These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.
Weight
Question: My question involves normal weight. I am a twenty-three year old female. I have always been under weight. I am 5’3″ and presently 95 lbs. I have been told that I should weigh approximately 110 to 115. I do not believe I suffer from an eating disorder. I pretty much eat anything I want. I do not concern myself with fat content or calories. My problem is I just cannot gain weight. Doctors have told me that I have high metabolism, and this will change when I have a baby. I would like to know if it is safe to try to change my metabolism, or should I just wait and see. I am very healthy and do not feel this causes any health problems for me. I would like to gain weight, but I cannot figure out a way to put it on. Any suggestions?
Answer: There is a wide spectrum of weights for each height. This is usually a function of the body distribution patters and metabolic parameters inherited from your parents. The government has published “normal” height/weight charts. These are always argued vehemently when they are revised. Being “underweight” is usually of less concern than being “overweight” as long as there are no medical problems leading to the weight level. There does not appear to be any simple way to change one’s metabolism. There is indirect evidence that more exercise increases metabolism and less exercise decreases metabolism. However, this has never been shown by experimental technique. As long as your physician has established that there is no medical reason to be “underweight” I would not concern myself too much.
Underweight
Question: My question deals with “normal” metabolism; I am a 22 year old male 5’9″ and 134 lbs. This has always been a problem and I have tried everything to gain weight. I have seen Nutritionists, Doctors, Acupucturists, Weight Trainers, but nothing has worked. I have thought about taking growth hormones or steroids, but am afraid that it might inflict permanent damage to my body. If you also agree that there is no other possible treatment, I will begin the implementation of a “CYCLE” (four week dosages of steroid injections) and take it from there. Perhaps you might think that I have a psychological problem. I have seen a psychotherapist and his prescription, weekly “discussion sessions” with other mental cases, and anti-depressants: PROZAC and TRAZODONE.
Answer: Body size and conformation is an area of medicine that is poorly understood. It is fairly clear that the size and shape of your parents is the best predictor of size and shape. The size and shape of your parents and grandparents at every 10 years of life is also predictive of what your shape and size will be at each decade of life. Changing one’s habitus with drugs is a possibility. However, it is likely to cause long term side effects including different types of cancers, strokes, etc. Major mood swings are also common while one is taking these drugs. These effects plus the fact that it is an illegal use of these drugs would counsel against their use. It is of interest that you have been on Prozac. These drugs have been used to change people’s appetite centers – an approach that might be of benefit.
A different aspect of the problem is your perception of your size and shape. Focusing on one’s size and shape as an explanation of emotional and psychological troubles is usually misdirected. Leading a “normal” life will have little to do with one’s habitus. I would recommend further sessions with your therapist tp explore different aspects of your belief system.
