How thin is too thin?
Why being underweight can be unhealthy too
It may well be politically incorrect to talk about weight gain in the midst of what the United Nations’ World Health Organisation has labelled an obesity epidemic, but for a significant percentage of the population, being skinny is a painfully unhealthy subject.
BMI balance
Last month, researchers announced that being underweight is associated with what they called a “surprisingly wide range of deaths,” which include cardiovascular disease, suicide and Alzheimer’s disease. The study, published in The Lancet Diabetes and Endocrinology, examined the data of 3.6 million people and more than 357,000 deaths. A body mass index (BMI) that is too high or too low can shorten a person’s life, Dr Krishnan Bhaskaran of the London School of Hygiene & Tropical Medicine, and his colleagues wrote in the article.
“The raised risks of many outcomes at low BMI, coupled with the fact that mental health conditions showed the strongest inverse associations with low BMI, might indicate pervasive effects of mental health problems on a range of outcomes, through pathways that could include poorer self-care and less access to or use of healthcare services, or both,” the researchers wrote, while acknowledging the study’s limitations — it did not take diet into account, for example.
“There are many health risks if an individual is underweight or has a low body weight, as the body is not getting vital nutrients to function and maintain healthy skin, hair, bones and so on,” says Zenia Menon, Nutritionist at the Dubai Herbal & Treatment Centre. “The struggle is real for people wanting to increase muscle mass (gain weight) and a constant effort, just as it is for people trying to lose weight.”
However, being skinny isn’t necessarily the same as being clinically underweight. People are considered underweight if their BMI — a measure of body fat based on height and weight — is below 18.5. A BMI between 21 and 25 is generally considered healthy, although the weight of bone and muscle also contribute to the figure. Overall, a low BMI could indicate frailty, particularly in older people, or an underlying medical condition when accompanied by sudden unexplained weight loss.
There are many health risks if an individual is underweight or has a low body weight, as the body is not getting vital nutrients to function and maintain healthy skin, hair and bones.
Menon advises cross-checking with a body composition analysis, available at most clinics or gyms. “The BMI measurement may be inaccurate for a person who is tall or short, or for an athlete with high muscle mass. A body composition analysis measurement, which shows the breakdown of muscle mass, fat mass and water weight, is a better measuring scale.”
Menon identifies three categories associated with super-skinny people. She says many underweight people may have hyperthyroidism, when the thyroid gland is far more active overactive. “In such a case, there is an increased demand for higher calories to maintain the weight.”
Diabetes link
Second, although the vast majority of those with type 2 diabetes are overweight or obese, some ultra-thin individuals may also develop the disease. “Thin people may also have type 2 diabetes are at an equally high risk of mortality and death as compared to individuals at the obese end of the spectrum,” Menon says. Finally, pregnant women are also considered a high risk group if their weight in below normal. “They are at high risk of preterm births or can have complications during pregnancy.”
However, even if you don’t fall into any of these categories, chances are your bones aren’t getting the sustenance they need, and your skin, hair and vital organs are being deprived of essential nourishment. How then do you go about punching above your (current) weight? Oddly enough, the foods often recommended to overweight people work just as well for the super-skinny. Healthy fats such as olive oil, avocados, nuts and nut butters and fatty fish are also high in nutrients and calories, so while they can promote feelings of satiety and spark weight loss, they can also help those who are thin to put on weight.
Slowly increasing your calorific load — preferably under the supervision of a medical professional or certified nutritionist — will help push the scales further, Menon says.
Menon cautions against filling up for the sake of it. “Weight gain is certainly more than just calories in versus calories out,” she says. “Calories you intake must be as per your current health status, metabolic rate, activity patterns, other lifestyle habits that can determine your weight management progress. The portion sizes that determine the calories are an important factor and the right macronutrient distribution for successful weight or muscle gain. Eating high-calorie foods that are also high in sugar, refined carbohydrates and saturated fats is not healthy weight gain.”
Finally, exercise is equally important for lightweights as it is for those on the heavier side. Resistance-training routines such as pumping iron can add muscle mass and stimulate the appetite. “The type of exercises that help increase muscle mass will also help support the weight gain process,” Menon explains.
In the long run, you may have to accept that you’ll never put on as much weight as you’d like — but there are certainly a lot of things you can do to get healthier. n
Top ways to pack on the pounds
Zenia Menon, Nutritionist at the Dubai Herbal & Treatment Centre, offers advice on adding to your weight
Pick a healthy balanced diet with a range of nutrients.
Keep a food dairy to record your daily meals to help create new eating habits and track the progress of the weight. Start with an extra 200 kcals per day and progress slowly to build a daily habit rather than suddenly pushing the boat out with high-calorie meals.
Add calorie-dense foods to your eating plan.
Pick avocados, coconut oil, coconut milk, coconut yoghurt, coconut cream, olive oil, nuts, seeds and nut butters to boost your calorie intake without increasing bad cholesterol.
Eat multiple meals throughout the day, in small portions, and don’t skip your meals.
Pick calorie-dense snacks such as seed porridges, smoothies with nut butters or avocado on wholegrain toast. For your main meals, focus on protein and healthy fats.
Avoid empty calories from foods that are high in refined sugars and salt.