BMI 17.8 - Am I unhealthy?

[Marcomat]

Hi guys, I am here because I have been doing calorie restriction for years now, as a recreational athlete / long distance runner, my daily calorie needs are 2750kcal./day My calorie restriction protocol to maximise my health and longevity aims for around 2200kcal daily on average. Meaning just 20% daily calorie restriction, with excellent nutritional intake. However I did not weigh myself for years because I did not want external factors to interfere with my CR practice. Today I weigh myself and I see I am 48kg., my height is 164 cm which makes my BMI 17.8. 
I am so disappointed about this , my doctor said I am “quite” healthy and my blood work is excellent, but as a health conscious person I am so disappointed to see my BMI is underweight. 
if I feel physically and mentally great, do you think I can just continue to eat as I do or di I need to increase my calories? 
 

what advice do you have for me? To be honest I feel physically good and as a runner I have not experienced an injury in years since I started calorie restriction, I feel my body activates those healing processes way better when I restrict calories and I don’t get as injured

[IgorF]

Hm, maybe not the best idea to advice on such a complex topic with so many variables, I will just point out to two common aspects that are worse to keep in mind

- bone mass and quality

it is maximizing in the late thirties and will not be better afterwards, so it makes sense to try to preserve it in as good state as possible. While we can't control deseases we can at least try not to make it worse from the malnutrition and sedentary perspective. So for a sedentary man @1700kkal/day slow drifting to a very low BMI is not ok, to what degree - no one can say definitely. For a fit athlete with 2200kkal/day it is much less a concern, generally, because he keeps a good load on the most critical parts of the sceleton. However I can't say if forces at unusual angles will not be more harmful and also there is no good way to assess the bone health reliably, the tooling available is an addition to the clinical picture and on such cases doctors advice is better that my speculations.p

- immune function

it is a very complex thing and can not be covered in a brief. I would say if a person's diet composition and/or energy support is at lowest normal there is a risk to face a single challenge ok but fail with two consequent, e.g. bacterial attack after a first viral attack, bacterial attack after a stroke and many more scenarios, including after-marathon immune function decline. While it is not possible to assess the immune function easily I personally think neutrophils less than 1100 (neutropenia is diagnosed at 500) while theoretically it is ok and most of them could just "socialize" outside of CBC analysis visibility for a normal state of the body could be a sign to increase the nutrients and/or energy availability.

Concluding - I personally in such a situation would like to stop the weight drift, this will require to be in ~5-10% CR (hard to say precisely, the brain will decide stepping up or down the rate of burning) and maybe getting back to BMI 20 but that needs to see much more context.

In other words - you could be moving to definitely less healthy situation but it is better to listen for your doctor's opinion and/or collect other doctors opinions on such a topic if possible. It is in any case a risk management approach, no other tool for such a complexity is known to people.

 

Br,

Igor

Edited February 2, 2023 by IgorF

[Marcomat]

2 hours ago, IgorF said:

Hm, maybe not the best idea to advice on such a complex topic with so many variables, I will just point out to two common aspects that are worse to keep in mind

- bone mass and quality

it is maximizing in the late thirties and will not be better afterwards, so it makes sense to try to preserve it in as good state as possible. While we can't control deseases we can at least try not to make it worse from the malnutrition and sedentary perspective. So for a sedentary man @1700kkal/day slow drifting to a very low BMI is not ok, to what degree - no one can say definitely. For a fit athlete with 2200kkal/day it is much less a concern, generally, because he keeps a good load on the most critical parts of the sceleton. However I can't say if forces at unusual angles will not be more harmful and also there is no good way to assess the bone health reliably, the tooling available is an addition to the clinical picture and on such cases doctors advice is better that my speculations.p

- immune function

it is a very complex thing and can not be covered in a brief. I would say if a person's diet composition and/or energy support is at lowest normal there is a risk to face a single challenge ok but fail with two consequent, e.g. bacterial attack after a first viral attack, bacterial attack after a stroke and many more scenarios, including after-marathon immune function decline. While it is not possible to assess the immune function easily I personally think neutrophils less than 1100 (neutropenia is diagnosed at 500) while theoretically it is ok and most of them could just "socialize" outside of CBC analysis visibility for a normal state of the body could be a sign to increase the nutrients and/or energy availability.

Concluding - I personally in such a situation would like to stop the weight drift, this will require to be in ~5-10% CR (hard to say precisely, the brain will decide stepping up or down the rate of burning) and maybe getting back to BMI 20 but that needs to see much more context.

In other words - you could be moving to definitely less healthy situation but it is better to listen for your doctor's opinion and/or collect other doctors opinions on such a topic if possible. It is in any case a risk management approach, no other tool for such a complexity is known to people.

 

Br,

Igor

Hi and thank you for your advice, your points sound pretty sound to me, I did not measure my bone density and quality , so I can’t tell anything , I have noticed a decrease in overall strength and muscle mass of course. My former weight was 51-52kg. My BMI was about 19.5 before I started CR, I have always been athletic and healthy as a teen and young adult, now I am 25. I am just now trying to listen to my body and eat to comfortable fullness, I honestly cannot stuff myself “just because I have to gain weight”, but I guess little tiny daily changes can go a long way … for example adding a few more fats and things, I don’t believe I need drastic changes, just tiny little adjustments I feel, based on the result in the scale. I feel like a failure because I am gonna lose my CR lifestyle, David Sinclair has inspired me a lot, along with Luigi Fontana and CR studies. Anyway, maybe at this point CR can do more harm than good. However if I eat more than 2000-2200kcal a day I get bloated and feel miserable. I have been so used to be on an energy deficit that I cannot tolerate 2500kcal or more. I am not willing to feel physically stuffed and sick to be honest.. I hope I manage to find a solution to this

[IgorF]

Hm, at 25 I think focusing on getting the best bones possible is a good investment, unlike CR theories that novadays looks rather like dreams than solid science (maybe it could change in the future but..) the profitability of good bones is obvious for our species for it's whole history. Just to get a quick look on the topic it is enough to listen to the audiobook of Mayo's clinic about osteoporosis, it is 1-2 days of time and is enough to have a clue about how important it is not to get this condition.

Regarding getting more calories I think it is very easy to do it, just add a bit more of some delicious fruits into already established way of eating, usually this works.

Also it could make sense from the bones perspective to add some strength exercises, yoga is also a good thing, this will support the bone modeling for the next several years.

And if you will want to go with stronger CR in the future you will have a better start, bones quality seems will be a one way road (after mid30ies) for our species for the next decades.

Br,

Igor

Edited February 2, 2023 by IgorF

[Dean Pomerleau]

Hi Marcomat. You wrote:

54 minutes ago, Marcomat said:

I honestly cannot stuff myself “just because I have to gain weight”,

And:

54 minutes ago, Marcomat said:

I feel like a failure because I am gonna lose my CR lifestyle,

And:

54 minutes ago, Marcomat said:

I have been so used to be on an energy deficit that I cannot tolerate 2500kcal or more. I am not willing to feel physically stuffed and sick to be honest. 

Excuse my bluntness, but those statements sound to me like they are bordering on an eating disorder. More CR isn't always better either physically as Igor points out, or psychological, coming from someone who has been there. 

As someone who now eats a lot more calories than you and who is also extremely physically active and with a somewhat higher BMI than you (18.5-19), I can assure you that you can maintain your energy level and CR benefits (like improved immune function and impeccable blood work) while eating a healthy diet with enough calories to maintain a higher BMI and to fuel exercise. And as Igor points out, in the long run your body and especially your bones will thank you. 

--Dean 

[Marcomat]

15 minutes ago, Dean Pomerleau said:

Hi Marcomat. You wrote:

And:

And:

Excuse my bluntness, but those statements sound to me like they are bordering on an eating disorder. More CR isn't always better either physically as Igor points out, or psychological, coming from someone who has been there. 

As someone who now eats a lot more calories than you and who is also extremely physically active and with a somewhat higher BMI than you (18.5-19), I can assure you that you can maintain your energy level and CR benefits (like improved immune function and impeccable blood work) while eating a healthy diet with enough calories to maintain a higher BMI and to fuel exercise. And as Igor points out, in the long run your body and especially your bones will thank you. 

--Dean 

Yes that’s what my family says too but to be honest I feel stuffed when I eat even as much as 2200kcal when I don’t exercise I usually eat 1800 then on training days a bit over 2000kcal. I don’t know if I have an eating disorder but I have been accustomed to eat so little for my energy needs that eating normally really makes me feel uncomfortable at a physical level I mean, stuffed. Plus I felt good at something and now I feel like a failure because my primary goal was to focus on my health. Yeah probably I took it too far, but it’s not a big deal if I just have to gain a couple of kg. It will happen over time I guess by making tiny little changes that allow me to maintain a higher BMI 

[Dean Pomerleau]

Modest steps are quite reasonable. But again as someone who has come back from going what I considered too low (~BMI 17.2),the keys are to stop further weight loss and to not feel bad about eating more or feeling full.

What I did to turn around was to weight myself daily and eat a little more of a food I found palatable and reasonably healthy each day (on top my usual diet) until I started to see slow but steady weight gain. I used bananas as the extra food but pick whatever you enjoy.

It took a few months to put the weight back on but that's fine. Just don't go to the other extreme and start binging. Take it slow and good luck! 

--Dean 

[Marcomat]

14 minutes ago, Dean Pomerleau said:

Modest steps are quite reasonable. But again as someone who has come back from going what I considered too low (~BMI 17.2),the keys are to stop further weight loss and to not feel bad about eating more or feeling full.

What I did to turn around was to weight myself daily and eat a little more of a food I found palatable and reasonably healthy each day (on top my usual diet) until I started to see slow but steady weight gain. I used bananas as the extra food but pick whatever you enjoy.

It took a few months to put the weight back on but that's fine. Just don't go to the other extreme and start binging. Take it slow and good luck! 

--Dean 

 

Thank you Dean, I have always been very health conscious and extremely motivated to follow CR as my lifestyle, I absolutely don’t think I will continue to lose weight, because I have maintained this weight for a while now without knowing it until today, because I didn’t want the scale to interfere with my practice. I will now write down what I eat, and see how my weight changes accordingly, but I feel it’s too much pressure to make huge changes right away because I will feel too full and uncomfortable , a tiny little step like the one you suggest sounds very reasonable to me, until I gain to BMI 19 or something so it’s healthy, then I guess I need to find out my new maintainance because I don’t wanna keep gaining weight , once I reach a healthy BMI I wanna stay there. I remember before I used to eat a lot more when my BMI was 19. Only problem is I see no CR benefits if I eat in excess every day, plus I am not used to feel full anymore

[Dean Pomerleau]

Sounds like you are on the right track. Note - I ramped up the amount of bananas to start gaining weight and then I ramped them back down when I approached the weight that I thought was reasonable. That way they served as ballast on top of my already healthy and complete diet

[Dean Pomerleau]

P.S. At a BMI of 17.8 you really should be carefully tracking your nutrition via software like Cronometer if you aren't already. 

[Marcomat]

42 minutes ago, Dean Pomerleau said:

P.S. At a BMI of 17.8 you really should be carefully tracking your nutrition via software like Cronometer if you aren't already. 

At the moment that I am eating more, my intake has been at 2200kcal today, and I ate more than usual, so I guess calorie wise its fine. Based on Cronometer I meet all vitamins and minerals except for today . I think my body fell a bit below it a set point because I am much hungrier than usual since I increased my training recently. I usually don’t feel so empty and hungry even if I do calorie restriction, so I guess tiny little changes to bring me to my set point will be easy if I just listen to my hunger. At my set point, usually bmi 19, I never feel this hunger

[Marcomat]

Just now, Marcomat said:

At the moment that I am eating more, my intake has been at 2200kcal today, and I ate more than usual, so I guess calorie wise its fine. Based on Cronometer I meet all vitamins and minerals except for today . I think my body fell a bit below it a set point because I am much hungrier than usual since I increased my training recently. I usually don’t feel so empty and hungry even if I do calorie restriction, so I guess tiny little changes to bring me to my set point will be easy if I just listen to my hunger. At my set point, usually bmi 19, I never feel this hunger

Do you think my BMI is dangerous? Why do you say that I should be “carefully” tracking Cronometer? Usually I just go by sensation, stop eating before I am completely full and always eat but only when hungry. The doctor I visited a few months ago said I look “quite” healthy, I guess my weight got this low now because I increased my running significantly, without changing my CR diet

[pwonline]

you're 25, your body will hide it's weakness much better than your later life.

The danger of bone density loss can and most likely will occur. It's going to be even worse for you to judge the bodies slow deterioration due to low bmi because as a runner you must be used to a higher pain threshold and push through any niggles....until the damage is irreversible.

instead of picking a random CR percentage / calories, first get your BMI to healthy normal range ... 18.5 then whatever calories your body needs to be at that BMI, stick to them, this way you are getting the best of both worlds, your doing everything science says that will help with longevity and optimal bodily functions.

I would say go for 19.5 BMI then stay on that for a year and once your bodies adapted, slowly over years reduce your calories and see if you can maintain a BMI of 19.5, if not then that is your target.

every bodies are different. Matt (another CR member) was consuming 1600 calories and able to maintain a BMI of 19.5, he also went really low on his BMI and did as I outlined, increased his BMI to 18.5 and reduced his calories later while his body still kept the extra weight.

If your goal is longevity with a body that is able to withstand your lifestyle then honestly you are in dangerous levels, you are risking a future where you start having bone density loss and would lose your ability to exercise, to do normal activities!

Is betting (since it's still not guaranteed CR actual works in humans) on fragility and disability (very likely outcomes if you keep your BMI at 17.8) on an "potential" 5 years (if your lucky) of extra life?

as Dean mentioned this must be such a shock and takes some time to accept but do it slowly, take a month or two to get to the healthy BMI. Honestly think rationally and think smart. Sometimes we try to bite to much and end up sick from it when we could have gone nice and steady. Keep us update and good luck on this "recovery".

[Dean Pomerleau]

A BMI of 17.8 is getting very close to the threshold of what I think is OK vs risky territory. My concern is more over your words than your present weight, especially if you are indeed weight stable at 17.8 and tracking your nutrition.

 Intuitive eating like you describe can get dangerous. Anorexia means loss of appetite. Eating only when you feel hungry and stopping when you start to feel a full can get you into trouble at a low BMI like you have if your hunger and satiety signals are messed up by either physiology or psychology. That is especially true if you are exercising a lot. 

Start looking at the scale daily. If you don't gain a tenth of a pound or two every couple days, and especially if you dropped a couple tenths of a pound, eat more that day even if you already feel full. And keep eating a bit more until the weight starts to climb. 

Those are wise words from pwonline. I hope he's walking the walk! 🙂

[pwonline]

Just for completeness I weighed myself today and have a BMI of 17.3

from tomorrow I will start this protocol to get my BMI to 19.5, I want to take my time getting there maybe 6 weeks and like I've outlines let my body be the judge of what it deems necessary to have as my lower intake of calories. Even if you are consuming optimal nutrition, a BMI of 17.8 is still damaging you SLOWLY

we can both start this together

[pwonline]

Dean I'm certain I will increase my BMI, I have an eating disorder but can rationalise my thinking. Thanks to you I increased my calories to 1850 (from 1600) but now I want to focus on getting a healthy BMI of 18.5 and I'm starting gym again 🙂 I will update when I reach my goal. much love for your encouragement and time you give to helping us! thankyou

[Dean Pomerleau]

Glad to hear that you are moving in the right direction pwonline. But candidly you've been saying similar things since you joined and are still in risky territory. Hopefully this time you are serious about putting on a few healthy pounds of muscle mass with your new exercise routine and more calories. 

Good luck to both of you and keep us posted on your progress!

[pwonline]

added 20g ground chia seeds plus an extra 5 almonds, now calories per day are 1950, added 100g of calories, will increase increments of 50 calories a day till I start putting weight on and weigh daily

[Marcomat]

18 hours ago, Dean Pomerleau said:

A BMI of 17.8 is getting very close to the threshold of what I think is OK vs risky territory. My concern is more over your words than your present weight, especially if you are indeed weight stable at 17.8 and tracking your nutrition.

 Intuitive eating like you describe can get dangerous. Anorexia means loss of appetite. Eating only when you feel hungry and stopping when you start to feel a full can get you into trouble at a low BMI like you have if your hunger and satiety signals are messed up by either physiology or psychology. That is especially true if you are exercising a lot. 

Start looking at the scale daily. If you don't gain a tenth of a pound or two every couple days, and especially if you dropped a couple tenths of a pound, eat more that day even if you already feel full. And keep eating a bit more until the weight starts to climb. 

Those are wise words from pwonline. I hope he's walking the walk! 🙂

I started to track everything as a start , and because my exercise habits are extreme , with long distance running and active lifestyle, on top of my running, I have seen from tracking my intake my average calories are usually ranging from 1800-2200kcal a day , I maintained with this intake BMI 17.5-18 during the last year at least. I think first I need to just allow myself to eat intuitively , even if it means underrating, and track what I eat so I understand where I need to go from there, I know from my past calculations that I maintained a Bmi of 19 for years , with an intake of about 2200-2500kcal a day., when I was running at my best my weight was 51-52 ranging and my BMI about 19-19.5 which is now my goal. So I have made myself eat and track what i eat, to see how many calories I manage, usually about 2000-2200 with intuitive eating. Then from there if I don’t reach my goal of 2500kcal, I add them to whatever I eat? So I am trying to eat 2500kcal at the moment, it’s easy for a day or two but then my body wants to compensate on the next days, opposing the weight gain, like if I eat 2500kcal today it’s fine I can do it but then tomorrow I am probably gonna feel so full and struggle to even get to 1800kcal. Well, what you suggest me is a huge struggle! You want me to gain a pound in two days? With the running I do and Eating 2500kcal, which is only a little more than what I usually eat, it’s impossible. This is a problem it took a long time, months and years to develop, it can’t be solved in a day, especially psychologically I would feel sick full, I said I don’t wanna eat if I am not hungry it doesn’t come natural to me. But i will make sure with chronometer to eat 2500kcal, and see every week my weight, if it doesn’t increase to my former BMI of 19, then I have no choice but increase calories from fat, the only macronutrient with a high enough energy density. My habits of eating so many vegetables don’t help, I also feel I have an eating disorder because I really got addicted to feeling so hungry and great all the time that feeling satiated is a big trigger of my discomfort and raises feelings from my past trauma which I tried to hide all this time from feeling. I also hate to have sex drive because I feel a failure in women and cannot stand the sexual desire to be honest. Well I need to work on that too it looks like

[Marcomat]

18 hours ago, pwonline said:

Just for completeness I weighed myself today and have a BMI of 17.3

from tomorrow I will start this protocol to get my BMI to 19.5, I want to take my time getting there maybe 6 weeks and like I've outlines let my body be the judge of what it deems necessary to have as my lower intake of calories. Even if you are consuming optimal nutrition, a BMI of 17.8 is still damaging you SLOWLY

we can both start this together

Thank you both very much I didn’t expect this kind of support here, well it seems we need to work a little on our eating habits. It’s extremely difficult for me, I am so disappointed and worried about my bone mineral density. I have actually maintained a BMI of 19-19.5 very naturally before I started My severe calorie restriction, I used to eat years ago 2200-2500kcal a day and maintained a bmi of about 19.5 with a slender athletic body. Now I didn’t realise the seriousness of the situation until I stepped on the scale again today 48kg. I think I need to take this slowly, this means increasing my calories from what I ate-1800-2200kcal to 2500kcal. So that’s my target, ensure I get everyday 2500kcal by writing down everything I eat on chronometer, then see during the month or weeks if I make progress on the scale, it would take me just a few kg. To get to BMI 18.5 and to 19 I would need to get up to 51kg. It’s not much but I feel it takes work to change habits that developed a long time. I also think I have an eating disorder because all my family thinks it and with my history of trauma, I have used my exercise and restriction for a long time to cope and hide my feelings. I am sorry to hear if you struggle with that too, it seems you are even eating less than me, I hope we can both take your advice . But really I don’t want to turn this into a binge and feeling stuffed all the time, I feel to make things good I will also start gym again tomorrow, and increase the energy density from fat, so I need to use less volume of food to ensure I get 2500kcal, I hope that is enough to make me gain a bit because I can’t manage to eat more I feel 

[Dean Pomerleau]

3 hours ago, pwonline said:

added 20g ground chia seeds plus an extra 5 almonds, now calories per day are 1950, added 100g of calories, will increase increments of 50 calories a day till I start putting weight on and weigh daily

That's sounds like a very good plan! 

6 minutes ago, Marcomat said:

Well, what you suggest me is a huge struggle! You want me to gain a pound in two days?

No! I never said that. I said you should aim for enough calories to produce slow and steady weight gain, at a rate of a 1/10th or 2/10ths of a pound every couple days on average, or about 0.5 to 1 pound per week. 

3 minutes ago, Marcomat said:

But really I don’t want to turn this into a binge and feeling stuffed all the time, I feel to make things good I will also start gym again tomorrow, and increase the energy density from fat, so I need to use less volume of food to ensure I get 2500kcal, I hope that is enough to make me gain a bit because I can’t manage to eat more I feel 

Eating a couple hundred calories per day to get to 2500 is not a binge. If you feel less stuffed eating the extra calories from healthy high fat source, go for it. But watch the scale and make sure your weight is consistently ticking upwards. 

15 minutes ago, Marcomat said:

I think I need to take this slowly, this means increasing my calories from what I ate-1800-2200kcal to 2500kcal. So that’s my target, ensure I get everyday 2500kcal by writing down everything I eat on chronometer, then see during the month or weeks if I make progress on the scale, it would take me just a few kg.

Yes - exactly! That sounds like a great plan. 

7 minutes ago, Marcomat said:

I also think I have an eating disorder because all my family thinks it and with my history of trauma, I have used my exercise and restriction for a long time to cope and hide my feelings. 

It sounds like you might want to consider getting some professional help with some of these more fundamental issues. Without addressing them directly it may be difficult to fix the secondary challenges you are facing with your weight and eating. 

Strangers on the internet probably aren't the best source of help, no matter how well-intentioned! 

Best of luck and please do keep us posted. Questions are always welcomed. 

--Dean 

[pwonline]

From tomorrow daily I will eat an extra (from my 1850 calorie diet)

8 almonds

10g chia seeds

10g sunflower seeds

20g red lentils

20g pot barley

 1 tsp EVOO

my base calories will be 2100

hoping this would be enough to kick start me gaining weight, otherwise I will adjust

To OP you can do it

[Marcomat]

1 hour ago, Dean Pomerleau said:

That's sounds like a very good plan! 

No! I never said that. I said you should aim for enough calories to produce slow and steady weight gain, at a rate of a 1/10th or 2/10ths of a pound every couple days on average, or about 0.5 to 1 pound per week. 

Eating a couple hundred calories per day to get to 2500 is not a binge. If you feel less stuffed eating the extra calories from healthy high fat source, go for it. But watch the scale and make sure your weight is consistently ticking upwards. 

Yes - exactly! That sounds like a great plan. 

It sounds like you might want to consider getting some professional help with some of these more fundamental issues. Without addressing them directly it may be difficult to fix the secondary challenges you are facing with your weight and eating. 

Strangers on the internet probably aren't the best source of help, no matter how well-intentioned! 

Best of luck and please do keep us posted. Questions are always welcomed. 

--Dean 

Hello Dean, thank you very much for your message, and sorry for my misunderstanding. I think my leptin levels are extremely low because now that I am starting to eat more I am experiencing extreme hunger, also because I went running today, and burned a huge amount of calories, so you don’t advice me to do intuitive eating? Listening to my body was a failure I feel, maybe it’s better to eat with numbers on hand, the scale, to see and adjust calorie intake accordingly, and food diary to ensure a daily calorie of 2500kcal. I just quit therapy, it doesn’t work for me. I went to see professional help for my issues, but it didn’t help. I feel my mental health will take a turn for the worse because I am addicted to feeling hungry, it hides my emotions that I don’t wanna feel, so I expect a steep increase in my mental health struggles . Anyway I don’t wanna bother anymore with that. The priority is physical health of course, I hope I didn’t cause long lasting damage to my bones . 

[Marcomat]

1 hour ago, pwonline said:

From tomorrow daily I will eat an extra (from my 1850 calorie diet)

8 almonds

10g chia seeds

10g sunflower seeds

20g red lentils

20g pot barley

 1 tsp EVOO

my base calories will be 2100

hoping this would be enough to kick start me gaining weight, otherwise I will adjust

To OP you can do it

Yeah thank you… sounds very hard for me

[Dean Pomerleau]

2 hours ago, Marcomat said:

I hope I didn’t cause long lasting damage to my bones. 

The body is pretty resilient at 25 and you've still got time to increase your bone mass with a healthy diet and weight-bearing exercise (which it sounds like you do plenty of). Don't fret over your bones. Get your weight up and you diet dialed in and you will be fine.