How to Help the Child with ADHD Who Isn’t Eating Well
November 26, 2023
Children with ADHD often struggle with appetite. Learn why children with ADHD lose their appetite and what you can do about it.
Kids with Attention Deficit Hyperactivity Disorder (ADHD) often experience loss of appetite due to the use of medications in the treatment of the symptoms of ADHD. Many families worry that their child is not eating well and look for ways to help.
As a pediatric dietitian, I’ve cared for kids with ADHD. One of the common concerns is the use of ADHD medication and how it may cause irregular eating patterns leading to weight loss. It’s one thing for your child to lose his appetite, but a more serious issue when this is accompanied by weight loss or an underweight status.
Is your child with ADHD losing weight? Stating they’re not hungry? Losing their appetite?
In this article, you will learn:
- why children with ADHD experience a loss of appetite
- how to increase appetite in children with ADHD when needed
- and how to help your child gain weight.
Erratic Eating and Appetite Swings in Children with ADHD
Tyler had ADHD. He didn’t have much of an appetite. “He never seems very hungry,” his mother told me. “He picks at breakfast and lunch. After school, he’s hungrier, but doesn’t eat very much until the evening rolls around. Then, he starts eating and never stops!”
Tyler was particular about what he wanted to eat, gravitating toward quick energy, low nutrient foods like crackers, and simple carbohydrates like sugary foods.
She also said he started showing signs of loss of appetite when he started on ADHD medications. She worried he wasn’t getting the right nutrition. He was experiencing weight loss and becoming underweight.
Does ADHD Cause Loss of Appetite?
One of the ADHD symptoms commonly seen in children is a lack of appetite, especially during the day, causing irregular meals. The condition of ADHD itself does not cause a loss of appetite. However, the medical management of it may alter appetite, specifically reducing hunger cues.
When kids have ADHD, the optimal path for managing it depends on the child. Your healthcare team will look at the whole picture. For example, if you have a young child, behavioral management training of parents may be the treatment of choice.
For a school age child, a combination of medication and behavior training may be most optimal.
Some parents seek adjustments in the diet as the primary treatment mode (and an alternative to starting medicine). While a healthy ADHD diet is certainly beneficial, there isn’t evidence that it is an effective stand-alone mode of treatment.
A healthy diet for ADHD is considered a complementary treatment to medication and behavioral management. Proper nutrition is important for every growing child, and meeting the nutritional needs for the child ADHD may be a bit more challenging when medication is part of the equation.
ADHD and Sensory Issues
Some children with ADHD also have sensory issues or food sensitivities and this can compromise their eating.
They may be picky eaters, preferring to eat their favorite food. Or, they may appear to have picky eating on the outside, but the characteristics of food, such as smell and texture, can send their sensory systems into overdrive.
The willingness to try new foods may be low and this can lead to unhealthy foods in the diet, and compromise the overall balance of the diet.
If your child is picky and it’s interfering with his appetite, eating, weight and overall growth, you may need to engage with feeding therapy. Check out my parent guide on extreme picky eating and how you can find more help.
Does ADHD Medication Cause Weight Loss?
When children receive ADHD treatment, they often start on medications to reduce their impulsivity and improve attention during their time in school.
While there are a myriad of medication options for ADHD, some carry the common side effect of stimulant medications, including reduced appetite, abdominal pain, and/or headaches.
Some studies indicate up to 30% of children experience reduced appetite on methylphenidate products (Concerta, Ritalin, Focalin, etc) and amphetamine products (Adderall, Vyvanse, etc). Fifteen percent of children on atomoxetine (Strattera, Intuniv) experience no appetite.
Other research suggests up to 60% of children on medications experience loss of appetite, while 40% report abdominal pain, and 20% complain of headaches.
Use of medication can cause any of these symptoms and can lead to poor appetite, inadequate eating, nutritional deficiencies, and weight loss.
How to Gain Weight on ADHD Medication
If your child could benefit from weight gain, the first thing is to think about are ways to increase your child’s appetite. One of the ways I teach my clients to do this is to improve the irregular eating habits that children with ADHD often have. In other words, I encourage families to get on a schedule for feeding meals and snacks and promote regular meals. For example, meal planning can include setting regular meal times and scheduling healthy snacks so they occur about every 2 to 3 hours for the toddler/preschooler, and every 3 to 4 hours for the school-age child.
One of the benefits of following a schedule for meals and snacks is that you are training your child’s body to experience the sensations of fullness and hunger cues.
When a child eats, his belly fills up. After 3 or 4 hours, his digestive system has cleared the way for more food, and the hormones that tell the brain “I’m hungry!” kick in. As a result, your child feels hunger.
When your child is not eating, not only do they dull the recognition of hunger, but they may miss out on the opportunity to build an appetite and thus learn how to regulate appetite and eating. This may lead to eating quick energy foods, other foods of poor nutritional quality, and have poor impulse control when too hungry.
Getting your child to the table, whether they eat or not, is a primary goal. It establishes a rhythm and routine for the day and for food.
Along with creating a meal and snack schedule, you want to establish boundaries that help reinforce your schedule. One that comes to mind is The Kitchen is Closed policy. In brief, it’s simply closing the kitchen between meals and snacks which helps to create those breaks when your child isn’t eating. This alone can help your child establish a healthy eating habit.
A Variety of Food May Improve Brain Function
Brain function relies on nutrients. When a child doesn’t eat for hours, it can cause reduced attention, lack of focus, fidgeting, mood swings, and emotional outbursts.
Nutrition alone can make a big difference in how your child functions during the day. Nutritious foods provide essential nutrients that help the brain function optimally. Not only do nutritious meals offer a variety of important nutrients for the brain, such as iron, zinc, vitamin B12, choline, and omega-3 DHA, they also support energy levels and executive function, including focus and impulse control.
My Child with ADHD Needs to Gain Weight
When kids with ADHD are underweight, the goals are a bit different. For one, helping your child gain weight is a top priority. Why? Because when kids are at an optimal weight, they grow well, and we can assume they are getting the energy they need to function well. However, just because your child’s food consumption is full of plenty of high-caloric foods for weight gain, it doesn’t mean those calories are ideal.
We know that children with ADHD have nutrients that are at risk in their diet. Elements like magnesium, iron and omega-3 fatty acids, for instance. Studies report that these, among other nutrients, tend to be low or at risk in children with ADHD.
Bottom line: You want to correct an underweight status by helping your child gain healthy weight. In other words, the type of weight gain that contributes to overall functioning and health at the same time.
There are certain foods that are high in calories and nutrient-rich. Work some of these into your meal and snack preparations.
Favorite Weight Gain Foods for ADHD
- Eggs
- Beans, especially in dips (hummus), soups (black bean or chili) or mixed into dishes (pasta, rice)
- Peanut butter and other nut butters
- Nuts (offer age-appropriately as these can be a choking hazard for young children)
- Chicken drumsticks and thighs (with skin)
- Hamburger
- Turkey (dark meat from thighs or legs)
- Deli meats
- Cheese (slices, sticks, cubes, shredded, etc)
- Milk (whole or 2%)
- Full fat yogurt
- Cottage Cheese
- Banana
- Mango
- Canned fruit
- Dried fruit
- Potato
- Sweet potato
- Avocado
- Edamame
- Black olives (and others)
- Corn
- Peas
- Filled pastas such as tortellini, ravioli and gnocchi
- Fruited bread like raisin bread
- Muffins
- Bagels
- Granola (bars, bites, etc)
- Some ready-to-eat cereals (with clusters or dried fruit)
- Butter
- Plant oils such as olive and vegetable
- Mayonnaise
- Sour cream
- Cream cheese
- Guacamole
- Hummus
- Tapenade (olive dip)
- Salad dressing
- Jelly and jams
Take care to watch for excessive artificial food colors in the foods you feed your child with ADHD, as these may disrupt behavior in some children.
Add More Calories to Foods for the Underweight Child with ADHD
If your child has a low body mass index (BMI), or has been stalling on the growth chart, or losing weight, you’ll want to make some dietary changes. Boosting calories in the foods your child already likes and eats is another approach to increase the overall caloric content of the diet and promote weight gain.
Try These Tips:
- Add butter or oils to vegetables, pasta, rice, and breads in generous amounts.
- Substitute whole milk, half and half, or cream in recipes calling for water or milk.
- Double dress pasta by draining first, adding olive oil to coat, then add sauce, butter, or cheese.
- Use fruit dips or whole milk yogurts as a high calorie dip for fresh fruits.
- Go “full fat” whenever you can.
You can find more calorie-boosting suggestions in my article about helping toddlers gain weight. Be careful to avoid relying on sugary foods for extra calories. These won’t offer the nutrients your child needs.d more calorie-boosting suggestions in my article about helping toddlers gain weight. Be careful to avoid relying on sugary foods for extra calories. These won’t offer the nutrients your child needs.
ADHD Food Fixation
Some kids may be fixated or appear to be obsessed with food. They may be dopamine seekers. Dopamine is a feel good chemical in the brain, and sweet foods and other sources of simple carbohydrate, particularly, may trigger a dopamine release. As such, kids with ADHD may hyper-fixate on sweets and treats, and binge (consume large amounts of food) and overeat them.
Learn what it takes to nourish and nurture the child with ADHD.
Resources
- The ADHD Diet for Kids is a program for parents of children with ADHD. Learn how to choose the right foods, the ideal balance of nutrition, and fill in the nutrient gaps. Master positive feeding including structure, boundaries, and choice, while setting your child up for healthy choices down the road.
- Check out my other ADHD resources for families.
- Check in with your healthcare provider if you need more help; check my private practice offerings.
- My book, Kids Thrive at Every Size: How to Nourish Your Big, Small, or In-Between Child for a Lifetime of Health and Happiness, will help you set up the essential lifestyle habits every child needs.
Jill Castle, MS, RD
I like empowering parents to help their children and teens thrive at every size with realistic advice centered on healthful habits around food, feeding, nutrition and health behaviors. As a pediatric dietitian and author, my goal is to share strategies and realistic advice to help you raise a healthy and happy child through my articles and podcast.