What if obesity is not an issue, and your problem is that you can't gain weight or maintain a healthy body weight on the other end of the spectrum?
I actually have a couple of friends who have been unable to gain weight, one due in part to her metabolism and medication, and the other due in part to anorexia. Both of my friends are extremely thin, and frequently have had people comment on their size. In fact, both of them said it is not unusual for even a stranger to say they need to gain weight, 'put some meat on their bones', or to offer them more food or larger portions because they can stand to eat more.
Just like obesity and overweight are not necessarily always caused by overeating, the same is true that being too thin is not always caused by under eating either.
Carson Kressley, who hosts the Lifetime Television show "How to Look Good Naked", was quoted on the show as saying, "...Zero is not a size, okay? It's a warning sign." (episode aired: January 10th, 2008)
In other words, there does come a point where being thin can become too thin, and that is a warning sign of other potential problems. There are ways to determine when your body weight is normal, below normal or in the danger zone.
Possible Symptoms of being Too Thin
Having a body mass index of less than two to three points below normal for your height and weight is a warning sign of being too thin.
For a woman, menstrual irregularities or lack of menstruation can be a sign for being too thin.
Being diagnosed with anemia or other deficiencies in vitamins and minerals can be a sign of being malnourished, which can result in being too thin.
When bones are clearly visible or palpable through the skin, particularly ribs and collarbones, it's a good bet this is a sign of being too thin.
A body weight of more than 15% under ideal weight is likely too thin.
Anorexia and bulimia symptoms are a clear warning sign that a person either is or is going to be too thin.
When trying to determine how thin is too thin, it is important to look at many other aspects besides the ones listed as warning signs. Genetics, just as with obesity and overweight, plays a role in a person's body size. If a person comes from a family with small statures, small frames, and thin relatives, then leaning on the thinner side is not as big of a warning sign of being two thin as a person who comes from a family of larger individuals and are leaning toward being too thin.
Also, looking at diet is important too. A healthy person who eats enough calories during the day for fueling their activities, eats a good variety of nutritional foods, and does not exercise too much but is still very thin might not actually be too thin, while someone the same size might be too thin.
When is being Too Thin a Sign of a Bigger Problem?
Anorexia nervosa and bulimia are certain types of psychological disorders that can cause rapid and unhealthy weight loss, to a weight that is exceedingly too thin for the build of a person. These eating disorders cause other problems besides just being too thin.
Some warning signs to look for to determine if being too thin might actually be an eating disorder are:
Rapid and unexplained weight loss
Hair loss, bleeding gums and loose teeth
Unexplained chronic bad breath
Never observing the person eating
Severe change in energy levels
Dark circles under the eyes, changes to the color of the whites of the eyes
Strange body odor, particular that which is similar to nail polish remover or alcohol
Disorientation, confusion or ‘brain fog' that is persistent or chronic
Dizzy spells, fainting, and nausea
Unexplained bruising, bone fractures or injuries
While some people are just naturally thin, and perhaps thinner than what is considered the norm, not everyone who is underweight or too thin has an eating disorder. Self esteem and self image can also lead to being too thin due to over-exercising and intentional over-exertion to maintain a certain body image.
There is no hard or fast rule for how much exercise is too much, if a person exercises to the point of exhaustion or physical energy, coupled with being too thin, this is a warning sign of a body image problem that should at least be addressed.
It is important to note that just like obesity and overweight, being too thin is not always the blame of the person, but perhaps an issue with certain medication, metabolism, health problems and more. However, just like obesity and overweight, being too thin is a medical condition that can lead to certain health problems, and thus weight should be managed by a qualified medical professional.
Michelle, thanks for writing on a topic which many people blow off. You point out rightly that over/underweight should be viewed as a condition that can affect our health, and that health should be the first concern, not the visual appearance. Great article!
Sorry, but I just have to point this out. Rapid weight loss is not a normal symptom of bulimia nervosa, and in fact most bulimics are of a normal or near overweight weight range. This is a common misconception. This is why bulimia nervosa is left untreated longer than anorexia nervosa -- because their weight usually does not dip to the underweight range and has very little physical symptoms, it's very uncommon for bulimics to be underweight.
Anyone reading this should keep this in mind. I used to suffer from bulimia nervosa myself.
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