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Underweight

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Underweight is a medical term for a body weight that is too low to maintain health. It is a condition that carries significant health risks for individuals. In many developing nations, being underweight is a primary cause of mortality. While obesity is a major public health concern in developed countries, underweight status is also a serious issue. It can be categorized into different levels of severity based on specific measurements. For example, a person with a body mass index (BMI) below 16.0 is considered severely underweight. A BMI between 16.0 and 16.9 is moderate, while 17.0 to 18.4 is classified as mild underweight.

To assess weight, doctors often use the Body Mass Index, or BMI. This is a ratio of a person's mass to their height squared. The result is usually measured in kilograms per meter squared (kg/m²). Another way to identify underweight individuals is by comparing them to a specific group. If a person weighs 15% to 20% below the average weight for their age and height, they are considered underweight. Scientists also look at body fat percentage to understand body composition. This method distinguishes between adipose tissue, which are fat cells, and muscle tissue. The American Council on Exercise notes that women need 10–13% essential fat for reproductive function. Men require between 2–5% essential fat to remain healthy.

Many different factors can cause a person to become underweight. Genetics can play a role in a person's natural body shape. Some people suffer from a lack of food, often due to poverty. Medical conditions such as type 1 diabetes, hyperthyroidism, cancer, and tuberculosis are also linked to low weight. Problems with the liver or gastrointestinal tract can prevent the body from absorbing nutrients. Eating disorders, such as anorexia nervosa, are another significant cause. These disorders can lead to nutrient deficiencies or result from excessive exercise. Some people also have a low appetite or use drugs that affect their hunger.

Being underweight can lead to several serious physiological problems. It can be a primary condition or a secondary symptom of an underlying illness. Severely underweight people often have poor physical stamina and a weak immune system. This leaves them more vulnerable to infections. Robert E. Black from the Johns Hopkins School of Public Health noted that underweight status and micronutrient deficiencies decrease host defenses. This can lead to death if infectious diseases follow. Malnourishment also involves a lack of vital micronutrients, like vitamins and minerals, and essential amino acids. This can cause anemia, hair loss, and other bodily issues.

In women, being severely underweight can cause specific reproductive complications. It may lead to amenorrhea, which is the absence of menstruation. This can result in infertility or dangerous complications during pregnancy if weight gain is too low. Being underweight is also a risk factor for osteoporosis, a condition where bones become weak. This can affect even young people through a process involving hormone changes. In cases of excessive exercise and disordered eating, hormone changes during ovulation can lead to a loss of bone mineral density. If this leads to spontaneous fractures, the damage is often irreversible.

Global data shows that the prevalence of being underweight has changed over time. In 1975, the age-standardized global prevalence was 14.6% for women and 13.8% for men. By 2014, these numbers had dropped to 9.7% for women and 8.8% for men. This indicates a worldwide reduction in the extent of undernutrition. However, the mortality risks remain notable. Some reports suggest that being underweight increases mortality at rates comparable to morbid obesity. This effect is much less drastic in non-smokers who have no history of disease. Smoking and disease-related weight loss appear to be leading factors in these mortality rates.

There are several ways to treat underweight status and help a person gain weight. One common method is increasing calorie intake through calorie-dense foods. People may also consume liquid nutritional supplements to help. Exercise can also be used to increase body mass through muscle hypertrophy, which is the growth of muscle tissue. Weight lifting is effective for improving muscle tone and bone mineral density. While exercise is catabolic, meaning it causes a brief reduction in mass, the body undergoes anabolic overcompensation during recovery. This process causes muscles to grow through increased muscle proteins or enhanced glycogen storage. Finally, doctors may prescribe appetite stimulants, such as certain antidepressants or antihistamines, to help.

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