Gastrointestinal Issues: Exploring Causes of Low Weight and Treatment Options

Gastrointestinal issues

Hello Doctor: My height is 165 cm and my weight is 45 kg, giving me a BMI of 16.9.
My father, uncle, and paternal uncle are all slim.
When I was a child, I used to add soup to my rice to make it easier to eat when I couldn't finish my meals.
However, I stopped doing that as I grew older.
I consulted a traditional Chinese medicine practitioner who said it is a hereditary condition that cannot be changed.
During my month of military training, I woke up at 6 AM, ran 3 kilometers, had breakfast, trained, had lunch, trained again in the afternoon, had dinner, and went to bed at 10 PM.
When I enlisted, I weighed 43 kg, but during that month, I shot up to 52 kg! However, after a four-day break following my training, I weighed myself on the fourth day and was back to 45 kg.
During those four days, I still went to bed at 10 PM and woke up at 8 AM, but I didn't exercise and just stayed home playing on the computer and watching TV.
I would like to ask the doctor if some say that damaged intestinal villi might prevent weight gain, as I tend to have bowel movements in the afternoon after eating more in the morning.
Is there a way to treat this? Being too thin as a male is always considered unattractive.

Patrick, 30~39 year old female. Ask Date: 2017/02/01

Dr. Chen Qifeng reply Gastroenterology and Hepatology

In addition to dietary recommendations to increase protein and carbohydrate intake, one may consider taking digestive enzymes and appetite-stimulating medications.
As for small intestinal villous disease, it is a rare condition that typically presents problems from infancy.

Reply Date: 2017/02/01

More Info

Understanding gastrointestinal issues, particularly those leading to low weight, can be complex and multifaceted. Your situation, characterized by a low BMI of 16.9 and a history of rapid weight fluctuations, suggests that there may be underlying gastrointestinal or metabolic factors at play.
Firstly, it is essential to consider the role of nutrient absorption in your condition. The small intestine is responsible for absorbing nutrients from the food we consume. If the intestinal villi (tiny hair-like structures) are damaged, a condition known as malabsorption can occur. This can lead to symptoms such as diarrhea, bloating, and significant weight loss, as the body is unable to absorb the necessary nutrients effectively. Conditions such as celiac disease, Crohn's disease, or infections can lead to villous atrophy or inflammation, resulting in malabsorption.
Your description of having bowel movements shortly after eating, along with the sensation of food passing through quickly, raises the possibility of rapid gastric emptying or other gastrointestinal motility disorders. This can result in food not being adequately digested or absorbed before it moves into the colon, leading to loose stools and inadequate nutrient uptake.
Additionally, your family history of being naturally thin may suggest a genetic predisposition to a higher metabolism or lower body fat percentage. However, it is crucial to differentiate between being naturally thin and having an underlying health issue that could be contributing to your low weight.
In terms of treatment options, a comprehensive approach is necessary. Here are some steps you might consider:
1. Medical Evaluation: A thorough evaluation by a gastroenterologist is essential. This may include blood tests to check for nutrient deficiencies, stool tests to assess fat malabsorption, and imaging studies or endoscopy to evaluate the structure and function of your gastrointestinal tract.

2. Dietary Adjustments: Working with a registered dietitian can help you develop a meal plan that focuses on nutrient-dense foods. This may include increasing your intake of healthy fats, proteins, and complex carbohydrates. Incorporating small, frequent meals can also help manage symptoms of fullness and improve nutrient absorption.

3. Supplements: If malabsorption is confirmed, supplements may be necessary to address specific deficiencies. For instance, if you are not absorbing enough vitamins or minerals, targeted supplementation can help improve your overall health and weight.

4. Lifestyle Changes: Regular physical activity can help stimulate appetite and improve overall health. However, it is essential to balance exercise with adequate caloric intake to avoid further weight loss.

5. Monitoring and Follow-up: Regular follow-up with your healthcare provider is crucial to monitor your weight, nutritional status, and any gastrointestinal symptoms. This will help in adjusting your treatment plan as needed.

6. Psychological Support: If your weight concerns are causing distress or impacting your mental health, speaking with a mental health professional may be beneficial. Body image issues can significantly affect one’s quality of life, and addressing these feelings is important.

In conclusion, while your situation may have a genetic component, it is vital to rule out any underlying gastrointestinal disorders that could be contributing to your low weight. A multidisciplinary approach involving medical evaluation, dietary management, and lifestyle modifications can help you achieve a healthier weight and improve your overall well-being.

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