could help you with that.
This information is provided for general medical education purposes only. Consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
*Keyword: weight, anorexia