Underweight

Underweight

The underweight range according to the Body Mass Index (BMI) is the white area on the chart.
ICD-10 R62.8
ICD-9 783.22
MeSH D013851

The term underweight refers to a human who is considered to be under a healthy weight. "Underweight" means weighing less than what is expected to be a healthy person (underweight = insufficiency of weight). The definition is usually made with reference to the body mass index (BMI). A BMI of under 18.5 is usually referred to as underweight.[1] This medical definition of underweight may differ from other uses of the term, such as those based on attractiveness.

Contents

Causes

The most common cause of a person being underweight is primarily malnutrition caused by the unavailability of adequate food. The effects of primary malnutrition may be amplified by disease; even easily treatable diseases such as diarrhea may lead to death.

Some people are underweight due to genetics;[2][3] others due to poverty.

Being underweight can sometimes be the result of mental or physical disease, such as hyperthyroidism, cancer, or tuberculosis. People with gastrointestinal or liver problems may be unable to absorb nutrients adequately. People with eating disorders are likely to become underweight, such as anorexia nervosa.

Problems

The immediate problem with being underweight is that it might be secondary to, and/or symptomatic of, an underlying disease. Unexplained weight loss requires professional medical diagnosis.

Underweight can also be a primary causative condition. Severely underweight individuals may have poor physical stamina and a weak immune system, leaving them open to infection. According to Robert E. Black of the Johns Hopkins School of Public Health, "Underweight status ... and micronutrient deficiencies also cause decreases in immune and non-immune host defenses, and should be classified as underlying causes of death if followed by infectious diseases that are the terminal associated causes."[4] People who are malnutrative underweight raise special concerns, as not only gross caloric intake may be inadequate, but also intake and absorption of other vital nutrients, especially essential amino acids and micro nutrients such as vitamins and minerals.

In women, being grossly underweight can result in amenorrhea (absence of menstruation), infertility and possible complications during pregnancy. It can also cause anemia and hair loss.

Underweight is an established[5] risk factor for osteoporosis, even for young people. This is a particular insidious consequence, because the affected persons do not notice the danger.[6][7] After the occurrence of first spontaneous fractures the damage is often already irreversible.

Being underweight causes increased mortality at rates comparable to that seen in morbidly obese people.[8]

Treatment

Diet

There are two ways to gain weight - an unhealthy way and a healthy way. The unhealthy route to gaining weight is consuming junk food and not getting adequate exercise. The healthy way to gain weight is by increasing calorie amounts of the food that you already eat. Placing reasonable amounts of butter, cream or cheese sauces, peanut butter, olive oil, salad dressing, seeds, and nuts on foods help increase food calories. Eating calorie-dense foods can also be beneficial. Some examples of calorie-dense foods are: dried fruits, cheese, raisins, and nuts.[9] Drinking liquids with high calories can add up weight. Some examples of popular weight gain drinks are Ensure and Boost. Other examples are milk and fruit juice.[10] Eating a healthy diet is also crucial in weight gain. Consuming starchy vegetables like potatoes and corn can also add weight gain. Eating protein, healthy fats, carbohydrates, vegetables, fruits are important for a weight gain diet. Nutritional supplements may be beneficial for people who aren't getting enough vitamins or minerals.[11][12]

Exercise

Another way for underweight people to gain weight is by exercising. The article previously states that there are two ways, and is now introducing a third|date=November 2011}} The addition of muscles will increase your body mass. Weight-lifting exercises are effective in helping to increase muscle tone and gain weight.[13]

Appetite Stimulants

Finally, certain drugs may increase appetite either as their primary effect, or as a side-effect as in the majority of cases. Antidepressants such as mirtazapine or amitryptiline, antipsychotics (particularly chlorpromazine and haloperidol, as well as tetrahydrocannabinol (found in cannabis), all present an increase in appetite as a side-effect. In states where it is approved, medicinal marijuana may be prescribed for severe appetite loss, such as that caused by cancer, AIDS or even severe levels of persistent anxiety. Other drugs which may increase appetite include certain benzodiazepines (such as diazepam), sedating antihistamines (such as diphenhydramine or promethazine, or B vitamin supplements.

Exercise itself is catabolic, which results in a brief reduction in mass. The gain in weight that can result of it comes from the anabolic over-compensation when the body recovers (via rest and eating) and overcompensates via muscle hypertrophy. This can happen via an increase in the muscle proteins, or through enhanced storage of glycogen in muscles. Exercise can help stimulate people's appetite if they are not inclined to eat.

See also

References

  1. ^ Calculate your Body Mass Index, National Institutes of Health, http://www.nhlbisupport.com/bmi/, retrieved 2009-04-27 
  2. ^ "Body Shape 'Is Down to Genes'". Indian Express. http://www.indianexpress.com/news/body-shape-is-down-to-genes/695697/. Retrieved October 23, 2010. 
  3. ^ "'Skinny Gene' Exists". Science Daily. September 5, 2007. http://www.sciencedaily.com/releases/2007/09/070904122434.htm. Retrieved October 23, 2010. 
  4. ^ Black, Robert E.; Morris, Saul S.; Bryce, Jennifer (28 June 2003), "Where and Why are 10 Million Children Dying Every Year?", The Lancet 361: 2226–34, PMID 12842379 
  5. ^ Gjesdal; Halse, JI; Eide, GE; Brun, JG; Tell, GS (2008). "Impact of lean mass and fat mass on bone mineral density: the Hordaland Health Study". Maturitas 59 (2): 191–200. doi:10.1016/j.maturitas.2007.11.002. PMID 18221845. 
  6. ^ Nattiv; Agostini, R; Drinkwater, B; Yeager, KK (1994). "The female athlete triad. The inter-relatedness of disordered eating, amenorrhea, and osteoporosis". Clinics in sports medicine 13 (2): 405–18. PMID 8013041. 
  7. ^ Wilson; Wolman, RL (1994). "Osteoporosis and fracture complications in an amenorrhoeic athlete". British journal of rheumatology 33 (5): 480–1. doi:10.1093/rheumatology/33.5.480. PMID 8173855. 
  8. ^ Waaler HT. (1984). "Height, weight and mortality. The Norwegian experience". Acta Med Scand Suppl 215 (679): 1–56. doi:10.1111/j.0954-6820.1984.tb12901.x. PMID 6585126. 
  9. ^ "Weight Gain Can Be As Difficult Losing It". The Detroit News. October 16, 2010. http://detnews.com/article/20101016/OPINION03/10160302/1005/rss32. Retrieved October 23, 2010. 
  10. ^ "Healthy Weight Gain". Children's Hospital Boston, Center for Young Women's Health. http://www.youngwomenshealth.org/gain_healthy_parent.html. Retrieved October 23, 2010. 
  11. ^ "Gain Weight and Be Healthy". About.com. http://nutrition.about.com/od/tryingtogainweight/a/gainehalthyweig.htm. Retrieved October 23, 2010. 
  12. ^ "Achieving Healthy Weight Gain". Health Central. http://www.healthcentral.com/diet-exercise/c/56/57317/achieving-gain. Retrieved October 23, 2010. 
  13. ^ "Men's Health". Men's Health. http://www.menshealth.com/cda/advicedetail.do?site=mensHealth&channel=best.life&conitem=3d084d5dfcf53010VgnVCM100000cfe793cd____&expertId=1c74f5b65fa53010VgnVCM100000cfe793cd____. Retrieved October 23, 2010.