Underweight
BMI (body mass indicator) less than 19 means underweight.
Underweight Young Women Without Later Weight Gain Are at High Risk for Osteopenia After Midlife[1]
In 2016, 75 million girls were registered as moderately or severely underweight. Exemplified by French girls, against the year 1998, in 2006, the likelihood increased by 41% for them to be abnormally thin or even underweight.
Specifically, in adolescents, physical and mental health linked to body shape plays the central role for major aspects such as successful career development, sexual life and long-term partnering.
In Germany, about 50% of female teenagers and 25% of male teenagers with physiologically normal body shape do believe to be overweight undergoing unsupervised dieting early in life. “Disordered eating” frequently leads to the clinical manifestation of eating and mental disorders as well as substance abuse in adolescence.
Amongst reported eating disorders, the absolute majority of cases are represented by anorexia nervosa and bulimia. The pubertal changes usually increase awareness of an individual body shape, when teenagers consider their bodies with enormous self-criticism. if anybody expresses a negative opinion about their shape particularities, this might negatively impact individual attitude in a long-term manner.
Experienced psychiatrists report specific behavioural patterns associated with the following:
- dieting mothers: if the mother is permanently talking about or undergoes dieting frequently, her daughter(s) follow this behavioural pattern; even after the mother stops dieting, children often continue uncontrolled starvation until their condition is diagnosed as an “eating disorder”
- children of academics: for example, children of teachers are particularly systematic and perfectionistic in dieting and developing anorexic conditions
- overprotected children: hyperactive parents strongly promote their initiatives focused on the children protection that significantly suppresses an adequate development of own interests, activities and competencies by children, who simply follow the behavioural patterns of their parents
- “stiff” families which are highly conservative following traditions; any change is considered to be damaging the family and may lead to disordered behaviour of affected children including eating and mental disorders.
- “conflict-mitigating” behavioural pattern in the family, when parents are avoiding any opinion difference in the family as potentially “destabilising” that may lead to eating and mental disorders of teenagers.
Particularly affected are usually teenagers with a meticulous personality and the tendency to perfectionism. Further to this, mood disorders such as depression go hand-in-hand with eating disorders.
Adverse childhood experiences may play a role as a vulnerability factor for eating disorders. Childhood maltreatment comprises any kind of experience of physical, sexual or emotional abuse as well as physical and emotional neglect.[2]
Chronic energy deficiency can lead to hypothalamic anovulation in underweight women.
Eating disorders, such as anorexia nervosa, constitute the most common cause of infertility in underweight women, who, in addition, experience miscarriages, and sexual dysfunction.
The relative energy deficiency in sports involves menstrual dysfunction due to low energy availability, which results in anovulation. Moreover, lipodystrophies, malnutrition, starvation, systematic illnesses (malignancies, endocrinopathies, infectious diseases, advanced chronic diseases, neurologic illnesses), and the utilization of drugs can cause excessive weight loss. They may result in fertility problems due to the loss of adipose tissue and the subsequent hormonal disturbances.
Nutritional counselling should target the restoration of energy balance by increasing intake and reducing output.
Medical treatment, recommended only for patients who did not respond to standard treatment, may include antipsychotics, antidepressants, or leptin administration.
Psychiatric treatment is considered an integral part of the standard treatment.[3]