Daughter is Very Thin

Patient

Q: My daughter will be 13 in a couple of weeks. She is 5'5" and 94 pounds. She seems very thin to me, and has lost about 5 pounds since May of 2013.

Almost a year ago, she started having these episodes where she would vomit and feel poorly for 2 or 3 days, then perk up and be back to normal. She never ran a fever during these episodes. A few weeks to a month later, she would have another episode all over again. This started July of 2012, and continued until the beginning of May, 2013. During this time, we took her to our family doctor several times. We first got a diagnosis of stomach flu (even though she was not running a fever), then that the stomach flu had returned, then a possible intolerance to dairy (which we tried removing from her diet and it made no difference). They never ran any tests on her at these doctor visits, except for the last one, in which they tested her urine and found nothing. Eventually, these episodes stopped, and she has not had one for nearly a year now. We never figured out what was causing them.

Since her last appointment, in May, she seemed like she was getting thinner to me, but we chalked it up to the fact that she was getting older and taller, and that she was thinning out, and she has always been a fairly thin child. I was also pretty thin as a child, so we considered this to be normal. Then, when we took her to her well-child exam in December of 2013, the doctor was concerned because she had lost weight. We were not able to see our regular doctor, and were seen by another doctor. The doctor ran a thorough blood test on her, which came back normal, except that she was very low in Vitamin D. She suggested Vitamin D supplements, and to schedule another appointment in a few months to recheck her weight and Vitamin D levels. We just took her to the follow up appointment this week. They took her blood again, and we are waiting on the results on that. She had lost about a pound since her previous appointment. They told us that it could be that she is just a skinny kid. They suggested we add more healthy fats to her diet, and to recheck her again in a few months.

She seems to be otherwise healthy. She never runs fevers, hardly ever gets sick (except for the vomiting episodes), has good color, good energy, is not sleeping too much, is not irritable, has normal bowel movements (her doctor asked this at her last appointment), and just started her menstrual cycle a couple of months ago. She has always been a light eater, (eating like a bird), eating only when she is hungry, and will not eat if she is full. The only exception to this has been when she was on a growth spurt, when she would eat constantly. It does seem like lately I am having to push her to eat 3 meals a day. I do not think she has an eating disorder, or that she is trying to be thinner. She herself has said at times that she thinks she is too thin, and is very sensitive to being called, "skinny".

I can't help but think that this is somehow connected to the vomiting episodes and has something to do with her stomach. A little bit of family history - my brother was diagnosed with Acid Reflux in his teens, and lost a lot of weight previous to his diagnosis, as he did not want to eat foods that would cause him discomfort. My mother also has GERD, which she takes medication for. Am I right to be concerned about this, or should I stop worrying?

Doctor

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