Underweight (Weight below the standard)

Underweight (Weight below the standard)

When a patient has a Body Mass Index (BMI) value lower than <18.5 kg/sq.m, it is considered underweight. However, if it is a case of severe underweight, it is counted when BMI is <17.0 kg/sq.m.

The cause of underweight may be due to the body losing energy or using more energy than it receives, which leads to a decrease in weight or abnormal weight. It may also be due to a lack of energy and nutrients, such as from poverty, loss of appetite, or fear of gaining weight, leading to bulimia nervosa. This disease is characterized by an abnormal preference for thinness, and is commonly found among models and teenagers who often think they are overweight. Physical diseases that result from receiving less food than normal, include problems with the mouth and teeth or digestive system, which may cause abnormal digestion and absorption.

Groups that consume more energy than normal include:

1. Toxic thyroid disease

2. Strenuous exercise

3. Taking certain medications or using addictive substances such as drugs

4. Diseases that cause rapid weight loss due to water loss

5. Diabetes, high blood sugar causing frequent urination

6. Diseases that have abnormally high levels of calcium in the body, such as certain types of cancer

The dangers of being underweight include increased risk of heart disease and osteoporosis if it is caused by toxic thyroid disease. If it is cancer and left untreated, it can spread and become untreatable. If it is bulimia, stomach acid after vomiting can cause sores in the cheeks, tooth decay and sensitivity. 

Approaches to treatment in nutritional therapy

In the case of obesity phobia, it is necessary to provide treatment that adjusts the understanding of the patient and their relatives, provide knowledge about nutrition and diet, and medication may be used to help with psychiatric conditions.

In the case of overeating without becoming overweight, it is not recommended to consume excessively sweet, salty, or high-fat foods to increase calorie intake, as this may increase the risk of diabetes, high blood pressure, and high blood cholesterol, or lead to belly fat instead of muscle. It is recommended to consume protein-rich foods such as milk, eggs, beans, and whole grains to build muscle, and to exercise, such as lifting weights or practicing yoga. It is also beneficial to consume carbohydrates that are good for the health, such as brown rice and wild rice. Weight gaining should be done by increasing energy intake by 500 kcal/day, and those additional meals should be high in protein, or low in sugar and fat.

• Increase protein intake by 1.5-2.2 grams per kilogram of body weight.
• Increase carbohydrate and fat intake by 300-500 calories per day to gradually increase weight.
• Milk is a good source of protein and should be consumed with meals, about 1-2 glasses per day or after exercising.
• Eggs should be eaten daily, one egg per day. If there are problems with high blood fat, limit intake of red eggs to no more than 3 per week or eat white eggs instead.
• One portion of white rice equals one ladel weighing 55 grams and providing 80 calories. If it's glutinous rice, one portion weighs about 35 grams and provides the same amount of calories. Rice also contains protein, but in small amounts.
• Legumes are another option because they provide high energy, and one handful of almonds contains 7 grams of protein and 18 grams of good fats. They can be eaten as a snack, but in limited amounts.
• Red meat helps to build muscle and contains amino acids. Eating fatty red meat will provide more energy than lean red meat.
• Whey protein is a popular source of protein among bodybuilders because it helps to build muscle. It should be consumed before or after exercise or for people with nutritional problems, increased intake of whey protein is recommended.
• Whole grain bread is high in carbohydrates and is made from unrefined grains. Eating it with protein helps to increase weight.
• Avocado is rich in good fats and one avocado provides 332 calories, as well as vitamins and minerals.

Besides adding food, there should be behavioral changes that may contribute to weight gain, as follows:

• Exercise to increase appropriate muscle mass and increase appetite. Focus on protein and carbohydrate intake.
• Get enough rest, at least 8 hours per day.
• Divide meals into 5-6 times per day and do not drink water before meals.
• Reduce consumption of beverages that contain caffeine or energy drinks, as they can decrease appetite.
• Quit smoking, smokers tend to have a greater tendency to decrease their appetite than non-smokers.