Underweight & Can't seem to Gain Weight

@billie3 Hi Billie. You’re in one of those situations many people would find enviable, to shed a pesky 7-8 pounds. But it can be disconcerting when you’re not trying, especially when you don’t have excess weight to lose. Are you uncomfortable at this new weight or mostly concerned that this is unexplained?

You’ve seen an endocrinologist and dietitian so underlying conditions have been ruled out.
Have you had any fevers, night sweats, change in bodily functions, do you feel weak? Have you plateaued at this weight and no longer losing?
How about medications? Have those changed in the past year?
I read your bio. You appear very active, health conscious and participate in a lot of activities that require energy and calories. Had you increased the amount of activity during this time?

If you’re feeling healthy and all your blood tests such as CBCs have come back clean, at least that’s great news. My only experience with having to regain weight was after many rounds of chemo and a bone marrow transplant. Calories were vital. So for a few luscious, decadent months I could eat all the ice cream and high caloric foods I’d avoided for years! I felt so delightfully guilty. LOL. It did take several months to gain 10 pounds of the 30 I’d lost. At that point I backed off and reverted to a healthy diet and remain at that weight.

Hopefully someone in this Mayo Connect community will have some insights and suggestions to share! Lori.

@billie3 It sounds like you've had a steady weight all of your adult life. It makes sense you sought medical care for unintentional weight loss when your typical weight is already low.

May I ask how quickly you have lost the weight and was there anything significant that changed in your life during this time? COVID-19 comes to mind.

I had the same issue during and after antibiotic therapy for a long-term infection, and was given the same advice...easy to hear, but harder to execute, especially since I had no appetite at the time. I did everything suggested, and finally succeeded by adding a protein shake (I used Orgain) every day - usually in midafternoon, a handful of cashews every evening, and Instant Breakfast in my morning coffee. I also stocked my refrigerator with individually wrapped cheese snacks, and ate one before I went out of the house, whether to walk, garden or run errands. I literally forced myself to eat something every 2 hours from getting up to going to bed. It took a whole year, but I have regained 6 of the 20+ pounds I lost. Now, I must be vigilant to keep up with the high-calorie snacks or I lose some of my hard-fought gain.
Sue

Hi @billie3

I appreciate your post about the need to eat and maintain your weight. I also work to keep my weight up. I've had three surgeries of the upper digestive tract which included resections. After the second surgery, I also experienced a diminished appetite with weight loss. it was a concern to me as well. I suppose whenever we feel any part of our life is out of our control, it has a way of creating anxiety.

Since you mentioned having seen an endocrinologist and a dietician I'm wondering if you have seen a gastroenterologist. This doctor might do endoscopies to look for any problems in the digestive tract which may cause weight loss or a lack of appetite. Have you seen a GI specialist recently?

While it is certainly difficult to eat when you don't feel hungry, I certainly agree with what Sue, @sueinmn, said about being very intentional about eating small meals on a regular basis. Meals and snacks high in protein and good carbohydrates are important.

I look forward to hearing how you are doing with this problem. Will you post again and keep in touch?

@billie3, I can so relate to what you posted because I lost 30 unintended pounds over months. Despite labs and various scans, no medical reason was discovered. Despite the tests, after a few months I realized that my nausea and loss of appetite began after being prescribed Metformin for prediabetes. While I stopped the nausea with ginger, lack of appetite and wt loss continued. It was my own research that revealed that one of the first side effects of Metformin can be nausea.

It has been a daily challenge over the past 1 1/2yrs to try to regain more appetite and weight. Dietitian and pcp encouraged more high caloric foods and to eat more frequently., which I was already doing. After requests to pcp for more help, she eventually prescribed an appetite enhancer, Megestrol Acetate which did increase my appetite initially but lost effect over time. I have now regained some of the weight but at 5'8" and 104 pounds, I remain far from my goal of reaching the 125-128 stable weight enjoyed all of my adult life.

The fact that other older friends have mentioned less appetite now than when younger may be another contributing factor to having to force more food at mealtimes and with snacks. "Just 5 more bites" has become a constant refrain. Smiles

As you mentioned having seen an endocrinologist, I have requested a referral to an endocrinologist for help with osteoporosis and possible weight gain. I will take copies of the previous labs,tests, and scans to that appt. but it sounds as though the endo may not have new suggestions.

I appreciate Teresa's, @hopeful33250, suggestion of seeing an gastroenterologist as well.

Like Sue, @sueinmn, you, I and others have to stay vigilant as she writes to maintain what has been regained.

I wish for more research and reporting for those of us who struggle to maintain and regain a more normal weight. I've posted on other forums about my weight loss and inability to regain but if more of us speak out about this health concern perhaps eventually more ways will be found to address and improve the condition. Glad you posted and wanted you to know that you are not alone in this.

Hi @fiesty76 I have the opposite problem with not being able to lose any weight regardless of what I do. It is frustrating. Before my AVM I grew tarragon in my garden. One of my friends gave me a plant. I thought its flowers were pretty. When I researched its side effects and benefits I discovered tarragon increased appetite so I did not use it in my cooking. Mango fruit is another food that can increase weight. Although those 2 foods taste great I managed to omit them from my diet. Perhaps using different foods with timing for increasing or maintaining weight will fool your body. Often we hear our body can get used to a substance so it becomes less effective. Hopefully you will get answers from your endocrinologist soon. Wish you well. Toni

Thx for all the comments/feedback re:unintentional weight loss I've experienced. Reassuring to know I'm not alone with this issue. Last summer (in August) it was bloody hot here for wks. Despite the heat/humidity I was working a lot outdoors in our garden and I think that's when my weight (115) started to slip. And as one of you mentioned, Covid was in high gear at that pt and could have been a factor in my weight loss. When Covid hit and the reality of not being able to see our grandkids for months & months (still haven't seen them!) I think I was mildly depressed and my appetite waned for sure.
In the meantime . . . thank you to Sue, Lori, Erika, Teresa, fiesty76 and others who've "weighed in" (no pun intended). I have a colonoscopy scheduled for March 8 so maybe that will reveal something. I continue to eat 6 small meals/day, get serious about protein, etc. I started to eat junk food and/or fatty food to see if I could gain, but gave all that up since that would just make my A1C # increase (mine is normal rt now) and increase my blood cholesterol. There are days when my appetite wanes and I have to remind myself to eat. Someone mentioned a med to increase one's appetite, but I'd rather not take a med to "fix" my dilemma.

@avmcbellar, Whether we fall into the over or under weight spectrum, it can prove a perplexing challenge to find and try new approaches to help our condition. I truly appreciate your response and suggestions!

I do grow and use tarragon as a seasoning but now will be much more liberal with it. Mangos, otoh, have never seemed that flavorful to me but I am more than willing to give them another chance, too! smiles Maybe mixing them with more flavorful fruits would be the trick?

An aside that now has me yearning even more for summer occurred yesterday in doing a "dr.google" search to see if hollyhock seeds appealed to backyard birds. Hollyhocks are prolific seed bearers and it was truly a surprise to learn that all parts of the hollyhock are safe edibles for humans. While they don't seem to get much attention from the birds I've been feeding, I was stunned to learn this.

Still waiting for the endo referral appt but in the meantime, I am looking forward to "mixing up my diet" with more new appetite tempters thanks to you, Toni.

@fiesty76 you’re welcome! I wish you much success with trying a variety of foods. I know how frustrating it can be to struggle with body weight. Hopefully soon you will find answers through your endocrinologist. Unfortunately the medications proved to be unsuccessful for the people I had known to try them. Too bad they don’t work for everyone. Don’t give up.Toni