Underweight but not from starving: risky?

The reason I pose this question here rather than the weight gain forum is because I am specifically confused about how to deal with the issue of being underweight when it is NOT caused by starving oneself.  I've received support on here to gain weight in the past, but have trouble assessing or dealing with my own situation because so many of the issues discussed revolve around trying to eat even just normal calorie amounts, and most of the "problems" are associated with starving.

For vanity and athletic purposes I do want to gain weight.  However, letting go of the weight thing and even calorie counting allowed me to have more of a life AND perform and feel better this summer than I have in a while.  However, my weight has dropped back to the place where it was in December when I joined and started such hard work to gain about 5lbs...

I really want to gain at least 10lbs [those 5 back + 5 more], but it takes a lot of work and force.  even to remain in my underweight state, I eat quite a bit [and currently participate in no activity, but when and what I do makes little difference in my weight even with the same  amount of eating for some reason].  I consider 3000 calories a low day's intake.

That's just a little background to hopefully explain where this question is coming from:

Are there risks that come with being underweight alone, or are most of the common risks you see [heart problems, etc.] from the starving part, not sololely th elow weight?

Also-what IS a good target weight?  I feel so caught inbetween--just letting myself be can feel the best, but by definition I should weigh so much more: is it really healthier to push it higher if starving didn't cause it to be so low?

What situation caused you to be underweight? How tall are you and how much do you weigh now?

A good target weight for weight gainers is usually a BMI of 20+.

I'm not a doctor, but I believe it is dangerous to remain underweight regardless of whether it was caused by disordered eating or not. After all, weight loss for whatever reason mean you were not taking in enough calories to sustain your body at its prior weight, no matter how many calories you were taking in.

Complications of being underweight include malnutrition, low iron, a compromised immune system, bone density loss, arthritis, infertility, miscarriage and muscle loss (and yes, the heart is a muscle). Other problems such as electrolyte imbalances also become more likely when you are underweight. It's hard to consider the risks you face without knowing why you are underweight, how underweight you are or how long this has been going on, but I don't see any reason to indicate you would be an exception.

I haven't lost weight, except for that which I forced myeslf to gain last winter.

That's why I'm asking the question: does being underweight alone give someone health risks?

vs. does not eating enough/losing weight/etc. cause problems...

''To become a little fatter and flabby isn't going to look good compared with looking thin and vigorous,'' says Dr. Mayer. But the individual who is exercising vigorously every day and whose daily pattern is a physically demanding one may be advised to moderate activity."

"The surroundings in which meals are eaten are also important. Sometimes it helps to make eating a social event with friends. How much food thin people actually consume also can be a key to the problem. Although the lean may swear that they eat a lot, some nutritionists recommend keeping a daily record of food intake for a more accurate reading."

"It is important, however, that snacks be eaten shortly after meals so that they do not interfere with the desire for the next meal"

"Most often, nutritionists recommend adding high-carbohydrate foods to the diet to boost cal-ories. Dried fruits, seeds and O O mod-erate amounts of nuts, for example,are ideal. So are hardy soups, whole-grain cereals, bread and rolls with unsweetened fruit butters and dairy products such as skim milk, buttermilk, low-fat yogurt and low-fat cheeses. At mealtimes, foods such as beans, corn, rice, peas and potatoes will add calories as well as important nutrients."

So, there are some quotes fromhttp://www.nytimes.com/1982/04/04/magazine/be auty-being-underweight-can-weigh-heavily.html ?&pagewanted=2

about how to possibly gain weight. I know it's frustrating but perhaps seeing a doctor about your thyroid or maybe cutting back on the amount of activity that you're doing would be helpful. how much activity do you get currently?

Chrissy,

I don't want to be mean and I appreciate you taking time to respond, but I'm really  not asking anything about "how do i gain weight or eat more."

Part of the reason I'm not posting this on the weight gain thread is because I really want to isolate purely the concept of

being underweight alone:

can this be problamatic and how?

not weight loss, not starvation, overexercie, etc.
JUST being underweight in and of itself--is that a problem/how?

The risks vary based on the WHY but in general, YES there are risks of being underweight. are you an athlete? the risks associated with being underweight are different if you got that way through exercise, a thyroid condition, or starvation.

Here is some information on being underweight...

Blanco-Schumacher notes that those who are underweight are prone to infection due to weak and easily compromised immune systems and tend to have low muscle mass, hair loss, and in some cases disrupted hormone regulation. Being underweight can also derail intake and absorption of vital nutrients, including amino acids, vitamins, and minerals, leading to increased risk of osteoporosis and anemia. In addition, underweight women are prone to amenorrhea and possible pregnancy complications.

it comes from...http://www.todaysdietitian.com/newarchives/td jan2008pg56.shtml

the reason i posted gaining info is because you expressed a desire to gain 10 pounds, so i thought it would be useful to give you some info. anyhow, i hope this helps answer your question.

Original Post by tears2triumph:

being underweight alone:

can this be problamatic and how?

 Yes, it can be problematic.  Being clinically underweight always has the medical implications above.  And the bottom line is that no matter what the specifics, the person has only become underweight by not eating enough to match their energy output needs.   That definition qualifies as malnutrition....  If you eat 3000 cals a day but you need 4000 or 5000 cals a day then you are just as malnourished as the person who needs 2000 cals a day but tries to exist on 500.

It's not the motivation or the method, it's the outcome that is important. 

If I start working as a trainer again (I am studying and not working at the moment),  what do you think is the responsible thing to do, in regards to under weight clients?

In the one gym that I worked at, the leading superior trainer who trained me,   recommended that I gain to 115 when I was about 108 (about 5 ‘ 5)    and I thought that was a responsible recommendation.

I hope that other trainers would act in the same way.

She said that even though I looked great/ healthy,  that there were still medical risks.


But was do you guys think is the limit?   BMI 18.5?    I think this is a good guide,    but think that it also depends on the clients body type; a BMI 20 women could look too thin, thus should be advised to gain,  and instructed on how to gain some muscle with the fat too.

But unfortunately, other clients can have BMI’S of 17 and still look healthy due to having very small frames;  how do YOU think trainers should handle clients that LOOK healthy,  but who are JUST below the healthy BMI cut off point?

Do you think the BMI of 18.5 should be part of our duty of care ? For example, should all clients that LOOK healthy but have SLIGHTLY lower BMI’S than 18.5 be advised to gain as part of the gyms policy?


What do YOU guys think is the cut off weight at which a trainer should allow?


I do not know how or if there are many gyms that make the recommendation of 18.5 BMI’S an  obligation that their trainers need to recommend.

I am by no means a doctor. This may sound ignorant, so forgive me.  However; have you been tested for hyperthyroidism?

If someone's clinically underweight, even though they LOOK healthy, then I think you should always recommend they a) get a doctor's note before they start and b) aim to gain.  You're not a doctor and illness doesn't show up necessarily from external appearance.  Also there's the question of liability.   If the underweight client lies about their health and you give them a trianing programme that ends up killing them, for example, then you could be regarded as irresponsible/liable for that.

Ask the question the other way around.  What would you say to a client that was in the obese category?...  BMI >30.   Would you hedge your bets that the person LOOKED pretty healthy (and it's possible, of course) or would you be advising them to see a doctor before they get started & encouraging them to work on a programme that resulted in weight-loss?   I expect you wouldn't even think twice about that one.

Definitely Jane -  I am concerned  because I do not actually think that a lot of gyms HAVE to make sure all members are above BMI of 18.5


As in,  when they join the gym,   I am fairly certain that there is no rule that every member needs to be weighed and measured, to make sure they within the healthy BMI range.

SOME gyms have a policy for OVER weigh people -  they some times need a doctors certificate before they are aloud to do  more intense exercise

But there is nothing for the under weight people, who are in the OPPOSITE predicament.

I think it should be standard rule in every gym.


Because society tends to think being under weight is   “ okay”   for people because “ they have fats metabolisms”   so a lot of normal people just assume it is healthy to have BMI’S of 16 or 17.

In fact, most people do not know that the same health risks still  apply to under weight people, even if they DO eat high amounts of calories;  as in, just because they do not starve themselves, most people assume that there is no risks for the under weight people who are “ naturally” that way.

I've pondered this very issue GIJANE and PERSONALTRAINER...I work at a gym and I see anorexically thin women and the trainers who work with them still treat them as if they have weight to lose. it's as if the trainer cares more about getting the client than helping someone to be in good health.

I think that perhaps there should be a minimum weight requirement to use the gym facility at all, otherwise the club should be held liable if someone happens to faint or kill themselves from over-exertion. Gyms have a responsibility to encourage healthy practices, and it seems that money is driving them too much. Maybe I'm overly critical because I work in Los Angeles and the prevalence of EDs here is surely greater than the general public and "health clubs" are fueling it instead of improving it.

Okay, so maybe it's not the responsibility of the gym to ensure that everyone is at a "healthy weight" but there are definitely instances when people are of such a low weight that exercise IS dangerous, whereas some people can be mildly underweight "naturally" and don't necessarily have immediate risks from exercising.

hmmm...great question. i definitely agree that no training under a certain BMI, unless it's strength training focused because the strain on the cardiovascular system could lead to cardiac arrest and literally kill the person. not good.

Original Post by chrissy1988:

I think that perhaps there should be a minimum weight requirement to use the gym facility at all, otherwise the club should be held liable if someone happens to faint or kill themselves from over-exertion. Gyms have a responsibility to encourage healthy practices, and it seems that money is driving them too much. Maybe I'm overly critical because I work in Los Angeles and the prevalence of EDs here is surely greater than the general public and "health clubs" are fueling it instead of improving it.

Okay, so maybe it's not the responsibility of the gym to ensure that everyone is at a "healthy weight" but there are definitely instances when people are of such a low weight that exercise IS dangerous, whereas some people can be mildly underweight "naturally" and don't necessarily have immediate risks from exercising.

Hmm. Well I have been turned away from gyms before when I was very underweight. That said, I was not a member already. I was trying to get a membership and they said not until I was a healthier weight. In hindsight, bravo to them! At the time, I was furious ;)

I do imagine it would be harder to turn away gym members who become underweight after joining, but I still think it is necessary. I'm good friends with a girl who was asked not to return to her gym until she had gained weight.

I was maybe 12 or 13 when I joined a gym?? And just beginning to recover from anorexia (BMI 15-16ish). I had to have my mom in there with me EVERY TIME (gym policy), so I was constantly watched (overexerciser) and only allowed to use the weights, except for a 5 minute walk on the treadmill (speed couldn't exceed 3 mph). Now I'm rarely at the gym... most of my training is outdoors! (much better, IMOP). THe gym really helped my recovery though, as it gave me something to look forward to in weight gain (MUSCLES!).

But to the OP- I'd check with your doctor about being underweight. If you have your period, and clearly in good health (good skin, thick-ish hair, strong nails), then *I* say you're in good health. BMI isn't always everything. I think some people with a BMI of 27 can be completely healthy if they're very muscular or just very larged framed. Same goes for something BMI 17+, I think it CAN still be healthy. Ask a doctor about it though... (as an example, my mom was always around a BMI of 18 and never had any health problems, and is perfectly healthy, though clinically underweight).

Oh GOOD -        I am SO relieved to hear that SOME gyms are responsible!!!!

tryatri -       &n bsp;  I totally agree -  but only a VERY SMALL minority of women can be healthy, get their periods, and have thick hair and nice skin at BMI’s of 18 and under.


Although I know a lot of women who can be healthier at BMI”S of 18.5 and over -  when it goes to BMI 18 or UNDER --     that is when  I have observed that is VERY rare for women to be able to be healthy at that weight.

But I am just confused about the rare exceptions -   women who have thin parents, have their periods, have thick hair, eat a LOT   and look very healthy at a BMI of  say, 17 -       &n bsp; SHOULD A GYM   make exceptions to raw individuals in this predicament - or is it BETTER for them to be safe than sorry?

In OTHER WORDS:   medically,women with BMI’S of about 17,  who have their period, have skinny parents with BMI’S of 18 or less,   have thick hair and healthy skin and also EAT a lot more than average -    are these people AT THE SAME RISKS of symptoms of being under weight?

I think gyms should have a policy where they require a doctor's clearance (note) before they are allowed to join. That way BMI won't play into a factor, and the really skinny and healthy people can join, whereas, (hopefully) anorexic over-exercisers won't.

Weight is just a number. It can influence how healthy someone is. A person won't die because they're underweight- they die because their heart collapses from lack of calories. A woman won't lose her period because she's underweight, she loses her period because her body fat dropped too low. It just so happens that usually a person is underweight when they're endangering themselves. 

That's my answer. A person can be healthy and *underweight*. You would know if you were just naturally underweight. If you're reading this, chances are you are not naturally underweight because otherwise, you wouldn't be on this site. (I do have to say, I'm borderline underweight, though my doctor says I'm extremely healthy. I joined this site to focus more on sports nutrition- stop BONKING in a 3 hour ride, ect.)

Original Post by personaltrainer87:

medically,women with BMI’S of about 17,  who have their period, have skinny parents with BMI’S of 18 or less,   have thick hair and healthy skin and also EAT a lot more than average -    are these people AT THE SAME RISKS of symptoms of being under weight?

Yes.

I think that there are some exceptions to the BMI classification charts. One person with a BMI of 26 can be just as healthy as someone with a BMI of 21. Similarly, a person with a BMI of 17 can be just as healthy as someone with a BMI of 21. 

The BMI charts are guidelines - it's not 100% accurate. You might be one of the exceptions. 

If you eat 3000+ calories a day, have nice skin, nails, and hair, and get your period, then I think you're fine. I have a couple of friends who are very naturally thin - they've always been that way. But they eat just as much as I do and they get their periods. They have nice thick hair as well. I really just think it's genetics. 

I am also borderline underweight but my doctor also says I am healthy - and I look very curvy and healthy too.

But I also look curvy fit and healthy at BMI less than 18.5 -      according to every one and my doctor.- not just my own opinion.

Lately it has been very cold so I have slipped to 49 kilo’s despite the fact I eat normally - so I am eating 3000 or more calories to add a little extra. Which is hard given that I already look healthy; but now that I appreciate the medical facts I am motivated to gain purely for those reasons.

Some people just cannot be bothered gaining  too much “ insurance”  weight JUST purely to protect themselves -  continuing to eat more than 3000 calories purely to gain “ insurance”   is just an added chore for some people, myself included.

so gaining to the 18.5 - 19 mark looks and feels fine for for me. cannot be bothered gaining more if my body does not dictate it.

So - as far as I am concerned if a client was borderline than I do not have an issue - as long as they do not have a problem with gaining the weight back if they lose any.


I would refuse to train them if they fell below the 18.5 mark and refused to gain it back.

And I would also refuse to train people who I thought tried to artificially control their weight so that it stayed at the lowest possible BMI.

Because people in this position are still putting themselves at risk of all those health problems;  just because a person is in the healthy range,    even the HEALTHY range can be unhealthy for many individuals.