This is a guest post by Jill Castle, a registered dietitian, childhood nutrition expert, and blogger/podcaster over at The Nourished Child. You can learn more about nutrition for kids with ADHD in her online program, The ADHD Diet for Kids: Feed Your Child for Better Attention, Behavior and Growth.
If you have a child with ADHD, you may notice he (or she) isn’t as hungry as usual, especially when on ADHD medication. Some kids with ADHD experience a loss of appetite. This happened with eleven-year-old, Annie.
Annie rarely complained of being hungry. She’d get up in the morning and feel nauseous, so she wouldn’t eat anything before school. She didn’t eat much at lunch because she still wasn’t very hungry and didn’t like what the school offered. She also worried about eating in front of other students. After school, Annie would manage to eat half a granola bar or other light snack before hitting the lacrosse fields.
You can imagine that Annie was very hungry when she returned home at the end of the day for dinner. In fact, she was exhausted…and emotionally fragile. Irritability, impatience, and the occasional meltdown were normal for her. And, she was too thin and wasn’t growing well.
I’ve seen many kids with ADHD like Annie struggle with eating and loss of appetite. It’s one of the most common concerns I hear from parents.
Loss of appetite, poor eating, and inadequate nutrition will almost always affect the child with ADHD, from their ability to focus and learn in the classroom, to their behavior and general sense of well-being.
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ADHD Medication: The Big Reason Kids with ADHD Aren’t Hungry
Certain ADHD medications are known to cause a loss of appetite. Studies tell us the overall rate of appetite reduction is about 60% in children who take an ADHD medication. The good news? Typically, the reduction in appetite is not significant enough to discontinue medications, however, it may warrant discussing a change in ADHD medication dosage with your doctor and/or the format of delivery to minimize the effect on appetite.
Specifically, studies on methylphenidate products such as Concerta, Ritalin, and Focalin have shown that about 30% of children experience reduced appetite while taking them. Amphetamine products such as Adderall and Vyvanse have been shown to have the same effect on appetite. Additionally, nearly forty percent of children on ADHD medication will experience abdominal pain, which can interfere with their willingness to eat.
Another reason kids with ADHD may not have an appetite is that they simply get used to not eating, or eating sporadically. This was happening with Annie. Her lack of eating had trained her body and mind to disregard feelings of hunger.
Think about it: When kids go for hours without eating, their appetite gets dulled, and they experience erratic hunger signals to eat. They aren’t hungry for hours, then they’re starving and out of control. And the whole cycle repeats. It’s almost as though kids get programmed to eat less simply through the habits they develop around eating.
The Impact of Low Appetite in Kids with ADHD
When children lose their appetite, they are at a higher risk for nutrient deficiencies, weight loss (or lack of weight gain), and growth problems. When this happens, their ADHD medication may not be as effective.
One of the most important aspects of successfully managing a child with ADHD is to have your eye on nutrition. Yet, nutrition is often the last factor considered. Good nutrition will not only help your child feel good and function well, it will support your child’s ADHD medication management while encouraging optimal nutritional status and growth.
I think we can all agree that good nutrition is important. The question is: How do we help our kids with ADHD eat better? I’ve got you covered.
3 Simple Tips for Helping Kids with ADHD Eat Better (Even if They Aren’t Hungry)
1. Set up a Schedule for Eating
Ideally, all children should be eating three meals a day, and one or two snacks between meals, depending on their age. I like to call these “opportunities” for your child to eat and get proper nutrition.
For example:
- 7 am breakfast
- 10 am snack
- noonish lunch
- 3 pm snack
- 6 pm dinner
These are not times to force your child to eat. Rather, they are regular times throughout the day for a dose of nutrition. Keep in mind this scheduled approach to offering food can help build your child’s appetite. Encourage your child to eat and work with him or her to select foods that are nutritious and easy to eat (see #2 below).
If you have a child who will pass on food, that’s okay. Making an offering of food fulfills your job as parent and affords your child an opportunity to eat.
2. Select Nourishing, Wholesome Foods
Kids with ADHD are known to miss out on several nutrients in their diet. As such, you want to be cognizant of those nutrients when planning meals and snacks. For example, iron, zinc, magnesium, and omega-3 fatty acids are some of the nutrients at risk in kids with ADHD.
Other elements in food, such as artificial food colors and preservatives may trigger undesirable behavior in children with ADHD. These can be avoided with careful planning.
When you keep nutritious and wholesome food front and center, you’ll trend towards meeting your child’s nutrient requirements and avoid his or her potential triggers.
3. Add a Bedtime Snack to Your Child’s Routine
If your child isn’t eating enough or struggles to gain weight, I recommend a regular bedtime snack. Keeping it wholesome and nutritious is the key! A slice of peanut butter toast, a bowl of low sugar cereal and milk (or non-dairy substitute), half a nut butter and jam sandwich, or a fruit and veggie smoothie are all good options.
When kids have a bedtime snack, they get the benefit of extra calories that won’t be burned off by running around. They may also sleep better!
Want More Help?
Confidently feed and nourish your child with ADHD for better attention, behavior and growth with my solid nutrition and feeding plan for kids with ADHD: backed by science and steeped in practicality. The ADHD Diet for Kids helps you balance food, eliminate food sensitivities, target inadequate nutrients, and feed with love and limits so your child improves in all areas, including attention, behavior, learning, growth and overall health. Learn more here.
What has helped your child eat when he’s not hungry? Share in the comments below!
Adderral was given to my son for him to take on school days so he can focus. He has ADD, and I usually dont give it to him on weekends but his dad wants me to even give to him on weekends so we can control his appetite is this ok?
Usually, ADHD/ADD medication is given daily whether you ‘feel you need it’ or not, because the brain likes stimulants and functions better with them – some people benefit from a couple of days off stimulant medications a week while other people, like myself, function better taking them even on days we might spend in bed.
If your child has issues with appetite because they’re ‘over-eating’ and have gained a lot of weight, this shouldn’t explicitly be controlled through stimulant medication. It’s ethically wrong to give anyone a medication for a purpose other than the one it was prescribed for, and if he has issues with self-control around eating, these won’t go away just because they’re suppressed by the Adderral. Food cravings, over-eating and disordered thinking around food is best solved by him working with a suitably trained clinical psychologist around his attitudes to and patterns regarding food consumption.
So give or don’t give the meds on the weekend, but do it because your child feels and functions better on them (or worse off them). If they want to be off them at the weekend, they should be. If they want a break from medication-induced focus, they should get it. Conversely, if they feel ‘more themselves on meds’, as most of us with ADHD do, then they should be allowed to take them.
The fact that your husband wants to us his ADHD medication to control his eating is a red flag to me – while I’m sure it’s well intentioned it won’t fix any of the underlying causes of over-eating and these can be deeply rooted and hard to shift. Worse, medicating the surface effects can make the underlying attitudes and beliefs toward food more deeply entrenched and harder to resolve healthily.
He may also benefit from having his iron, magnesium and zinc levels tested and perhaps supplemented as these can change appetite and focus levels, particularly in people with ADHD.
My son was on a few different medications over a few years. He was never hungry on any of them and was extremely skinny. No appetite for breakfast or lunch and would only eat once the pill “wore off”. Then he ate voraciously but it still did not affect his weight. A few times he even lost weight between appointments! The doctors were very unhelpful – one pediatrician said to get him a McDonald’s milkshake everyday! And another suggested to put lots of white sugar in a homemade smoothie/milkshake! Sheesh. I did not follow that advice. He has now been off the medication for a couple years as I felt the effectiveness of the pills were not worth his overall health. He is a good eater now and has gained some weight so he’s only slightly underweight now. His ADHD still rears its ugly head but we have learned a few things to help us/him cope.
I think saying “Making an offering of food fulfills your job as parent …” is not quite right. If your child is not eating during the day then, as a parent, you need to fight for something different. Whether it’s a different medication, natural supplements (like B-Complex and GABA), giving them the pill right before school so they can have breakfast, give half a pill at breakfast and have them take another half at lunch so they may be able to eat something in the morning and at lunch, try a 24 hour pill to see if it regulates the appetite, try no medication and work on coping skills/heavy work/etc. Your job as parent is to make sure your child has the tools to succeed and just by offering them food and then shrugging it off if they don’t eat anything is not enough.
Nutrition goals for ADHD sufferers is fine and dandy but means nothing if they won’t eat.
Thanks for your perspective. When I say “making an offering of food fulfills your job…”, I mean it in the sense that as a parent, you need to show up with food, rather than wait for your child to indicate he’s hungry. Some parents of kids with ADHD get worn down in the feeding department (understandably so), and don’t give meals and snacks the thoughtful attention they need, especially in light of underweight or lack of growth. I agree with you, it’s not the end-all-be-all of parenting ADHD — you do need to make adjustments, evaluate the underlying causes and correct them, whether they be food-related or not. The goal is to help kids eat, because you’re right, it’s not nutrition unless it’s eaten. How we help them is just as important as what we put on the plate. Thanks for sharing your story.
Your comment is spot on except for the part about “natural supplements.” Supplements are not natural; they are drugs and untested, unregulated at that. B6 is particularly dangerous as most people believe it is “water solvable” but it is not really. The half life of B6 is 25 days. So it builds up quickly in the body and can cause severe nerve damage. Don’t risk it. Only give vitamins for a deficiency. Never as a security measure.
My son has been on ADHD meds since the 2nd grade and he is now in 9th grade. It still surpresses his appetite. I make him a big breakfast in the morning with alot of protein because this is the meal he is most hungry. He takes a protein bar to school and that is all he eats all day. Then he eats dinner late. We have tried many things to not have the med but his grades go from honor roll to failing when not on the med and he ends up driving me crazy because he is all over the place. The doctor told me that kids who take summers and weekends off of the med usually end up needing a hirer dose in the long run and my sons goal is to not have a hirer dose. We went from Vyvanse to Focolain. Focolain didnt work when he was little but he likes it alot better now that he is older. I myself, have ADHD. I went most of my life without a med. It has caused alot of life problems for me and since my sons diagnosis, I got the diagnosis and also take Focalin and its a life changer. I was the person who could only last a year at a job and Id get bored and quit. My previous job I was there almost 8 years (with meds) longest job I ever had.
My 10 yr old step son was diagnosed with ADHD at age 5 and was on medication until about 3yrs ago. To this day, he consistently is not hungry and will refuse to eat – especially breakfast and lunch. Is this normal and what can we try to do to encourage him to eat? There is a possibility that ODD is also present – so he can be very determined not to eat when he doesnt feel like it. How hard do you press to “make him eat” ?
In general, setting up a routine for three meals and two to three snacks should help — view them as opportunities to eat. Pressuring him, nagging, bribing, etc will stimulate resistance and if he may have ODD, it will make things harder. I would just ask him to gather with you at the table for meals (have a nutritious meal available with 1 or 2 items he enjoys and other foods to round out the meal) and make the gathering enjoyable and free of pressure. If you need to boost calories or protein in food to help with weight gain, this article can help: https://jillcastle.com/childhood-nutrition/feeding-skinny-kid/
Wow, while that must be tough for some kids and families to deal with, it makes me desperate wish my parents had let me take ADHD meds as a child instead of disregarding the doctor’s advice – I may not have ended up being extremely overweight at such a young age if they had! Sometimes I think I was basically medicating myself with food, and became very fixated on eating, like obsessed with food and always thinking about it. Now I am trying to fix all of that, but I’m looking at 150ish pounds to lose and it’s so disheartening.
Thanks for sharing your story. Some kids do develop self-soothing activity related to food and eating, the opposite of lack of appetite. How you were fed may have a relationship to this as well — kids who are restricted around food and eating (ie, tightly controlled) may exhibit food fixation. I wrote about this here: https://jillcastle.com/childhood-nutrition/food-restriction-restrictive-feeder/. I’m glad you’re working on sorting all of this out.
This is a great article that I found very insightful and helpful as I have a recently diagnosed child with ADHD who definitely has experienced a lack of appetite. I really like the suggestion of ‘opportunities’ to eat vs. making them a must. Particularly with girls there are already more issues w/body issues. The idea of a bedtime snack is also a good one I had not thought of. Thank you for sharing your insights and tips!
You’re most welcome!
My son takes Ritalin and experienced more significant appetite loss in the first 6 -12 months of taking it. Our best solution at the time was finding a kids bar, like Clif Kids with protein for his breakfast and occasionally as a snack. It wasn’t a lot of calories, but it was better than nothing. His appetite is much better at breakfast now and he eats a wide variety again. He didn’t eat much lunch, still doesn’t these days. He is usually hungry for a snack after school, eats dinner, and then eats a lot in the evenings. We encourage better choices like cheese, nuts, peanut butter, dried fruit, fruit cups, popcorn, homemade granola bars, and oatmeal/cereal for snacks. We still let him choose potato chips or similar on some days.
I’m glad you found a solution that seems to be working! :)
My daughter was on Concerta and it made her so sick. We got lucky and had an appointment with a neurologist for a concussion and he put her on amantadine which is not a controlled substance. And her grades went from 18% to 90% in 6 weeks! No side effects either. There are other options out there. I just think pediatricians push specific brands.
Hi-I just looked up that medication, it said it’s used to treat Parkinson’s disease…no mention for focus. I’m always looking for something to replace Adderall, just wondering if the spelling was incorrect?
Thank you!
Yea that’s the one. It is off label used for ADHD. It was originally used for the flu in the 70’s. You may need to seek out a neurologist to get it prescribed. But I recommend it to everyone. It’s not a stimulant and has no side effects. It has been life changing for my daughter and our family. Do a google search for “amantadine for adhd”.