Underweight in adolescents

By: Jutta Kamensky – Consumer Service Bavaria

For several years, numerous training programs and campaigns have been taking place for overweight children and adolescents. The flip side of the coin, the underweight, is hardly a topic in public to this day. The fact that gaining weight can be a real problem is often underestimated as much as the suffering of adolescents. So-called "bean stalks" and "asparagus tarantulas" can seemingly "Eat as much as you want", but don’t increase. Causes and consequences of underweight are diverse, but not always questionable. Those who weigh too little do not necessarily have health problems. However, if the underweight with a malnutrition and that there is an undersupply of nutrients, caution is advised. A balanced and tasty diet supplemented by many high-calorie tips can help to weigh a few pounds more slowly but surely.

Underweight in adolescents – no problem?

About 8 percent of children and adolescents between 6 and 16 years are at least 15 percent below their normal weight and are therefore underweight. The current Child and Adolescent Health Survey found that 21.9 percent of 11-17 year olds have characteristics of an eating disorder. Girls are affected almost twice as often as boys. The "slimming craze" is still worrying. That is why female teenagers often opt for a strict and one-sided diet. Other teenagers are underweight without the desire to be slim. They find their body and especially the thin arms and legs unattractive. Unsuccessful attempts to gain weight put a lot of strain on young people and above all on their self-confidence.

When does underweight begin?

Even without scales and calculations, underweight can be easily recognized by the sharp protrusion of the chest and pelvic bones. The body mass index (BMI) can also be used to assess whether the weight of children and adolescents is within the normal range. The BMI indicates the relationship between height and weight. For the calculation, the body weight in kilograms is divided by the height in meters squared.

Example: 50 kg / (1.65mx 1.65m) = 18.3
This BMI of 18.3 indicates a slight underweight.

Weight classification according to BMI:

  • under 17.5: pronounced underweight,
  • under 18.5: underweight,
  • between 18.5 and 25: normal weight,
  • between 25 and 30: overweight,
  • between 30 and 35: obesity grade I,
  • between 35 and 40: obesity grade II,
  • over 40: extreme obesity, grade III.

Since the normal body fat percentage in children and adolescents changes constantly depending on their age and gender, the percentile curves (growth curves) for the BMI have been developed for them. The percentile curve shows the range in which the value is based on age and BMI.

Causes of underweight

Heredity plays an important role in the causes of underweight, because the body structure is largely determined by the genes. Some people have a genetically very active metabolism. Their calorie requirement is on average 300 to 400 calories higher than that of people who are "good feed utilizers" and tend to gain weight quickly. Even under stress, which hits many people on the stomach, there is also some weight loss. Stress affects the feeling of hunger and appetite. Particularly active underweight people, who generally place little importance on food intake, also tend to be underweight. They even forget to eat something every now and then.

Weight loss in the event of illness

If you eat normal and are still underweight, you should definitely have a doctor check whether you have an illness that is associated with weight loss. This is the case, for example, with inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis. Food intolerance or hyperthyroidism can also be responsible for low body weight.

There is an eating disorder?

Not every underweight adolescent suffers from an eating disorder. And yet a body mass index below the normal range could also have a purely psychological cause. If parents suspect that the adolescents are suffering from severe forms of disturbed eating behavior such as anorexia (anorexia nervosa) or eating-vomiting addiction (bulimia nervosa), professional help from a doctor or psychotherapist is always required.

Harms underweight health?

Those who are underweight do not automatically have to get sick. Some people do not gain weight due to their increased metabolism and remain very slim for a lifetime, even though they consume plenty of calories. If underweight teenagers feel comfortable and productive, there is no cause for concern. For safety reasons, the health status of the pediatrician should still be clarified. Aiming for normal weight could be a long-term goal.

Underweight malnutrition

Underweight only has a negative impact if there is a malnutrition or malnutrition at the same time. Insufficient intake of the essential nutrients carbohydrates, fat, protein, vitamins and minerals is shown in the long term by a variety of symptoms. The immune system is weakened by the breakdown of muscles, fat tissue and metabolically active cells. Underweight people are more susceptible to infections and have few reserves for stressful periods. The risk of later osteoporosis is significantly higher in underweight people than in normal people.

Signs of serious underweight

  • inefficiency
  • Depression
  • Fatigue despite having enough sleep
  • stunted growth
  • difficulty concentrating
  • Circulatory disorders
  • frequent freezing
  • dry skin
  • dull or brittle hair until hair loss
  • Menstrual disorders

Gain healthy with underweight

If medical reasons for underweight are excluded, it is helpful to take a closer look at eating behavior. A nutritional log for 4 to 7 days provides information about the actual nutrient and calorie intake. It also clearly shows where calories can be added or saved too much. The basis for weight gain is in any case a wholesome diet. It should be balanced and cover the need for all important nutrients. As a guideline for the composition of the diet, the same recommendations apply as for normal people. The food pyramid shows the amounts and importance of the individual food groups per day that children and adolescents should consume.

Young people need daily:

  • plenty of liquid: water, tea, juice spritzer or a glass of juice
  • plenty of grain and cereal products, potatoes, rice or pasta
  • plenty of fruits and vegetables
  • moderate milk and milk products
  • moderate meat, low-fat sausage, fish and eggs
  • economical oil and fat
  • every now and then a small portion of candy or high-fat snacks

Copyright: BZfE, idea: S. Mannhardt

Energy requirement when gaining weight

On average, adolescents between the ages of 13 and 14 need about 2200 (girls) and 2700 (boys) kilocalories per day. For 15- to 18-year-olds, the energy requirement is 2500 (girls) and 3100 (boys) kilocalories. Underweight people should consume at least 500 to 1000 kilocalories per day in addition to their average energy requirements. This additional calorie intake may also be slowly increased from 500 to 1000 calories.

Tips for gaining weight

The goal for underweight people is to achieve a slow but continuous weight gain by means of a balanced and varied mixed diet. For gaining weight, it is ideal to take at least five to six meals a day or to eat something every two hours. High-calorie snacks between meals improve the energy balance. Diet and light products are not part of the diet of underweight people.

This is how dishes become rich in calories

The art of gaining weight is to eat high-calorie meals without quickly feeling full. The easiest way to achieve this is by using an energy-rich preparation and upgrading the dishes with calories from fat and sugar. Flatulent and highly filling meals are unfavorable because they inhibit appetite rather than increase it.

Enrich soups, sauces or casseroles with

  • Cream, double cream cheese and creme fraiche
  • 1 to 2 tablespoons of oil
  • grated cheese
  • wobble

Salads or raw food supplement with

  • roasted hazelnuts, almonds or walnuts
  • Oil seeds such as sunflower seeds, sesame seeds, pumpkin seeds
  • vegetables in oil such as dried tomatoes, zucchini, aubergines, mushrooms, artichokes or olives
  • cheese cubes

Refine desserts with

  • Cream and melted flakes
  • one to two teaspoons of high quality vegetable oils
  • glucose

Choose the high-calorie variant

Low-calorie alternatives are naturally available or influenced by many foods. Underweight people should in any case always for decide the high-calorie variant. When preparing the food, care must also be taken to add more energy.

To be preferred for underweight:

  • Bananas, grapes or plums instead of watermelons
  • Muesli prepared with a milk and cream mixture in a ratio of 50:50 instead of milk
  • bound cream soups instead of clear broth
  • Bread topped twice and brushed generously with butter or vegetable margarine
  • As a topping: high-fat cheese (from 50 percent fat in the dry matter) or high-fat sausage (liver sausage, mettwurst, salami)
  • high-energy spreads such as nut butter, pesto or nut nougat cream
  • Salad sauces with high quality oils such as walnut, olive or rapeseed oil
  • Use dairy products with full fat content (e.g. cream curd cheese instead of skimmed curd cheese)
  • High-fat fish such as salmon, tuna or mackerel
  • Whole grain bread instead of white bread
  • Swirl the vegetables, pasta and rice in butter
  • Avocados with 30g fat to 100g as a dip or pasta sauce

Increasing snacks

  • Vegetable sticks with cream curd dip
  • Fruits rich in sugar
  • Puff pastry, batter or shortcrust pastries such as Croissants or nut cake
  • Muesli and cream yoghurt
  • Wholegrain biscuits, fruit slices
  • Covered sandwiches

Drinks for more weight

Instead of mineral water, two liters of undiluted fruit and vegetable juices are allowed per day. For a change, a glass of whole milk, cocoa, soy milk, lemonade and cola tastes good. Milkshakes can be upgraded well with cream ice cream or delicious fruit and a cherry on top. It is best to sweeten tea with honey or syrup. Better drink after eating as before or with it, otherwise you are full early.

Snacking and nibbling desired!

  • granola bar
  • Chocolate, candy, gummy bears
  • Trail mix, nuts, dried fruit
  • Chips, cubes of cheese, peanuts
  • ice cream

This stimulates the appetite:

  • Various herbs and spices such as parsley, coriander and caraway
  • a lot of variety on the menu
  • several courses with each meal
  • Sets, napkins, appealing table decorations
  • favorite dishes
  • a harmonious table community
  • Walks in the fresh air

Fast food: yes!

Eating in company increases appetite. For a high-calorie meal – contrary to other recommendations – the fast food restaurant is also a good place to go. A maxi menu delivers more than 1000 kilocalories and also brings variety, a nice community and lots of fun.

Special products: drinking food

Those who are not successful with “normal” foods can try high-calorie drinking foods from the pharmacy. They come in many different flavors, sweet and savory. They are suitable good as well on the go.

Sport – light and well dosed!

Intensive exercise and high stress can slow down the feeling of hunger. Light and regular exercise is important and can even stimulate your appetite. Exercise to build muscle is recommended. This shapes the body and promotes a positive body feeling, which is often not very pronounced in underweight people. In endurance sports such as jogging, swimming or rowing, many calories are consumed, which then have to be replenished with food. To avoid excessive fat burning in these sports, they should be done for a maximum of 20 minutes.

Photo credit: 3638035 © PeJo Woman with underweight

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Calculation of the body mass index

eating disorder

The Free State of Bavaria provides you with independent, science-based information on consumer protection on this website.
Unfortunately, we are unable to offer individual legal information and personal advice. We are also not allowed to warn companies that are anti-competitive.
If you still have questions about your specific situation, please contact the contact points listed under Service.


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