Weight and Gastrointestinal Issues in Young Adults

Weight issues, gastrointestinal problems?

I am 156 cm tall and underweight, and I don't know why my weight has not been increasing.
My appetite hasn't changed; in February, I weighed between 46-47 kg, and at the beginning of March, I was still around 46-47 kg.
However, in April, my weight dropped to 44 kg, and since June, I have been fluctuating between 43-44 kg, with my lowest being 43.35 kg.
Recently, after eating, I have been experiencing bloating and frequent burping, with a sensation of gas in my throat.
My bowel movements occasionally consist of long, thin stools that do not taper off and do not have mucus.
Sometimes, I also have pellet-like stools that pass easily, and I can have both types of stools on the same day.
I have been drinking more water and eating vegetables; is this normal? I am extremely anxious about my weight, and no matter how much I eat, I can't seem to gain weight! I don't usually exercise, but last semester, I went from 42 kg to 46 kg, and I don't know how I did it.
I am still in high school, but my cholesterol levels were high when I had blood tests, while everything else was normal.
I have had gastrointestinal issues since elementary school, and I would like to know what might be wrong and how I can improve my situation.

A-Hua, 10~19 year old female. Ask Date: 2023/06/18

Dr. Chen Bozhang reply Family Medicine

Hello, if you feel unwell, please visit a family medicine or gastroenterology clinic for evaluation.
For dietary management, you can consult a nutritionist at the nutrition counseling clinic.
Thank you.

Reply Date: 2023/06/18

More Info

Understanding weight and gastrointestinal issues in young adults can be quite complex, especially when considering the interplay of diet, lifestyle, and underlying health conditions. Based on your description, it seems you are experiencing a combination of gastrointestinal symptoms, weight fluctuations, and anxiety about your health. Let's break this down.

Weight Management
Your concern about being underweight is valid, especially since you have noticed a decrease in your weight from 46-47 kg to 43-44 kg over a few months. Weight management in young adults can be influenced by several factors, including metabolic rate, dietary habits, stress levels, and physical activity.
1. Metabolism: Some individuals naturally have a higher metabolic rate, which means they burn calories more quickly than others. This can lead to difficulty in gaining weight, even if food intake seems adequate.

2. Dietary Intake: You mentioned that your food intake has not changed significantly, but it’s essential to evaluate the quality and caloric density of the foods you consume. Foods high in calories, such as nuts, avocados, whole grains, and healthy oils, can help increase your caloric intake without requiring you to eat large volumes of food.

3. Stress and Anxiety: Psychological factors, including stress and anxiety, can significantly impact appetite and digestion. If you are feeling anxious about your weight or health, this could lead to changes in your eating habits or digestive function.

Gastrointestinal Symptoms
Your gastrointestinal symptoms, such as bloating, gas, and irregular bowel movements, may indicate underlying issues that need to be addressed:
1. Bloating and Gas: These symptoms can be caused by various factors, including food intolerances (such as lactose or gluten), eating habits (like eating too quickly), or gastrointestinal conditions like irritable bowel syndrome (IBS). Keeping a food diary may help identify any specific foods that trigger these symptoms.

2. Bowel Movements: The variability in your stool consistency—from long, well-formed stools to "rabbit pellet" stools—suggests that your digestive system may not be functioning optimally. This could be due to inadequate fiber intake, dehydration, or stress. Aim for a diet rich in fiber (fruits, vegetables, whole grains) and ensure you are drinking enough water throughout the day.

3. High Cholesterol: The fact that you have high cholesterol levels at a young age is concerning. This could be influenced by genetics, diet, or other health conditions. It’s crucial to discuss this with a healthcare provider, as they may recommend dietary changes or further testing.

Recommendations for Improvement
1. Dietary Changes: Focus on a balanced diet that includes a variety of food groups. Incorporate more calorie-dense foods and ensure you are consuming enough protein, healthy fats, and complex carbohydrates.
2. Regular Eating Schedule: Try to eat at regular intervals to help regulate your metabolism and digestion. Skipping meals can lead to overeating later and may exacerbate gastrointestinal issues.

3. Hydration: Continue to drink plenty of water, as hydration is vital for digestion and overall health.

4. Physical Activity: While you mentioned not exercising regularly, incorporating some form of physical activity can help improve your metabolism, digestion, and overall well-being. Even light activities like walking can be beneficial.

5. Consult a Healthcare Professional: Given your ongoing symptoms and concerns about weight, it may be beneficial to consult a gastroenterologist or a registered dietitian. They can provide personalized advice, conduct necessary tests, and help you develop a comprehensive plan to address your concerns.

6. Mental Health: If anxiety about your health is affecting your daily life, consider speaking with a mental health professional. They can help you develop coping strategies and address any underlying issues contributing to your anxiety.

In conclusion, while your symptoms and weight concerns are understandably distressing, there are steps you can take to improve your situation. A holistic approach that includes dietary adjustments, regular eating habits, physical activity, and professional guidance will be key to managing your gastrointestinal health and achieving a healthy weight.

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