Chapter 12 - The Underweight

Organic Origins of Underweight | How to Gain Weight | How to Avoid Exercise | How Much Food for the Underweight?

It is difficult for our 25 million overweight citizens to realize that a sizable number of people suffer from the opposite extreme—underweight. To an obese person a condition of underweight might seem the next thing to Paradise.

Not so. The woman who is underweight feels that she has lost the softness of femininity. The fully developed female figure is glorified by movies, television, and advertising.

In spite of changing fashion trends we can look forward to undiminished interest in characteristics which can hardly be exemplified by the underweight. The "bony look" can be exploited only by fashion models, who display other types of attractiveness.

As for the males, they will continue to glory in the muscular physique which they assume is pleasing to females, to say nothing of its effect on their own egos. A trim, well-kept man is one thing, a skinny, undernourished-looking gentleman is another. By the stereotypes of our civilization an excessively thin fellow loses an element of his manliness. This is nonsense, but it is public opinion.

Organic Origins Of Underweight

If there is one thing which is true of both the obese and the underweight it is their failure to comprehend the reasons for their conditions. This is not a criticism. Sometimes the reasons are extremely subtle and can be determined only by skilled psychiatric care. A good many cases of underweight are caused by organic ailments. If the ailment is diagnosed and the person receives the proper treatment, the problem will be solved. As has been mentioned, organic disease is much more frequently the origin of underweight than of overweight.

Tuberculosis is one example. It is estimated that there are 400,000 cases of tuberculosis in the United States. About 150,000 of these have not yet been detected. Everyone who has not had a chest X ray within the past year should consult his physician or local health agency. Thanks to the National Tuberculosis Association, there are chest X ray surveys being carried out all over the United States.

The disease processes of tuberculosis increase body temperature and lead to a faster rate of food burning. In addition the toxic effects of the disease diminish the appetite. This can result in emaciation. If tuberculosis is discovered and the patient is given treatment, this will not happen. Modern tuberculosis drugs combat the disease poisons and stimulate the appetite.

Hyperthyroid conditions may also lead to severe underweight. These conditions are particularly evident in areas where there is a deficiency of iodine in the water. In this disease, the greater production of thyroid hormone stimulates the body to burn its food faster than normally.

Even in places where iodine is plentiful, nervous reactions may cause the thyroid to behave in a similar manner.

Hyperthyroid symptoms are easily recognizable. The patient complains constantly of being hot, perspires easily, uses a minimum of blankets in winter, and is always uncomfortable in summer. This condition can be relieved by treatment with radioactive iodine taken by mouth under the supervision of a competent physician.

In both tuberculosis and hyperthyroidism, it is the increased rate of burning food which leads ultimately to weight loss. In other ailments weight loss is caused by the destruction of body tissues. The latter group includes certain forms of cancer and malignant tumors of the blood.

The so-called wasting metabolic diseases, like diabetes and certain forms of kidney trouble, account for a substantial proportion of the underweight. Persons with diabetes lose food in the form of unburnt sugar in their urine. This results from lack of the hormone insulin, whose function is to metabolize sugar. About eighty per cent of all diabetic persons are overweight at the onset of disease.

Excessive eating strains the body mechanisms involved in utilizing food. The resulting overload can precipitate diabetes. This warning applies most urgently to overweight men and women from the ages of forty-five to sixty-five.

The 1 million diabetic patients under treatment have their illness under control. Some receive injections of insulin. All watch their diets carefully and are able to live full, active lives. But there are an estimated 1 million persons with undetected diabetes. Under the leadership of the American Diabetes Association, vigorous campaigns have been launched to locate these diabetic cases. A simple urine analysis is the first step in the detection of diabetes. Anyone who has not had such an analysis in the past year should certainly have one as part of his regular physical examination.

If the symptoms of diabetes were widely known, many of its unknown targets would be discovered. Here they are:

Excessive thirst
Constant hunger
Frequent urination
Loss of weight
Itching skin
Easy tiring
Changes in vision
Slow healing of cuts and scratches
Boils and carbuncles

Certain kidney ailments cause weight loss. In these cases, vital proteins, instead of being retained by the kidneys, leak into the urine and are lost.

Various diseases of the intestinal tract which prevent the absorption of food are also responsible for underweight. Among these are chronic diarrhea, colitis, ulcerations of the small intestines, intestinal parasites, and sprue. All are marked by diarrhea.

Other ailments of the intestinal tract result in so much pain after eating that some people starve themselves to avoid the discomfort. Among the most common of such conditions are peptic ulcers. These cause grinding, burning pains from one-half to two hours after meals, or they wake the sufferer with sharp pains in the middle of the night.

A large proportion of extreme "skin-and-bones" underweight is caused by anorexia nervosa. This is a psychological reaction to food which is the opposite of the compulsive eating already discussed. People suffering from anorexia must have help in solving the psychological problems which have interfered with their eating. These may be many and varied, dating from infancy and early childhood. Psychiatric care is essential before nutritional rehabilitation is possible.

Well now, let's assume that the somewhat grim matters just mentioned have been attended to—that is, that the organic illnesses have been discovered and treated and the psychological problems have responded to therapy. All we have to do now is to put back the missing pounds.

How To Gain Weight

What a delightful prospect. First, let's begin by reversing the lessons of this book. Let's proceed to do everything which is opposed to the advice of the previous pages.

We'll pour on the calories. We'll be profligate with butter, using it as lavishly as possible on meats, vegetables, cereals, and baked goods. We might use hot butter on bread, since it soaks in and enables us to consume more. Every pat of butter is 80 calories, every 3500 calories is equivalent to a pound of body weight.

Wherever we can, we substitute cream for milk. No sense in using an ounce of milk (16 calories) in your coffee when you can use an ounce of cream (100 calories). Remembering that fats and oils are the greatest concentrations of calories, we have a marvelous time saturating our salads with oil dressings. Our French dressing, for example, consists of three-fourths oil and one-fourth vinegar or lemon juice. By adding fats and oils we double the calories of virtually every food.

Others may settle for clear consommés, but we're on the lookout for cream soups. Let the overweight skip his gravy, we'll pour it on, realizing that each tablespoonful is almost one hundred calories.

Dessert is the caloric climax of every meal. We may settle for a 300-calorie slice of lemon meringue pie or, if we're quite satiated, may elect a mere 200-calorie sliver of apple pie. If the spirit moves us we might add a scoop of ice cream worth a few hundred more calories.

We have no scruples between meals, either, if the intake does not interfere with our regular meals. A 460-calorie malted milk or a 325-calorie ice cream soda is part of the daily routine. If we're still having trouble putting more flesh on the bones, our physician may prescribe the highly concentrated foods known as emulsified fats. These are available in drug stores under several brand names. They are palatable, can be added to any liquid, and are loaded with 100 to 300 calories to the ounce.

Readers who are underweight should show the same irreverence for the exercise advice previously given as for the recommendations on eating.

How To Avoid Exercise

When you're fattening up, take full advantage of modern labor-saving equipment. Whenever there's a choice between doing it yourself and flicking the "on" button of a machine, press the button. Let "do it yourself" be a slogan for the overweight. As far as you're concerned, allow the machine to dominate your every decision.

Your own motto might be, "Ride, Do Not Walk." Remember that for every mile you walk you will be burning 100 precious calories, so do not exercise excessively. Remember, however, that moderate exercise is healthful and stimulates the appetite. It helps to prepare you for more vigorous exercise at the dining table.

How Much Food For The Underweight?

You can find out how many pounds you are underweight by locating yourself in the table of Desirable Weights for Height, pages 7 and 8. Next, determine your total daily calorie expenditure by following the tables and instructions on pages 58 to 60.

Now you have to select a diet in excess of this amount. Whenever you consume 3500 calories more than you expend over a given period, you will gain one pound. If, for example, you eat 1750 calories a day more than you expend, you will add a half pound a day. Knowing your calorie expenditure, choose one of the Safe and Sure Diets which exceeds that amount. These are listed on pages 62 to 85. To this diet feel free to add as many of the extras discussed on the previous pages as you wish.

People who are overweight must reduce gradually, but the underweight are limited in eating only by their feeling of satiety.

If poor intake of food is the only factor affecting your weight, then you will gain automatically as you eat more calories than you expend. But this must be stressed—if the factors which caused your increased metabolism (such as the diseases we discussed) are still present, you will have to eat large quantities of food just to maintain your present weight and rapid weight gains will not occur.

If you are underweight, see your physician. Once the cause is removed, you can follow the diet pattern we have discussed and bring your weight up to its desirable point. Needless to say, you will then feel better and look better. You will find it a pleasure to buy the clothes to fit your new feminine figure or your new masculine physique.

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