DR FLO: I have no appetite. What can I do to gain weight?

Dr Flo, I am 22 years old. I am too thin. I want to add some pounds, but I have a problem gaining weight. I also have a problem with appetite. Please help me. MK

Dear MK
Some people add or lose weight easily, but others do not change their weight easily. It is actually healthier to have a body weight that does not fluctuate much.
As you grow older, it will become easier to add weight as your metabolism slows down. The notion that to be healthy you have to be “fat” is not right. If your weight is consistent at a healthy level, and you do not have any other health concerns like getting sick frequently, then there is no cause for alarm.

Focus on eating a balanced diet, exercising and avoiding unhealthy practices like smoking or taking too much alcohol.

Lack of appetite can result from having a chronic illness, medication, psychological issues, stomach problems, hormonal changes, low activity level, eating alone, unstructured meal times and practices, not being exposed to a wide variety of meals and textures when young, or unhealthy snacking between meals. However, there are things you can do to boost your appetite (see side bar), and in turn your chances of gaining weight.

Dr Flo, I am 22 years old and I have never conceived. I have been to many hospitals seeking treatment for a urinary tract infection (UTI), but I haven’t been cured. Is the UTI keeping me from conceiving? Rose

Dear Rose,
Urinary tract infections affect the urethra, urinary bladder, the ureters or the kidneys.
They occur when bacteria that live in the intestines travel from the anus to the urethral opening (where urine comes out), because the two openings are not far apart.
Women are more likely to get UTIs because they have a shorter urethra (the tube that carries urine to the outside of the body), than men, making it easier for bacteria to travel up to the bladder and cause an infection.
UTIs are easily treated with antibiotics. If the symptoms do not clear, you may need a longer course of antibiotics or a different type of antibiotics to clear the infection, even though the urine test may be normal.
Take a lot of fluids, about one-and-a-half to two litres of water per day; urinate when you feel the urge to (do not delay); urinate immediately after sexual intercourse; wipe yourself from front to back and keep the genital area clean and dry.
Urinary tract infections cannot cause infertility because they affect the urinary tract, not the reproductive tract. Some infections in the reproductive tract, like chlamydia and gonorrhoea, can spread to the uterus and fallopian tubes. This causes vaginal discharge, low abdominal pain, and can cause inflammation and blockage of the fallopian tubes which can lead to ectopic pregnancies or difficulties in getting pregnant.
Also note that it is not automatic that someone will conceive as long as they are not using any contraceptives, even though there is nothing wrong with either of the partners. In fact, medically speaking, concerns about fertility arise after one year of having regular unprotected sexual intercourse without getting pregnant.
In women, infertility can be caused by abnormal ovarian function, hormonal disorders, fallopian tube obstruction and abnormalities of the uterus. Some factors that can increase the risk of infertility are alcoholism, smoking, obesity, severe weight loss, extreme physical or emotional stress, and being over 35 years of age.
To deal with fertility concerns, please visit a gynaecologist. Check-ups will include a pelvic ultrasound to check the pelvic organs, a hysterosalpingogram (HSG) to check the fallopian tubes and a hormone profile to check the hormones. Your partner may also need to have a seminalysis and a hormone profile done.
Treatment is given, depending on what is found. For example, you may be given medication to stimulate ovulation or to control hormones or you may need surgery if there is scarring, endometriosis, or the fallopian tubes are blocked. Your partner may also be put on medication.

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