Underweight T1 teen

Hi People. I am looking for advice on what to add to my daughter’s menu to help her gain some weight without compromising her sugar levels. She is a tall, too thin 14 year old. Any thoughts? Thanks

Nuts or cheese for snacking. Cream in her coffee. Just a couple of ideas.

Whats does her doctor say?

Thanks. She likes cashew nuts - they are just so expensive here! But cream is a good suggestion

Her endo is concerned about her weight, but hasn’t offered any concrete suggestions. I am hoping to find a new dietician soon (the last one emigrated…) because I think I need to learn more about food combinations and the relationship between insulin and weight.

If you are looking to increase calories but you do not want to increase carbs then you want to add more protein and fat.

Just another question.
Is she willing to gain weight (has she been mentally evaluated, anorexia, bulimia, diabulimia)?
Just another thing you should consider with girls her age, and seek help accordingly.
there’s tons of fat that you can add to the food, put some melted butter over the veggies, as an example. good luck :four_leaf_clover:

Thanks, Tim. That makes complete sense.

She knows she is too skinny and says she is happy to gain weight. I am keeping watch, as eating disorders scare me. She has seen a clinical social worker several times - but she really did not enjoy the experience. I was really hoping she would accept some outside support, but no go. I will try the butter trick! Thanks for your advice and concern

1 Like

Watch for intentional high BG. Hopefully it doesn’t happen. However that is a type of an eating disorder that can impact teenage T1 girls more so than other population groups.

Eating disorders often times come with cover-ups where what is said is not the reality.

Trust but verify.

Yes - I saw a video on diabulimia - heartbreaking stuff. Thanks - I will be aware of other signs apart from her words

oh, have you checked her for celiac? common in T1s and makes you lose weight…

Yes, the endo did check that. Thankfully she doesn’t have celiac. She also checked Kate for TB and other nasties, and Kate’s bloods and xrays were clear


How tall & how much underweight? Has she started menstruating? Typically, girls her age will begin to gain weight on their own. My 2 oldest girls (now 37 & 33) we’re rail thin at that age. By the time they were 18 they had reached normal weight. As long as she’s eating healthy foods & not showing signs of being malnourished, I wouldn’t push.

1 Like

I have a 16 year old (not diabetic) who finally is at 50% per the weight and height growth chart. She started at 5%, hit 10% by age three and then maintained that percentage until puberty. Then it slowly crept up. My side is a family of thin people. Lower weight can be fine, as long as she is on the bell curve and is not dropping.

Her PED was initially concerned until I pointed out that she is healthy (thin chart) and most of his patients today are pretty big (considering 2/3 of the adult population is overweight). He agreed.

Glad she was screened for celiac disease. If you still suspect it, make sure the entire panel was ordered and keep in mind that some 10% of celiacs are seronegative. It can develop at any age and is most commonly linked to TD1.

1 Like

Hi Tia. She 1.7 m tall and 48kg. I was also thin at that age - guess I am just worrying about her because of the extra health challenge of T1. Her periods are very erratic, which is a concern. Hopefully she will fill out as she gets older

My oldest granddaughter will be 15 in January. She’s 5 ft 1 in & 99 lbs, obviously following in her mom’s footsteps as far as growth. She also plays volleyball & is on the cross country team, so she burns a lot of calories. Her younger sister is 13, also athletic, & also quite thin.

T1 can cause irregular cycles on its own.

Again, as long as she’s eating a healthy diet, I wouldn’t worry.

1 Like

Bernstein says that after sufficient fat, added fat won’t put on weight. he recommends added protein.
If her BG is ok, add carbs, if it starts to rollercoaster, add more protein.
She may be just naturally a skinny 14…as she matures, it should sort out.

Also google “feed the insulin” it’s how they rapidly put back on the weight when first diagnosed.

Also explain that if she wants to be skinny, she can do it healthfully with low carb and keep good BG numbers. As you may know, some deliberately withhold insulin to lose weight through high BG numbers.and start a vicious cycle. This should show up in the A1c reading.

I was also a pretty skinny little girl but a few years into my menstrual cycle, the weight came on. I agree, she just might be a skinny person. And as long as she is not running ketones (with holding insulin) as a way to stay skinny, it will probably be something she will our grew. A little more protein and some more carbs could help. So hard to tell a parent not to worry but if she is healthy and happy and all tests are fine, just let it ride for awhile. Good luck!

1 Like