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Defined by a body mass index of less than 18.5, thinness can cause discomfort and health problems. Zoom on its causes and consequences and advice to gain a few pounds.
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If those who are 40 and older dream of wearing 34, the threadlike women do not necessarily feel good about themselves. In a society where appearance is exaggeratedly important, thinness is just as badly experienced as being overweight. It can also have health consequences. Hence the interest in implementing a strategy to get closer to the "ideal" weight.

How do you know if you're too skinny?

  • The body mass index (BMI) gives a first indication. To calculate yours, just divide your weight (in kilos) by your height (in m) and divide the result again by your height. For example, if you weigh 50 pounds for 1.60 m, your BMI is equal to: (50: 1.6): 1.6, or 19.5. calculate your body mass index here )
According to the World Health Organization, a healthy weight compatible with good health corresponds to a BMI between 18.5 and 25 . Beyond, we are overweight and below, we are skinny. There is however a small margin: for people who have always been round, a BMI between 25 and 27 is acceptable. For people who have always been ultra thin, a BMI of 17.5 (45 kilos for 1.60 m) is not worrying.
On the other hand, at less than 17, following rapid weight loss , we speak of undernutrition , the severity of which increases with the drop in BMI.
  • The measurement of body composition gives a second indication, allowing to know if the fat mass or the lean mass is affected. Family scales with impedance  measurement (whose operation is based on the lean mass's ability to conduct electric current) are not very precise, but they do allow a trend to be identified 1 .
The lower the muscle mass, the more health risks are associated with thinness. Muscle wasting is often seen with the naked eye, especially in the legs (quadriceps muscles).

Causes of thinness 


We talk about constitutional thinness for people whose weight is stable and who have always been very thin, with a weight curve without break when they were children or adolescentsOften other family members are affected. For Pr Bruno Estour, of the Endocrinology, Metabolic Diseases and Eating Behavior Disorders Department at the Saint Etienne University Hospital, genetic factors are probably at stake. This doctor, who for years has been following with his team women " naturally "skinny (whose BMI is sometimes just equal to 15), notes that the latter have a completely normal energy intake. Compared to control women whose BMI is between 19 and 22, they have a slightly lower fat mass, but above all a reduced muscle mass and bone mass, which increases their risk of fracture in the medium or long term 2 .


Too low a weight can also result from weight loss, voluntary or not . In the case of anorexia nervosa , an overly restrictive diet, sometimes justified by some initial curves, leads to excessive weight loss. The wish expressed by the young girls or women concerned to gain pounds, often motivated by comments from those around them, is opposed to a distorted vision of the body image, with the feeling of being always "fat" 3 . Other diets, too strict and monotonous, followed for health reasons ( familial hypercholesterolemia , diabetes , irritable bowel syndrome , high blood pressure), can cause involuntary weight loss.
The same is true of emotional shock, which suppresses appetite via the released stress hormones. Many diseases ( celiac disease , Crohn's disease , hyperthyroidism , infectious diseases, cancers, etc.) are weight loss despite normal-calorie meal, resulting malabsorption of nutrients or energy increasing metabolism, ie by burning more calories than usual. If you find that your weight is decreasing while you are not on a diet, consult your doctor quickly to find the cause.

Leanness: what consequences on health?

The consequences on health are less in the event of constitutional thinness , which however exposes to osteoporosis (diagnosed from the age of 20 for 25% of the women followed by Pr Bruno Estour's team), or even to depression 1 .  
In other cases, thinness leads to fertility problems . Too low reserves and / or an insufficient supply of energy and lipids (fats), induce amenorrhea (absence of rules linked to an interruption of the ovarian cycle) which is accompanied by an increased risk of osteoporosis by estrogen deficiency. The return to a healthy weight fortunately restores fertility and reactivates bone mineralization 4 .
The thinness associated with muscle wasting , accompanied:
  • fatigue;
  • less capacity for effort;
  • a weakened immune system exposing you to infections;
  • longer healing or healing times in the event of illness or surgery.
The extreme thinness affects cardiac function. In the absence of care, it can cause death 5-6 .

Gaining weight: good advice for gaining weight 

Whatever the reason why the BMI is insufficient, weight gain is conditioned by an increase in energy intake.
  • Make sure you have a balanced diet according to the National Nutrition Health Program benchmarks: 3 to 4 dairy products and minimum 5 fruits or vegetables per day, meat, fish, eggs or legumes at least once a day , bread or starchy foods with each meal, rapeseed oil or nuts in the kitchen, at least 1.5 l of drink daily.
  • If you are quickly satisfied during the main meals, multiply the snacks , in the morning and in the afternoon, possibly at the end of the evening: an individual bread with cheese, cookies and a glass of milk, a fruit and a yogurt, a handful of nuts and a pressed fruit ...
  • If you have a very small appetite, enrich your yogurts, purees, soups , powdered milk, egg yolk, grated cheese, chopped ham ... Unless advised otherwise, you can perform a cure of one month '' a multivitamin food supplement to optimize your intake of vitamins and minerals.
  • Add flavor to your dishes with herbs and spices to whet your appetite; take care of their presentation.
  • With your doctor's agreement, relax a possible diet (no salt, no fat, no sugar, etc.) followed for health reasons.
  • If necessary, limit your consumption of tobacco, caffeine (coffee, tea, cola-based sodas, etc.) or alcohol , which increase energy expenditure or suppress your appetite.
  • Do not disdain sport , complementary to a correct intake of proteins (meats, fish, eggs, legumes, dairy products) to regain muscle mass. Resistance exercises are the most effective: work with dumbbells, rubber bands, foam logs in the water or weight machines in the gym.
If you are concerned with constitutional thinness, be patient, because you are fighting against nature. In a small study conducted by Pr Estour's service, a supplement of 700 kcal per day for a month only allowed lean women to take 700 g, while control women (BMI between 19 and 22) took 1 , 3 kilo. However, your efforts will eventually pay off, especially since lean people and people with "normal" BMI gain as much weight in life: around ten kilos between 20 and 50 years of age.
Do not hesitate to take advice from your general practitioner, a dietitian or a nutritionist .
If you are unable to eat certain foods or if you do not support the idea of ​​gaining weight, have the help of a psychotherapist , a psychiatrist or contact a mutual aid association for patients suffering 

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