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Recognize and Treat Underweight

When the body goes to its reserves, it is often due to underlying disease and the side effects of its treatment. “Eating more” alone usually does not help to gain weight.

Anyone struggling with being overweight can hardly imagine that the opposite can also become a problem: being underweight – due to illness, age, or too little calorie intake. When the pounds tumble and the body goes to its reserves, caution is advised. In most cases, this is an alarm signal that important nutrients are missing or cannot be absorbed.

A body mass index (BMI) of 18.5 and below is considered underweight. However, genetics and physique also determine whether the weight is still acceptable. As long as there are no vitamin and mineral deficiency symptoms, you do not necessarily have to do anything.

Being underweight is a risk factor for diseases

If you are severely underweight and malnourished, however, the risk of infection and mortality increase – so it becomes threatening. Malnutrition is often due to chronic disease and the side effects of its treatment. In the case of significant emaciation (e.g. due to prolonged fasting, anorexia, hyperthyroidism), doctors speak of inanition, the body breaks down the stored fat deposits.

Some diseases promote being underweight

Certain serious diseases are also associated with physical wasting (cachexia): When the fat deposits are empty, the body burns its muscle mass and its building fat – i.e. the last fat reserves, for example under the soles of the feet, on the buttocks, the buffer fat around the internal organs and under the eyeball. This can happen, for example, with cancer (tumor cachexia), asthma, COPD, and other chronic lung diseases (pulmonary cachexia, German: lung-related anorexia) or with chronic intestinal diseases. Here, nutritional intervention is urgently needed.

Symptoms of being underweight

People who are underweight often feel that their ability to perform is limited, they are tired and have trouble concentrating. Malnutrition can lead to vitamin or mineral deficiency symptoms, such as cracks in the corners of the mouth, dry skin, and frequent infections. Being underweight slows down metabolism and growth in children. Menstrual bleeding may stop in women.

Diagnosis of underweight

BMI is calculated by dividing your weight by the square of your height in meters. Example: A man is 1.82 meters tall and weighs 61 kilos – he has a BMI of 61 / (1.82 x 1.82) = 18.4. That means: His BMI is below normal weight, and he is underweight. The doctor can also use a special scale with electrical resistance measurement, the so-called bioelectrical impedance analysis (BIA), to determine the proportion of fat and muscle mass in the body. This measurement gives a more accurate picture of the nutritional status than the pure BMI value.

Being underweight is not the same as malnutrition

In order to determine whether malnutrition is present in addition to being underweight, the doctor will take blood and have the status of vitamins and minerals examined in the laboratory. Fasting blood values ​​can also indicate a thyroid malfunction or other possible causes of being underweight.

Therapy: Proper nutrition against underweight

The goal of nutritional therapy is long-term weight gain – based on a calorie intake of 2,500 to 3,000 calories per day. This can be achieved primarily through a wholesome diet with a higher calorie density, rather than through a larger amount of food. The basis of the diet should be vegetables, fruit, and whole-grain products supplemented with fresh sea fish, eggs, and high-fat dairy products.

Underweight cancer patients benefit twice over from fish because it contains L-carnitine. Studies have shown that this protein-building block promotes weight gain after a tumor in the pancreas.

Milk, cream, and quark contain protein, which we need to maintain our muscles, and calcium for our bones. Underweight people, including younger people, have an increased risk of osteoporosis and thus fractures. Legumes such as peas, lentils, and beans, nuts, and seeds also contain good protein.

At the same time, high-quality vegetable oils that are rich in omega-3 fatty acids are important. They strengthen the immune system.

Getting enough exercise is important if you are underweight

Another crucial pillar of therapy is regular exercise. Food is only properly metabolized if the body absorbs enough oxygen. Lung patients should also do special breathing training because incorrect or ineffective breathing costs the body energy so that it cannot gain weight.

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Written by John Myers

Professional Chef with 25 years of industry experience at the highest levels. Restaurant owner. Beverage Director with experience creating world-class nationally recognized cocktail programs. Food writer with a distinctive Chef-driven voice and point of view.

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