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Familial underweight - In this group if one or both parents are underweight there is increased chances of the child being under weight. This may be due to multiple factors like hereditary, same nutritional and social practices in the family. - It can be due to starvation of any cause. That is restriction in the diet causing reduction in weight may be due to famine or socio-economic reasons or to maintain a good figure or the fear of obesity or weight reducing diets. - Psychological conditions like anorexia nervosa. It is commonly seen in adolescent girls due to the fear of putting on weight or to remain slim forever. They eat very little food due to the fear of weight gain.
- Underweight can be due to any chronic illness like tuberculosis, asthma, cancer, immune deficiency syndrome, anaemia, some type of diabetes, etc. It can also occur in nervous, active, tensed and overworked people. In conditions like hyperthyroidism and chronic fever, underweight may be due to increased utilisation of the nutrient. In conditions like chronic bleeding, of any cause, result in loss of nutrients leading to underweight. Rule out any pathological cause for underweight. A high protein, high calorie, high fat diet is recommended for an underweight person. The total calorie should be increased. 500 kcal can be increased to the normal calorie allowance. This increase should be gradual in one or two weeks, otherwise digestive disturbances will occur.
Fat is also increased but fried and fatty foods are not recommended. Since it takes longer time for digestion and can cause diarrhoea in excess consumption. Butter, cream, margarine and oil will help to increase weight. These foods should not be taken at the beginning of the meal, since it may reduce appetite. High carbohydrate foods like potato, sweet potato, colocasia, yam should be increased in the diet for the carbohydrate allowance. Dried fruits, nuts, sweets, dessert, jam, jelly, cereals can be added into the diet liberally. The number of meals can be increased.
Normal fluid must be consumed in a day to avoid constipation and proper functioning of the kidneys. Fluids should not be taken before and in-between meals. Soft drinks, alcohol, tea and coffee must be reduced in the diet, since they reduce one's appetite. Exercise is good to stimulate appetite. Constipation should be corrected by taking plenty of raw vegetables, fruits and fluids. (Based on Net resources)
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In the west obesity is most common, whereas in the tropics underweight is more prominent due to poverty or lack of dietetic knowledge. Underweight may be due to constitutional (Familial), reduced intake, reduced absorption or due to increased utilisation of nutrients. A under-weight person is more liable to infectious diseases like tuberculosis and can belong to the high morbidity risk group. 
- It can be due to poor absorption in diseases like malabsorption syndrome or any other condition causing chronic diarrhoea or vomiting. 
Protein is also increased from 1 gm/kg body weight to 1.2gm/kg body weight. This should come from good quality protein like milk, eggs in the initial stages. Later other protein sources like pulses and legumes, nuts, meat, fish, poultry can be included in the diet. 
Unlike protein, fat and carbohydrate there is no need for extra vitamins and minerals. Daily-recommended allowance of vitamins and minerals will be adequate. But if anaemia or any particular nutrient deficiency is present, it should be corrected. 
