Why Can't I Gain Weight? Underlying Health Issues - Surgery

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Could an inability to gain weight indicate an underlying health condition?


Hello, doctor.
My height is 157 cm and my weight is 40 kg.
I have been wanting to gain weight, but I am unsure which department to visit at the hospital.
What kind of treatment is typically provided for weight gain? Additionally, I have heard that difficulty in gaining weight may be related to metabolism or endocrine issues.
How can I determine the reason for my inability to gain weight? Do I need to undergo examinations in multiple specialties? I appreciate your help in addressing my concerns.
Thank you!

Xiao Jing, 20~29 year old female. Ask Date: 2002/05/19

Dr. Li Junde reply Surgery


Hello, Miss Hsiao-Ching: First of all, we need to correct our perspective on weight issues.
The most important thing is to prioritize physical and mental health.
If your weight is above the normal range, it may pose some problems; however, if it is on the lighter side and diseases have been ruled out, it should not be a major concern.
Using the Body Mass Index (BMI = weight in kg ÷ height in m²) as a measure, your BMI is 16.2 (the normal range is 18.5 to 22.9), which is slightly underweight.
It would be advisable to consult a family medicine or endocrinology specialist to check for any endocrine issues (such as thyroid problems) or other internal medical conditions.
If no other issues are found, there is no need to worry unnecessarily—just enjoy life!

Reply Date: 2002/05/19

More Info


Gaining weight can be a challenging endeavor for some individuals, particularly those who struggle with being underweight. Your height of 157 cm and weight of 40 kg indicate that you fall into the category of underweight, which can have various underlying health implications. It's essential to approach this issue holistically, considering both medical and lifestyle factors.

First and foremost, if you are looking to gain weight, it is advisable to consult a healthcare professional, specifically a primary care physician or an endocrinologist. These specialists can help assess your overall health and determine if there are any underlying medical conditions contributing to your difficulty in gaining weight. Common conditions that may affect weight gain include hyperthyroidism, diabetes, gastrointestinal disorders, malabsorption syndromes, and certain mental health issues such as anxiety or depression.

When you visit a healthcare provider, they will likely conduct a thorough medical history and physical examination. They may also recommend laboratory tests to evaluate your thyroid function, blood sugar levels, and other metabolic markers. These tests can help identify any hormonal or metabolic imbalances that may be hindering your ability to gain weight.

In terms of treatment, the approach to gaining weight typically involves a combination of dietary changes, exercise, and possibly medical interventions if an underlying condition is identified. Here are some strategies that may be recommended:
1. Nutritional Assessment: A registered dietitian can help you create a personalized meal plan that focuses on calorie-dense foods. This includes incorporating healthy fats (such as avocados, nuts, and olive oil), protein-rich foods (like lean meats, dairy, legumes, and protein shakes), and complex carbohydrates (such as whole grains and starchy vegetables).

2. Frequent Meals: Eating smaller, more frequent meals throughout the day can help increase your overall caloric intake. Aim for 5-6 meals or snacks daily rather than the traditional three.

3. Strength Training: Engaging in resistance training can help build muscle mass, which can contribute to healthy weight gain. Working with a fitness professional can help you develop a safe and effective exercise routine tailored to your needs.

4. Monitoring Progress: Keeping track of your weight and dietary intake can help you understand what works best for your body. Regular follow-ups with your healthcare provider can help monitor your progress and make necessary adjustments to your plan.

5. Addressing Psychological Factors: If emotional or psychological factors are contributing to your inability to gain weight, consider seeking support from a mental health professional. They can help address any underlying issues such as anxiety, depression, or disordered eating patterns.

6. Medical Interventions: In some cases, if an underlying medical condition is diagnosed, specific treatments may be necessary. For example, if hyperthyroidism is identified, medication or other interventions may be required to manage the condition effectively.

In summary, gaining weight is a multifaceted process that requires a comprehensive approach. Consulting with healthcare professionals can help identify any underlying issues and develop a tailored plan to support your weight gain goals. Remember, it’s essential to focus on healthy weight gain rather than just increasing numbers on the scale. Prioritizing nutrient-dense foods and incorporating physical activity can lead to sustainable and healthy weight gain over time.

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