Struggling with Low Appetite and Weight Gain: Seeking Solutions

Weight gain, body weight

Hello Doctor: I am currently about 185 cm tall but weigh only 52 kg.
I have undergone an endoscopy and other related examinations in the gastroenterology department, and there were no signs of parasites or other issues.
However, I often lack appetite and frequently feel hungry, but when I prepare to eat, I find that I cannot eat.
There are also times when I can eat more than three or four bowls of rice in one meal.
Since high school, my weight has fluctuated around this range, with my highest weight being about 60 kg, but in recent years, it has consistently remained around 52 kg.
I appear so thin that others often wonder if I am using drugs.
One factor that I am unsure about, which may contribute to this, is that I frequently experience insomnia at night, yet I can sleep for a long time in the morning.
Despite my efforts to adjust my schedule, I still often have insomnia at night, which disrupts my circadian rhythm.
I really don't know what to do...
I hope the doctor can provide suggestions and assistance to help me achieve a more standard body weight.

Ban Zhang, 30~39 year old female. Ask Date: 2021/03/26

Dr. Zhang Huangyu reply Nutrition

Hello, based on your statement, I recommend that you first visit a healthcare facility for a detailed examination and diagnosis at a family medicine or general internal medicine outpatient clinic.
The physician should determine the underlying cause of the abnormalities.
After that, you can consult a nutrition clinic for appropriate dietary recommendations.

Reply Date: 2021/03/26

More Info

It sounds like you're facing a complex situation regarding your appetite and weight management. Based on your height of 185 cm and weight of 52 kg, you are indeed underweight according to the Body Mass Index (BMI) standards. A healthy BMI typically ranges from 18.5 to 24.9, and your current BMI is approximately 15.1, which indicates that you are significantly below the normal weight range.
Your experience of fluctuating appetite—sometimes feeling very hungry but unable to eat, and other times being able to consume large quantities—can be quite perplexing. This inconsistency might be linked to several factors, including psychological stress, sleep disturbances, and possibly underlying medical conditions. Since you've already undergone gastrointestinal evaluations that ruled out conditions like parasitic infections, it may be beneficial to explore other potential causes.

Possible Factors Affecting Your Appetite and Weight:
1. Psychological Factors: Anxiety, depression, or stress can significantly impact appetite. If you are experiencing any emotional distress, it might be worthwhile to consult a mental health professional. Cognitive-behavioral therapy (CBT) has been shown to help individuals with eating issues.

2. Sleep Issues: You mentioned experiencing insomnia, which can affect your overall health, including your appetite and metabolism. Poor sleep can lead to hormonal imbalances that may suppress appetite or lead to unhealthy eating patterns. Establishing a consistent sleep routine and practicing good sleep hygiene can be beneficial.

3. Nutritional Deficiencies: Sometimes, a lack of certain nutrients can affect appetite. For instance, deficiencies in zinc or certain B vitamins can lead to decreased appetite. A consultation with a registered dietitian can help assess your dietary intake and recommend appropriate supplements if necessary.

4. Physical Activity: While exercise is generally beneficial, excessive physical activity without adequate caloric intake can lead to weight loss or difficulty gaining weight. If you are very active, consider adjusting your caloric intake to match your energy expenditure.

Recommendations for Improvement:
1. Increase Caloric Intake: Focus on consuming nutrient-dense foods that are high in calories but low in volume. Foods like nuts, seeds, avocados, and full-fat dairy products can help you increase your caloric intake without having to eat large amounts of food.

2. Frequent Small Meals: Instead of three large meals, try eating smaller meals more frequently throughout the day. This can help manage your appetite and make it easier to consume more calories.

3. Incorporate Protein: Ensure that you are getting enough protein in your diet, as it is essential for muscle maintenance and overall health. Consider protein-rich foods such as eggs, lean meats, legumes, and dairy.

4. Monitor Your Sleep: Work on improving your sleep quality. This might include establishing a bedtime routine, reducing screen time before bed, and creating a comfortable sleep environment.

5. Consult a Professional: Given the complexity of your situation, it may be beneficial to work with a healthcare provider, such as a dietitian or a physician specializing in metabolic disorders, who can provide personalized guidance based on your specific needs.

6. Consider Psychological Support: If you suspect that psychological factors are influencing your appetite, seeking support from a mental health professional can be very helpful.

In conclusion, addressing your low appetite and weight gain concerns will likely require a multifaceted approach that includes dietary adjustments, lifestyle changes, and possibly professional support. It's important to be patient with yourself as you work towards achieving a healthier weight and improving your overall well-being.

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