Diet

Underweight

definition

Even if in ours western world rather Obesity is one of the main problems Underweight for those affected at least just as far-reaching problem, the serious and the bad consequences can result.

Too often not only children have to come up with terms like "Very skinny male human"Or"Beanstalk“Listen. In Germany, according to the Federal Statistical Office, up to 2 million citizens affected, especially Women under 30 years of age. In the USA over 3% and in France even almost 5% of the population weigh too little.

Not to be confused with being underweight Malnutritionwhich on a Lack of food intake and thus Vitamins, Proteins, Fats and other building materials that are important for the body. So not every underweight is malnourished.

The Malnutrition is especially in developing countries the main cause of underweight and affects almost 50% of the local population.

At the Underweight there are many more considerations and causes to be considered. Next physical and mental Causes, it is always important to consider the variations and whims of nature and not every underweight person needs treatment. It is not always Limit to underweight so easy to pull off even when one is by one BMI (=Body mass index) under 18.5 kg / m2 speaks of underweight.

A BMI of less than 17.5 kg / m2 is described as pronounced underweight. From the age of 60 this limit is only drawn with a BMI of 22 kg / m2. Of the Body mass index is in Germany on frequently used directional scale to Assessment of body weight and is calculated using a formula from height and weight.

The meaningfulness is meanwhile heavily criticized, because too high muscle proportions too incorrectly high measurement of being overweight. Particularly in children, a great deal of attention is paid to body weight as part of the preventive examinations. However, this is not the BMI but the so-called age-appropriate percentiles used as a reference and measured value. The children are compared with many other children of the same age.

causes

The wrong or insufficient diet can often be the reason for being underweight.

The cause of pathological underweight is always one Mismatch between need and supply of nutrients, mostly in a row too little calorie intake. The caloric value of a food gives it Energy delivery value in the body and is printed on the packaging of many foods.
Is in the body itself Leptin the most important marker of the current energy status. A good energy balance leads to Body fat cells to distribute the Hormones Leptin. Hormones are considered in the body Messenger in the blood to find.

Leptin conveys the information whether enough energy is present or whether the victim Felt hungry when there is not enough energy. If no or less leptin is released due to a lack of energy, important functions in the body are down-regulated and the Deficiency symptoms occur.

Both in children and adults, however, the underweight does not have to have any pathological or treatment-requiring cause and by the individual metabolism and the personal physique plan, these people are slim and apparently too thin throughout their lives without their bodies having any problems with it.

Nevertheless, in children and adults who are underweight, all other physical causes must always be ruled out, because underweight is often one of them other disease is the cause and one must not prematurely assume a genetic underweight. Often times will Children also undergo a medical check-up classified as underweight.

According to a study by the Robert Koch Institute, almost 4 percent of children under the age of 6 are underweight. This proportion increases until the end of puberty. Often this determination is only temporary and the next check-up the children are already within the framework of the weight norms for the respective age and a growth spurt with lagging weight gain led to temporary underweight.

Every child follows their own growth plan and when you get the parents when asked, they often also report of Underweight during their actual development. In both children and adults, it is not the numerical value alone but also the circumstances that decide whether further diagnostics are necessary in the case of underweight.

It is important not only to compare the child with their peers, but also to include in their decision-making whether it is a fit, lively child with a great urge to move or whether there are signs of a disorder such as fatigue, Listlessness or mental abnormalities available.

Physical causes

One of most common physical reasons for being underweight is the Hyperthyroidism (lat: hyperthyroidosis: hyper = over, Thyroid gland = thyroid). The thyroid is the central organ of ours Metabolism controls and can accelerate it in the event of overfunction so that Excessively burned nutrients and to Energy converted and no nutrients migrate into the body.

The central hormone of the thyroid is the so-called Thyroxinethat easy in one Blood test can be measured. The examination of the thyroid function in the blood is one of the first and easiest examinations in the clarification of underweight.

Since the Nutrient absorption from the intestine takes place, is the logical consideration that a bowel disease in underweight. This can all be chronically inflammatory Bowel disease again Crohn's disease and the Ulcerative colitis be the cause. These diseases are parts of the Intestinal mucosa almost permanently inflamed and the intestinal cells can no longer fulfill their function and only absorb insufficient nutrients, what in the long run to underweight with the resulting Deficiency symptoms leads.

Also previously unrecognized Intolerance to sugars such as lactose or Fructose can be the cause of intestinal disorders and thus be responsible for the underweight. Usually already in childhood a so-called Sprue noticeable. Here one leads Destruction of the intestinal cells by a allergy on the Grain protein gluten to malnutrition.

Even when the intestine is functioning, nutrients can still be lost through the intestine when ingested for example lack of splitting (as after Gastric removals or through Biliary obstruction such as Pancreatic malfunction) are not possible. In rare cases you can also Parasites or worms in the intestines hinder nutrient absorption.

Causes of unwanted weight loss and being underweight can also be remote from the digestive system. Many serious illnesses can use up the body's reserves due to their high energy requirements and lead to underweight. These diseases can Tumors who need a lot of energy due to their rapid cell growth. Furthermore you can tuberculosis or AIDS drive up the body's energy requirements and lead to underweight. Until a certain cause is found, these diseases cannot be ruled out and must be kept in mind.

Mental causes

Adults like children can as a result of one Stress response our bodies are temporarily underweight. The stress can be from Sadness through the death of an important caregiver, up to Stress in the workplace have many causes, all of which are literally upset, and those affected do not feel an appetite and lose weight.

Besides these temporary causes are the anorexia (=anorexia) and the Bulimia nervosa (=bulimia) other well-known psychological factors that lead to underweight. Since these two clinical pictures have a lot to do with one disturbed relationship to food and having to do with your own body is urgent therapeutic help to claim something.

Symptoms and consequences

Underweight is the result of fat and sometimes muscle loss in the body. Only when deficiency symptoms appear, one speaks of pathological underweight. You should consult a doctor at the latest when they occur.

Especially if the weight loss occurs involuntarily and for no reason, a visit to the doctor is absolutely advisable, as many serious illnesses are associated with sudden weight loss. In the case of malnutrition, the body lacks vital building materials and energy suppliers.

The body begins to break down fat and muscle in order to be able to provide the necessary energy for all body cells. The lack of energy first becomes noticeable in paleness, reduced performance, tiredness and difficulty concentrating. Further emaciation and slowing down of the metabolism eventually lead to the first physical symptoms such as poor circulation, dry skin, brittle hair or cracked nails.

Those affected are weakened in their body's defenses and are therefore more susceptible to illness than other people and need longer to get back on their feet after the illness. Wounds tend to heal poorly and, in combination with the higher susceptibility to infection, lead to higher complication rates.

The lack of building materials leads to short stature in children. This can occur during pregnancy and the children are born with a very low birth weight. In children, underweight leads to short stature in the course of their life if the nutrient deficiency is still present.
It is only when there is a long-term lack of energy in both children and adults that enough proteins can no longer be produced in the liver and fluid can no longer be held in the vessels and begins to get out of the vascular system and collects in various parts of the body such as the abdomen .
So the so-called hunger edema with an apparently bloated belly occurs when the rest of the body is emaciated. The consequence of permanent malnutrition is also a change in the hormonal balance.

In women, this manifests itself in menstrual disorders or even a complete absence of the menstrual period. However, cardiovascular problems can also occur. For bulimia, the Bulimia nervosa, the permanent vomiting of the salt and acid-base balance of the body can go completely out of joint and, last but not least, a loss of potassium can lead to life-threatening heart rhythm disorders.

However, effects on the calcium, magnesium, phosphate and iron balance are also to be expected. The constant vomiting attacks the teeth in the mouth and the hydrochloric acid contained in the gastric juice can cause irreparable damage to the teeth.

Patients with bulimia or other eating disorders are not always easy to recognize, as those affected usually go to great lengths to keep their eating disorder secret. But there are signs that the environment can react. Girls in puberty in particular tend to be dissatisfied with their own bodies and want to comply with the applicable ideals of beauty.
The affected girls try to increase their weight loss through excessive exercise. Food intake is much more critical, because those affected deal extensively with nutritional values and avoid nutritionally rich foods.

In everyday life they only try to eat food of their own choosing and avoid family meals or other public dining opportunities. Those affected feel the need to weigh themselves several times a day and feel too fat despite weight loss and underweight. Although food is barely ingested, people think about food most of the day and think about it all the time. It is important to recognize the eating disorder at an early stage and to seek help, because without help it is usually not possible to escape the eating disorder.

therapy

If the doctor or therapist recommends a diet for gaining weight, it should several small meals made from healthy foods consumed per day that many Vitamins, carbohydrates, Trace elements and Minerals contain. Bananas, nuts, whole grain products, pasta, potatoes, cheese, cream and cream products, oils, spices and shortbreads are particularly suitable for this.

Affected babies can have a special high-calorie milk food to be fed. Nevertheless, gaining weight is often not easy, even without an eating disorder, and you should be happy about small progress.

In the case of eating disorders, nutritional therapy cannot simply be started because the affected person is eating avoid despite being underweight become. Important part of the therapy anorexia or bulimia is to re-teach the affected person how to eat normally and a healthy relationship to convey to the body.
This is often done with the help of a outpatient therapy in a day clinic or inpatient therapy in a suitable clinic. In addition to building a normal body weight, the therapy also includes a psychotherapy in addition to physical and mental health, as well as one's own To restore body health and prevent relapse.

Only if those affected learn their own again Body to accept and by listening to its signals like hunger, they can get rid of the eating disorder. As part of psychotherapy, the Causes of Eating Disorder worked out and worked up to eliminate this as the cause of the eating disorder.

Is a bigger one social or family problem the cause can also be a Family therapy be advisable. The duration of the therapy varies, but generally speaking, the earlier the eating disorder is recognized, the better it can be treated. If the person concerned continues to refuse therapy despite life-threatening deficiency symptoms, a Force-feeding become necessary. This is via a Nasogastric tube, a thin tube through the mouth straight into the stomach.

diagnosis

The diagnosis of underweight results from the weight and questioning the person concerned. Here in particular is that Differentiation between normal and pathological underweight important to assess the need for treatment.

A food diary can be helpful here. To rule out physical causes, a blood test is suitable, in which many possible reasons for the underweight, for example through the Determination of thyroid levelscan be clarified.

When diagnosing an eating disorder, more sensitivity is required, as those affected usually try many means Eating disorder in secret to keep. By careful questioning and approach one reaches the person concerned. Careful preparation for the therapy is necessary in order to make the person concerned aware of the disease value of the disorder.
Can be serious evidence of an eating disorder extreme sport, repeated Weigh several times a day and the Refusal to eat be.

forecast

If you are underweight, the prognosis varies depending on the cause.

The Hyperthyroidism is through Medication or radioactive radiation correct and the thyroid function and then the weight can be normalized. More serious illnesses like tumor, AIDS or one tuberculosis are partly treatable and the prognosis varies with the severity of the disease.

Affected that are genetically underweight without deficiency symptoms, have little effect on their quality of life and life expectancy to fear. Statements on the prognosis for eating disorders are generally difficult. Generally stick around 50% of those affected lifelong more or less abnormal in their eating habits even when their weight is back in the normal range.

The chance of complete relief from the eating disorder is higher, the higher the fault was recognized earlier and is treated and decreases the lower the weight of the affected person has fallen. Even if one type of eating disorder is successfully treated, one can always be other form of eating disorder occur and the vicious circle begins again.

All in all to die despite good treatment procedures in Germany still 10% of those affected the eating disorder and its consequences. If you suffer from an eating disorder, the chance of another mental illness, such as depression or an addiction, e.g. to Alcohol, to become ill, and the chance of recovery of total increases mental and physical health further reduced.