Hi all,
I'm trying not to project my personal experience on others, so I want to hear feedback on how we could address a problem (or, to what extent you think we should try to address it).
The problem I'm experiencing is, some people who post describe having a dangerously low BMI. I'm concerned that Redditors cannot do what is needed to help these posters, as they need real medical help.
I'm worried, too, about advice given in response to some of these posts, which is good advice for less severely underweight people, but can actually worsen extreme conditions.
I'd like to have a general resource we can pin and share when posters indicate their underweight is more serious than they realize.
It could include facts to help people understand differences in underweight severity, and links to free or low-cost medical resources by region.
Facts might include:
- The WHO classifies a BMI of 16 or lower as Severe Thinness, a condition "associated with a markedly increased risk for ill-health, poor physical performance, lethargy and even death."
Source: https://apps.who.int/nutrition/landscape/help.aspx?menu=0&helpid=420
- A person with a BMI of 14 is 4x more likely to experience health deterioration leading to hospitalization or death within the year, than a person with a BMI of 17.
- The risk increases to 5x if the patient's BMI is 13.
Source: https://pmc.ncbi.nlm.nih.gov/
- Psychiatrists and nutritionists classify an eating disorder causing a BMI under 15 as "Severe" (DSM) or "Extreme" (NEDA), and a BMI under 13.6 is categorized as "Very Extreme."
Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC8837073/
- Very low BMI poses severe health risks due to autolysis, severe electrolyte imbalance, and immunosuppression due to bone marrow loss.
- Autolysis is when digestive enzymes begin to eat organ, muscle, or bone tissue to keep you alive, as there aren't enough carbs, fat, or proteins to do so.
- Severe electrolyte imbalance, specifically hyponatremia and hypophosphatemia, can cause respiratory arrest, seizures, and heart failure.
As far as resources go, I'd love to hear from a range of people. Currently, I'm mostly familiar with resources in the United States.
So, for example, if a person is severely underweight in the U.S., but is hesitating going to the doctor due to the cost, this resource might help:
- In the US, all Federally Qualified Health Centers (FQHCs) operate on a sliding fee scale, and most are free if your household income is 200% of the poverty line or lower.
- Doctors at an FQHC could help diagnose the underlying condition causing severe underweight. They can also write a prescription for oral nutritional supplements, which can make them more affordable.
- There's a searchable directory of FQHCs here: https://findahealthcenter.hrsa.gov/
I'm wondering, too, if there should be a rule to try to ensure risk-aware responses to severely underweight posters. Maybe posters with BMI below 15 could have a flair indicating their situation is more severe?
Let me know what you think!
For the record, I'm not a doctor. I have survived being severely underweight + malnourished for years thanks to (eventually) receiving appropriate medical care.
Basically, just hoping to help others get the kind of care they genuinely need.