Our expert says:
If your 9.5-year-old son is already 137 cm tall and weighs 32 kg, then his growth is certainly not being affected by the Concerta. The average height and weight for 10-year-old boys is 28 kg and 132 cm. Anti-ADHD medications can suppress the appetite and a decrease in weight is listed as a possible side-effect for Concerta in my copy of MIMS. Your son does, however, not seem to be losing weight and as mentioned above is already much heavier and taller than the average for 9-year-olds. The fact that he has a very hearty breakfast (more than many adults would consume) is excellent and should sustain his blood sugar levels until lunchtime. The fact that he does not eat any lunch may be a problem if his blood sugar drops to low levels. Ask him if he would be prepared to have an oat bar or an energy bar with a glass of cold flavoured milk or a smoothie (fresh fruit with low-fat milk plus honey), because if his appetite is depressed during the day, offering him chilled non-fatty foods may be a way of tempting him to eat or drink a healthy alternative to boost his blood sugar levels until suppertime. Experiment with the smoothies using different fruits in season and adding 1-2 tablespoons of skim milk powder to the milk and fruit mixture to increase the energy content. Let him taste the smoothies to find out which ones he would be prepared to drink. This is an alternative to the meal supplements you mention and smoothies certainly taste a lot better. The good breakfast and his catch-up eating over the weekends are supporting his excellent growth, so you need not worry about that aspect. One factor that could also play a role in the eating habits of children with ADHD is stress. Sit him down and discuss his school day with him and ask if he gets a lot of negative feedback from his teachers and fellow learners. If he indicates that he is under a lot of stress or often feels angry because other people tease him about his lack of concentration and/or restlessness, then it may help to take him to a child psychologist to relieve his feelings of frustration, which could in turn improve his appetite. Children with ADHD and their parents need all the help they can get, because our social system and the schools are generally not understanding or supportive.
Wishing you and your lad all the best
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