I have a 10 year old grandson who I believe has some type of eating disorder or medical condition that needs attention. I just don’t know how to address this. For about 3 or 4 years, eight out of ten times when we go out to dinner or have a big sit-down dinner he begins to feel sick and frequently starts to gag and has on many occasions thrown up. I and his parents have tried everything to determine the cause. It is making his life miserable. On family vacations it has become a real issue when we go to dinner. More importantly, I am worried about the long term effect this is having on him and don’t know what the course of action should be. He was born very premature (26 weeks) and had a vent tube for about 10 weeks and I have speculated that this has something to do with the problem. It seems that odors sometimes bring this on but it is not apparent that the problem lies there. His parents have now come to the conclusion that all this is in his head and that he should be able to control it and they get angry with him. He is very, very bright (an honor roll student) and has no complications from his prematurity at all. He only weighed 1 lb. 14 oz. at birth but has developed extremely well though he continues to be small in stature (54 inches and 62 pounds). He seems to be very concerned that he remains thin. I am very close to him and very overweight and wonder if this has caused some impact though these episodes happen whether we are with him or not. We went to his pediatrician with the problem and he immediately prescribed an anti-depressant which we were not comfortable with. Please give me any insight you have. It may be that this will pass but it has continued for a long time and I am concerned. – a very worried granny
Dear Worried Granny,
As the boy’s grandmother, you are in a very difficult position. There is wisdom that comes with age and experience, but you don’t have the power to make decisions on his behalf. It is my hope and prayer that his parents will be open to some gentle advice from you.
It must be exasperating to watch your grandson when he struggles with this problem at mealtimes, especially without understanding the cause. There are some children who are very sensitive to bitter tastes in foods (especially when trying something new) and will gag and even vomit, but that is usually in younger children—it gets less prevalent over the years until it disappears. Other causes of throwing up after eating are food intolerances or allergies. But you state that your grandson has had a medical evaluation to rule out any physical problems (although sometimes a second opinion is warranted, such as from a pediatric GI specialist). At this point, however, I would recommend that your grandson be evaluated by a child psychiatrist (an M.D.), especially since antidepressants were prescribed. This professional has both a medical and a psychology background, so can fully assess your grandson and determine the best course of action.
I can understand the boy’s parents’ frustrations, but I would agree with you that getting angry at him and minimizing the problem isn’t the answer. No matter what the cause of his gagging and throwing up, he could be headed down a path of disordered eating if the parents don’t address the issue appropriately. At his age, this is not just a stage or something that will just go away. I’m sure his parents want what’s best for him, and I hope they will be receptive to seeking professional help.