Overcoming Severe Malnutrition: A Guide for Busy Professionals

Q: Overcoming Severe Malnutrition: A Guide for Busy Professionals

Dear SILK： Based on your dietary analysis, your main issue is a lack of protein and caloric intake. <br>When preparing noodles for breakfast, in addition to the noodles and vegetables, you should include protein-rich foods such as eggs, beans, fish, and meat. <br>For lunch and di

Severe malnutrition

Dear Dr.
Shi,
Hello, I am an ordinary office worker, 155 cm tall.
I have been experiencing back pain for the past 4.5 years, which has gradually led to a loss of appetite.
I used to weigh around 50 kg, but now I weigh only 35 kg.
My menstrual cycle stopped a few years ago, and I feel extremely weak, fatigued, and pale.
I often suffer from frostbite and have severe skin peeling all over my body during winter, leaving me with numerous wrinkles.
My appetite is very poor, and I suffer from severe insomnia, feeling as if I am barely alive.
Due to family obligations, I still force myself to go to work, but I have been feeling increasingly overwhelmed in recent months.
I have started to make an effort to increase my food intake.
Chang Gung Hospital has been administering nutritional injections and prescribing vitamins, antidepressants, and anticoagulants for me for about six months now.

Currently, my diet consists of the following: for breakfast, I have one and a half servings of homemade fresh noodles (with either fried sauce or tomato paste); for lunch, I bring steamed buns, vegetable buns, and rice balls; for dinner, I eat less because I often feel nauseous after a long day at work.
Although I have been eating more—my weight was 37 kg six months ago—I have lost even more weight.
I often feel as though I might not make it through the day.
I would greatly appreciate your advice.
Besides going to the hospital, do I have any other options? I cannot be hospitalized as I need to work, and seeing a doctor is quite expensive and exhausting.
Thank you very much.
Sincerely,
Doctor Q&A Teams

SILK, 40~49 year old female. Ask Date: 2010/02/06

Dr. Shi Guimei reply Nutrition

Dear SILK: Based on your dietary analysis, your main issue is a lack of protein and caloric intake.
When preparing noodles for breakfast, in addition to the noodles and vegetables, you should include protein-rich foods such as eggs, beans, fish, and meat.
For lunch and dinner, it is best to combine staple foods (such as rice, noodles, buns, or gua bao) with protein sources and vegetables.
Ideally, you should consume fruit twice a day.
Use an appropriate amount of vegetable oil for cooking your meals.
You can also drink milk, yogurt, or soy milk between meals.
The above suggestions provide a cost-effective way to ensure proper nutrition.
Wishing you a Happy New Year! Sincerely, Dietitian Shih Kuei-Mei, Director of the Nutrition Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2010/02/06

More Info

Dear [Name],
Thank you for reaching out and sharing your situation. It sounds like you are facing significant challenges with your health, particularly with severe malnutrition and its associated symptoms. I commend you for your efforts to maintain your work responsibilities despite these difficulties. However, it is crucial to prioritize your health, as malnutrition can lead to serious complications if not addressed properly.

First, let's discuss the symptoms you are experiencing. Your weight loss from approximately 50 kg to 35 kg is alarming and indicates severe malnutrition. The symptoms you describe—weakness, pallor, skin issues, and severe insomnia—are all signs that your body is not receiving the nutrients it needs to function properly. Additionally, the cessation of menstruation is often linked to significant weight loss and malnutrition, which can affect your overall hormonal balance and health.

Given your busy schedule, it can be challenging to find time to focus on nutrition, but it is essential to make some adjustments to your diet and lifestyle to improve your condition. Here are some suggestions:
1. Nutrient-Dense Foods: Focus on incorporating more nutrient-dense foods into your meals. This includes foods high in calories and essential nutrients, such as nuts, seeds, avocados, whole grains, and lean proteins. Smoothies can be an excellent way to pack in calories and nutrients without requiring a large volume of food, which may be easier for you to consume.

2. Frequent Small Meals: Instead of trying to eat large meals, consider having smaller, more frequent meals throughout the day. This can help manage your appetite and reduce feelings of nausea or discomfort after eating. Aim for five to six small meals or snacks daily.

3. Hydration: Ensure you are staying hydrated, as dehydration can exacerbate feelings of fatigue and weakness. If plain water is unappealing, consider herbal teas or electrolyte drinks that can provide hydration along with some nutrients.

4. Nutritional Supplements: Since you are already receiving nutritional injections and taking vitamins, it may be beneficial to discuss with your healthcare provider the possibility of adding oral nutritional supplements. These can provide additional calories and nutrients in a convenient form.

5. Mental Health Support: The use of antidepressants indicates that you may be dealing with underlying mental health issues that can affect your appetite and overall well-being. It is essential to continue addressing these concerns with your healthcare provider. Consider seeking counseling or support groups that can help you manage stress and emotional challenges.

6. Physical Activity: While it may seem counterintuitive, engaging in light physical activity, such as walking or stretching, can help stimulate your appetite and improve your overall mood. However, be mindful not to overexert yourself, especially given your current state of health.

7. Social Support: Reach out to friends or family members who can provide emotional support and encouragement. Sometimes, sharing your struggles can alleviate some of the burdens you feel.

8. Professional Guidance: While you mentioned that seeing a doctor can be costly and exhausting, it is crucial to have regular check-ups, especially given your severe malnutrition. If possible, look for community health clinics or programs that offer services on a sliding scale based on income. They may provide more affordable options for ongoing care.

In conclusion, while your current situation is undoubtedly challenging, taking small, manageable steps towards improving your nutrition and overall health can make a significant difference. Remember, your health is a priority, and addressing these issues now can help prevent more severe complications in the future. Please consider reaching out to a healthcare professional for further guidance tailored to your specific needs.

Wishing you strength and better health,
Doctor Q&A Teams

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