Joseph R. Anticaglia, MD
Medical Advisory Board
A severely underweight person is as worrisome as a person being morbidly obese. Extremely underweight individuals are malnourished, and when the low body weight is persistent, it can have tragic consequences. Consider the situation with Karen Carpenter.
Former popular singer Karen Carpenter is a notable casualty of the eating disorder anorexia nervosa. This condition caused her to be severely malnourished, and chronically underweight, which led to her death. It is thought that low levels of the mineral potassium and other electrolyte imbalances, led to irregular heartbeats (cardiac arrythmias) causing her heart to stop beating. Her tragic death put a spotlight on the dangers of being underweight and her unpublicized battle with anorexia nervosa.
Princess Diana reportedly struggled with the eating disorder, bulimia nervosa. People with this potentially life threatening disorder have regular episodes of binge eating followed by selfinduced vomiting. Many with this problem take laxatives in the misguided idea of losing weight, or the hope of not gaining weight. This condition can result in electrolyte imbalances, such as low potassium and sodium, causing dangerous cardiac complications.
BMI is a screening tool that uses a calculation to estimate the amount of body mass. It uses a formula which is your weight in kilograms divided by your height in meters to determine your Body Mass Index. A BMI between 18.5 to 25 is considered normal. An index below 18.5 is underweight, and an index above 30 is obese.
It’s a rough estimate of your body mass. For instance, BMI calculations don’t apply to athletes with increased muscle mass, older individuals, or pregnant women. Waist to hip ratio, is another measurement that helps determine the health status of your body.
Subesity is a term I use to characterize severely, chronically underweight individuals in contradistinction to obesity. It’s a disorder in which your weight is persistently below the normal healthy weight needed by your body to perform at its best. With few exceptions, these individuals have a BMI below 18.5, and can encounter serious health problems. Subesity is more prevalent in women.
Significant weight loss that persists for 3 to 6 months, or longer, is a reason for concern. As the disorder persists, one may encounter nutritional deficiencies, compromised immune system, low blood pressure, dizziness, and frequent illnesses. People may complain of fatigue, feeling weak and tired all the time, loss of appetite, hair loss, irregular periods, poor concentration, feeling sad and depressed.
Psychological and physical conditions can cause people to be severely underweight. Psychological problems include anxiety, stress, depression, dementia, or eating disorders such as anorexia nervosa, or bulimia.
Physical disorders that cause people to be underweight include cancer, HIV, Crohn’s disease, type 1 diabetes, hyperthyroidism, and tuberculosis. Also, excessive exercise can worsen nutritional deficiencies; and chemotherapeutic drugs reduce appetite due to their side effects of inducing nausea and vomiting. At times, both psychological, and physical conditions may overlap requiring combined management.
If you are underweight, you have a greater risk of being malnourished with a lower immune system which exposes you to frequent infections. You might experience decreased muscle strength, be susceptible to osteoporosis, irregular menstruation, infertility as well as skin and hair problems. Underweight individuals are predominantly found in women.
Unintentional weight loss, or intentional extreme behaviors to lose weight or maintain a person’s weight are signals to seek medical attention. It’s essential to diagnose the cause of Subesity, and treatment options using the expertise of medical, psychological, and dietary professionals to treat this condition.
Etymology — Obesity is derived from two Latin words (Ob — over; egere -to devour, eat away)
Etymology — Subesity is derived from two Latin words (Sub — under, egere to devour, eat away)
This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.
