UNDERWEIGHT

NIVRUTHA
ASST.PROF.
R.A.COLLEGE FOR
WOMEN
 INTRODUCTION
• People who are less than 18.5 BMI are considered as
UNDERWEIGHT
• NNMB – 2006 survey - 55% of preschool goers were
underweight
LIMITATIONS
• Adult with <18.5 - ↓ VO2 max, ↓ capacity for heavy work
& low productivity
• Pregnant women - ↑ risk of underweight ↑ baby birth
relation to post partum BMI 25-16less
• Prolonged bed ridden condition
• Immunological deficits – particular in men with low BMI
• Age of menarche period is delay – 1-2yrs
 AETIOLOGICAL FACTORS
• Starvation due to famine condition or inadequate diet
• Also results from TB, DM, malabsorption syndrome, cancer
• Anorexia nervosa common among teen girls – diet maintenance,
body fitness etc.
• Pathological conditions – fevers, GI disturbances,
hyperthyroidism
• High metabolism
• Psychological problems
• High physical activity

• Familial history
 SIGNS & SYMPTOMS
Physical signs
• Sudden or rapid weight loss (over a stone in less than a month)
• Fatigue
• Frequent changes in weight
• Struggling to concentrate
• Feeling unwell after meals
• Loss of appetite
• Feeling cold all the time (even in warm environments)
• Thinning or loss of hair
• Dizziness or fainting spells
• Disrupted sleeping patterns
• Decreased heart rate
• Anemia
Behavioural signs
• Constant or repetitive dieting
• Changes in eating habits
• Excessive or compulsive exercising
• Always going to the toilet after meals
• Often skipping meals
• Cooking lots of foods for others, but not eating any themselves
• Pushing food around the plate, or chopping into very small portions
• Evidence of binge eating
• Regularly weighing self and always looking in the mirror
• Evidence of vomiting or laxative abuse
• Only eating certain low-calorie foods like lettuce or celery when
people are present
PSYCHOLOGICAL SIGNS
• Obsession with food and nutritional content
• Always worried about body size and shape
• Intense fear of gaining weight
• Constantly thinking they are fat, despite being told otherwise
• Uncomfortable eating in public places
• Preoccupied with celebrity images and their bodies
• Anxious about eating with others
• Mood swings, depression or easily irritated
• Seeing things, especially food, as black and white, good or bad.
 RISK FACTORS
• Osteoporosis. 
• Skin, hair, or teeth problems. 
• Getting sick frequently.
• Anemia. 
• Irregular periods. 
• Pregnancy complications
• Premature births. 
• Slow or impaired growth. 
• Gum problems
• Compressed immune system
DIET MANAGEMENT
High calorie

High protein

High fat

Liberal vitamin and minerals

Normal fluid
• Energy – additional 500kcals. Increase kcals gradually
• Proteins – 1.2g/kg. good quality protein is suggested
• Fat – easy digestible fat is suggested. Avoid fried and fatty
foods – cause diarrhoea
• CHO – GLV restricted, rich source – dried fruits, sweets, nuts,
desserts, jam, jelly, cereals, NV.
• No.of meals increased
• Vitamins & minerals – liberal quantity fluids – not adviced
before or mid of the meal. Enough fluid suggested to avoid
constipation
TREATMENT
• Adding snacks. High-protein and whole-grain carbohydrate snacks.
Examples - peanut butter crackers, protein bars, trail mix, pita chips
and hummus, or a handful of almonds.
• Eating several small meals a day.  cannot tolerate eating large meals.
Instead, eat several small meals throughout the day.
• Incorporating additional foods. add calorie-dense food sources to
their existing diet, such as putting slivered almonds on top of cereal or
yogurt, sunflower or chia seeds on a salad or soup, or nut butter on
whole-grain toast.
• Avoiding empty calories. Eating high-calorie foods may cause a
person to gain weight, but they also have excess fats that could affect a
person’s heart and blood vessels. avoid foods that are high in sugar and
salt.