Skinny Kids: 12 possible causes

Submitted by on April 3, 2012 – 8:18 pm57 Comments
thin girl playing by the water

Is your child too thin? ZisBoomBah’s nutrition experts talks about possible causes – some harmless, others reason for concern.

Parents of skinny kids need information about causes and solutions for their too skinny kids, but it seems like everybody is talking about childhood obesity. The Internet is buzzing with warnings about adverse long-term effects of kids’ unhealthy diets. Well-intentioned advice for parents of overweight children is abundant. But what about too skinny kids (below the 5th percentile on the CDC growth charts for boys and girls)? What is the healthiest way for these children to obtain a healthy weight?

When this short article on How to Help Skinny Kids Gain Weight ranked among the most popular reads on our blog week after week, we quickly realized why this might be. There simply isn’t much solid, relevant information out there for parents of children who are too thin – let alone tips for helping kids reach a healthy weight in a sensible way (meaning, NOT by feeding them a Happy Meal every day).

I sat down with ZisBoomBah nutrition expert Lisa Lanzano, MS, RD to talk about possible reasons why a child might be very skinny and when to be concerned.

Reasons why your child might be very thin — examine these for keys to a healthy weight

  1. Genetics. If being very skinny runs in your or your spouse’s family, chances are one of you has said this before: “I looked exactly like that when I was a child!”
  2. Your child is very active and burns a large amount of calories throughout the day.
  3. Your child is a fidgeter. “If your child fidgets a lot, his body is moving all the time, expending energy,” Lisa said. He probably even burns extra calories while watching TV.
  4. Your child is very muscular. “More muscle mass burns more calories”, our expert reminded parents.
  5. Your child has a poor appetite. “Your child could also be depressed, overtired or overstressed and then the appetite goes down,” Lisa explained. “Toxic dynamics at the dinner table can be an issue too.” Talk to your pediatrician about possible reasons and to rule out a more serious cause.
  6. Your child is a picky eater. This reason is very similar to the one above and might be difficult to distinguish. The difference is that you have ruled out underlying medical concerns.
  7. Your child has an undiagnosed food allergy or sensitivity. This in itself could lead to poor appetite. “If a child’s tummy hurts every time she eats, she is not going to want to eat,” Lisa explained.
  8. Other medical reasons – “With celiac [gluten-intolerance], for example, a child does not absorb enough food,” Lisa said.
  9. Your child’s diet is unhealthy. If your kid eats too much overly processed food, his taste buds are trained to like very sugary and very salty foods. “Then nutrient-rich whole foods don’t taste as good,” Lisa said. As a result, your child is missing out on these wholesome foods that would help him maintain a good weight.
  10. Too much fiber in your child’s diet. “Too much fiber causes unpleasant bloating and, as a consequence, your child might not want to eat as much,” Lisa said.
  11. Your child is lacking vitamins or minerals. For example, according to our nutrition expert, low zinc intake is associated with decreased sense of smell and taste. Thus, your child might not be able to enjoy food as much. “Also, low iron, low folic acid (folaid) and low vitamin B12 all can reduce your child’s energy level, which eventually reduces a child’s desire to eat enough,” she said.
  12. Your child’s or your relationship to eating is disordered. “Some parents withhold food or certain foods from their children—intentionally or unintentionally—because they don’t like these foods themselves,” Lisa said. “Or maybe the mother is on a long-term weight loss diet and cooks with little or no oil or butter, uses only skim milk for the family, etc.” Without fat in their diet, children’s bodies can’t absorb vitamins A and D. What’s more, Lisa said, “Kids need carbs.”

[Read our related article: Picky Eating or Eating Disorder? Know the Difference and When to get Help]

Lisa had one last comment to add. She knows from experience, that parents can get concerned about how little food kids are eating. “Small amounts could be just fine. Kids don’t need to eat as much as adults, and some parents can’t judge that,” she said. This article is not about children at a healthy weight who are not big eaters, but rather addresses parents of children who weigh less than experts recommended for their height.

Check back next week for tips on how to boost every meal and snack for weight gain.

We also spoke with moms of skinny kids about the problems and comments they face every day and what they do to help their children achieve a healthy weight.

Update: When we posted this article on ZisBoomBah’s Facebook page, one reader and concerned mom of a skinny girl posed the question how you would know if a child is malnourished, even if she seems happy and active. We had a feeling that this is queite possibly the number one question of parents of skinny kids, so we asked one of our nutrition experts, and turned her answer into this blog post: “Skinny Kids: How do you know your child is malnourished

Are you the parent of a skinny child? Do you find your child described under any of the reasons above? Please share your experience in the comment section below.

Also read: “Every Bite Counts: Boost meals for healthy weight gain

There is help for parents with skinny kids. Pinpointing the causes and determining the solutions that work well for your own child is the best way for parents to help skinny kids get to a healthy weight. 

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Categories: General, Healthy Meals and Activities for Kids, Issues, Skinny Kids

57 Comments »

  • Malia Cable says:

    Hi Lisa,

    While it is not recommended children eat bean burritos for all meals of the day, they will not make him fat. If you are concerned about your son’s weight, I would suggest keeping track of his weight every few weeks or so to see if he is losing any weight, or if he is staying stable. Try telling your son that by eating a well-balanced meal consisting of a lean protein, a whole-grain starch and fresh fruits/vegetables – his body will get it right every time! While we don’t want to eat processed foods on a usual basis it is okay to have processed foods occasionally (once per week at most).
    Malia Cable, RDN
    Registered Dietitian Nutritionist
    School Nutrition Dietitian
    970.818.2174
    Malia.cable@gmail.com

  • Malia Cable says:

    Hi Christopher,

    It may be that your son’s metabolism is very high and is able to keep up with the amount of food he’s eating! While this may be a reasonable eating pattern right now, while he’s young, it may not carry over well into adulthood. I would suggest that you talk to your son about lean proteins like chicken breast, turkey breast, and lean steak. Grain are best when they are whole, this means whole wheat flour in bread products, brown rice, popcorn, and quinoa – being whole grain, the food is digests at a slower rate than a simple carbohydrate and has less of an impact on blood sugars. And fats should be primarily made up of mono and polyunsaturated fats. This means the fat is liquid at room temperature – olive oil, canola oil, almond oil. Fats that are solid at room temperature are primarily made of saturated fats which can clog the arteries and lead to heart disease – i.e. lard.
    Malia Cable, RDN
    Registered Dietitian Nutritionist
    School Nutrition Dietitian
    970.818.2174
    Malia.Cable@gmail.com

  • Malia Cable says:

    Melissa,

    Have you gotten your daughter tested for food intolerances or allergies which may be the cause of the stomach aches? If there isn’t anything indicating a food intolerance or allergy, I would suggest keeping an eye on your daughter’s food intake and ensuring it is adequate for a gymnast. They typically need an extra few hundred calories on days they train. I would also suggest providing her with foods that follow a sports nutrition plan. This could look like – a high-carb (sugar) low-fiber food just before exercise (grapes, juice) and every hour she continues to exercise. Then immediately after exercise, provide her with a high-protein low-carb snack to rebuild muscles (hard-boiled egg, 2 oz chicken breast, Greek yogurt). This could help your daughter keep her lean muscle mass up and keep her weight stable.
    Malia Cable, RDN
    Registered Dietitian Nutritionist
    School Nutrition Dietitian
    970.818.2174
    Malia.Cable@gmail.com

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  • Karen Laszlo says:

    A couple of things concern me here. There may be a few things happening. It may not be ADHD (and I’m not a psychologist but I wouldn’t rule it out just yet — it may be worth a few sessions to see what happens) but I’d suspect at least something behavioral and here’s why: He says he’s hungry and then he denies it when you give him food. He’s been able to hone his diet down to his most favorite foods and may keep doing so until he is allowed to live only on those foods. He’s also getting a lot of attention for his efforts (the gagging, the complaints of an upset tummy, and on) and he may be loathe to give that up. There can be a payoff for him by seeing you get stressed when he turns down food he usually likes. The attention can be alluring to a 5-year-old who now has mommy exactly where he wants her. Stop begging him to eat and set some limits. Also let him know that when he says he’s hungry and then refuses food, he may not get the food he wants the next time because you won’t believe him. As for the cheese sandwiches and grape juice, those are fine but let him know that there’s a way to get them — he needs to taste (and without gagging) the foods prepared for the regular meal. If he gags, he needs to know he will not get the cheese sandwiches or grape juice. As for juice, it only comes after some food is eaten. If his behavior turns into a food tantrum, do not reward it. Also, if he exhibits lots of these food refusals and you don’t pay it much attention, watch what he does. If he acts out, then it may very well be behavioral. By the way, his tummy may feel funny when it’s been too long without food. As for a second opinion, you might consider a gastroenterologist, just to rule out anything organic going on. Hope this helps.

    Keith-Thomas Ayoob, EdD, RD, FAND
    Associate Clinical Professor
    Department of Pediatrics
    Albert Einstein College of Medicine
    1165 Morris Park Ave. 4th Floor
    Bronx, NY 10461
    718-430-3970 ext. 6412
    T: @KeithAyoob

  • Karen Laszlo says:

    I’m not sure how tall your son is but 50 pounds for a 7-year-old or average height is about the right weight. He may have more muscle and thus less fat, because he’s physically active in sports, so he looks a bit different because his weight is concentrated in different places (where he needs it!). Not sure about his bones hurting, unless he’s having a bit of a growth spurt and what he’s feeling are literally “growing pains” that happen when bones expand. This can often be more noticeable at night. His pediatrician isn’t worried, and that’s a great sign. If his appetite is good, he’s probably finding that he’s more interested in physical activity than in sedentary things and “can’t get enough” of those things he likes doing. A few healthful weight-gain foods are these: nut and dried fruit mixes are excellent for providing loads of nutrients with extra calories. Ditto peanut butter but try almond butter on whole-grain crackers or bread, or even spread onto apple slices for a good boost of nutrition and calories. Add nut butters to smoothies as well. Take advantage of full-fat dairy whole milk, full-fat Greek yogurt, cheese) for high-protein nutrition. After physical activity, flavored milk actually rehydrates athletes and helps repair muscle. And who doesn’t like cheese? Grate it and add it to his vegetables, salads, potatoes, melt it on bread, and on and on. Above all, make sure he eats breakfast and step it up here. Leftovers from last night’s dinner, or a quick omelet or scrambled eggs or grilled cheese can fill out his breakfast instead of — or in addition to — his cereal and milk. Follow-up with his pediatrician in a few months after trying some of these and see where he is. Chances are he’ll feel fine and enjoy his new nutrition boosters.

    Keith-Thomas Ayoob, EdD, RD, FAND
    Associate Clinical Professor
    Department of Pediatrics
    Albert Einstein College of Medicine
    1165 Morris Park Ave. 4th Floor
    Bronx, NY 10461

  • Karen Laszlo says:

    If his height is average and his weight is about 46 pounds, then his weight is within normal limits for his height. His diet is more limited due to his allergies, and avoiding gluten, eggs, and dairy knocks out foods that can supply a good amount of calories. His pediatrician has looked at his lab work and doesn’t feel that further evaluation is needed, and that’s great news. If he’s growing normally, and he hasn’t gained weight in a year, remember that he also instituted a new and more restricted diet at about the same time as his weight stabilized. Focus on high-calorie, nutritious foods he is able to tolerate. Make him smoothies with soy milk, peanut butter and fresh fruit. Consider trying soy yogurt and soy cheese. Spread nut butters on gluten-free bread and crackers, and nuts and dried fruit are loaded with good healthy nutrition and high in calories. Make a home-made granola with the grains he tolerates, along with nuts, dried fruit, etc. that he can eat with soy milk. Granola is usually way-high in calories from the nuts and oil it contains. He can also keep trail mix (make your own or buy ready-made but check labels for any possible allergens) in his book bag as a go-to snack when he’s away from home as well. These hints should help get him on his way to appropriate weight gain that keeps up with his growth.

    Keith-Thomas Ayoob, EdD, RD, FAND
    Associate Clinical Professor
    Department of Pediatrics
    Albert Einstein College of Medicine
    1165 Morris Park Ave. 4th Floor
    Bronx, NY 10461

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