Thin people have life problems, too

WALNUT CREEK, Calif. – Nancy Brueheim wishes she could break 100 pounds. Without working at it, Brueheim, who is 71 and stands 5-foot-2, fluctuates between 95 and 98 pounds.

The Martinez, Calif., mother of four always has been thin, even as a child. In fact, she comes from a long line of petite women who lived into their late 90s. Brueheim indulges in the occasional hamburger and, save for a food allergy, is free of disease and prescription drugs.

But the skinny life has its challenges. Clothes are difficult to find. And Brueheim has heard a lifetime of hurtful comments. “I’m healthy, I have a lot of energy, and yet people will say such things, like, ‘Gosh, you need to eat more.’ We’d never say such things to an overweight person,” she says.

You know the stereotypes. If someone is very thin or underweight, we assume they are ill or have an eating disorder. Or a hollow leg, right? Maybe they live at the gym. All not true.

While genetics and ethnicity play major roles, there is no one-size-fits-all reason why some people are slim and remain so without really trying, says Kaiser Permanente registered dietitian Nora Norback.

Orinda, Calif., marriage and family therapist Margie Ryerson says even innocent comments about weight can be damaging.

“Even if it comes from a sense of caring, it’s not appropriate and can create distress and unhappiness for the person,” Ryerson says. “They can feel blamed and criticized. In our society, we associate control, will power and strength with thinness. But for people who are naturally thin, it causes them to feel bad about themselves. They’re not trying to be the object of envy. And they don’t want to have to explain themselves. Why should they?”

Metabolism

Many thin folks point to a fast metabolism. Metabolism is influenced by many things, including gender (men have a slightly higher metabolic rate), hormones, sleep, exercise and use of stimulants such as caffeine and nicotine, Norback says. Also, some people simply have mild appetites, and must remind themselves to eat. Bottom line: Don’t judge a body by weight, because it’s not about numbers.

“It’s about health,” Norback says. “Healthy people do come in different shapes and sizes, but at the extreme ends, we certainly see more health problems. We make a lot of our judgments on how a person looks. But you shouldn’t assume that someone is unhealthy if they’re really thin.”

To rule out eating disorders, Norback looks at a variety of factors beyond the scale, including body image, diet and malnutrition, hydration status and exercise frequency.

Most are thin there

Brandon Gan loves his veggies. And whole grains. Despite his slender frame – Gan is 5-foot-6 and weighs 120 pounds – he has high cholesterol, so eating right is a must. When Gan was growing up in Malaysia, his father used to call him “chicken legs” when he’d wear shorts. But otherwise, no one made a big deal about his weight, because most people are thin in Malaysia, he says.

“I never really understood how skinny I was until I came here,” says Gan, 26, who moved to the United States in 2002. “People here are more vain, and everyone wants to improve their bodies.”

A few years ago, Gan, who says he was so thin his chest was concave, ate more to gain weight. He put on about 10 pounds, but didn’t like the way his face looked as a result, he says.

These days, he swims, lifts weights and takes a protein supplement to build muscle. While he still weighs 120 pounds, he feels strong and toned.

Thin, naturally

Many factors are involved in determining why certain people are naturally thin regardless of what they eat or if they exercise. But here are some basics from experts, including Norback.

Genetics. If mom or dad are thin, there’s a higher chance you will be.

Metabolism. Influenced by factors including gender, age, stress and stimulant use.

Thermic effect of food. An estimate of the energy required to process food. It is usually 10 percent of energy (calorie) intake, but can be higher in some people.

Variations in appetite regulation. Some people have small or mild appetites and have to remind themselves to eat.

Ethnicity. Thinness is more common in some populations, such as Asians.

Eating right. Diets rich in fruits, vegetables, whole grains, lean proteins and low-fat dairy.

Exercising regularly. At least three times a week.