Lose weight in certain conditions, or better, in certain phases of life is absolutely not recommended. Among the most contraindicated moments we recall: gestation, growth and third age.
Obviously, slimming means a reduction in body weight even if, in reality, it should indicate an exclusive moderation of the adipose mass.
In the treatment of obesity related to the child and to the pregnant woman, it is necessary to maintain a constant body weight while reducing the amount of total adipose tissue; this allows the growth of the organism (of the child in the first case and of the fetus in the second), however positively affecting the pathology of obesity.
In the event that the weight loss is "forced", the child or fetus may experience more or less serious and irreversible developmental anomalies.
The failure to thrive ( failure to thrive or FTT) or faltering weight ( faltering weight or weight faltering ), is a condition that mainly affects the pediatric age, but is also applied in adulthood and in veterinary medicine (also known as ill thrift ).
The FTT indicates insufficient weight gain or undesirable weight loss; we reiterate that, unless otherwise specified, the term FTT refers to human patients in pediatric age.
Lose weight in pediatric age: FTT
The FTT is estimated in terms of total mass (in kg) and the diagnosis can be confirmed either by insufficient weight, or by the slow increase (both referring to age).
In the pediatric clinic, the FTT identifies only the developmental anomalies and does not identify the causes, especially the secondary ones such as: mental delays, emotional problems or social problems.
The term has been used in different contexts and several objective standards have been defined. Many of the definitions regarding FTT use the 5th growth percentile as the cutoff .
Mostly, the causes of FTT are divided into endogenous and exogenous, and the first investigations to be carried out concern physical conditions or pathologies, the caloric intake of the diet and psychosocial evaluation.
Recently, the term faltering growth has become a popular substitute for FTT which, in the minds of some professionals, represents a more euphemistic noun.
Endogenous or Organic Causes of FTT
The endogenous causes are essentially linked to problems of a child's physical or mental nature. They may include several inborn errors of metabolism or problems with the gastrointestinal system; for example, gas and acid reflux are potentially painful conditions that compromise the child's willingness to eat sufficiently. Cystic fibrosis, diarrhea, liver disease and celiac disease make nutritional absorption more difficult. Other causes may include physical deformities such as cleft palate and tie tongue . Allergies or intolerances to milk nutrients can cause FTT early. Absorption and metabolism can be altered by parasitosis, asthma, urinary tract infections, other febrile causes and heart disease; in this case, it is very rare that the energy requirement of the organism is fulfilled with diet alone.
Exogenous or non-organic causes FTT
They are generally caused by the action of those who feed or assist the child. Some examples include: the physical inability to produce enough breast milk due to poor suckling by the newborn (sleepy baby syndrome), the inability to procure formulated milk when needed, intentionally limit total caloric intake (to make more pleasant the image of the child) and the inability to offer the right or sufficient solid food after weaning (over 6 months).
Mixed Causes
The causes of FTT are not dichotomous and it is not uncommon for them to coexist within the same clinical case.
For example, a child who does not regularly receive the right food ration can spontaneously restrain himself in the face of an attempt at normal nutrition; in the same way, a child with severe gastric reflux who manifests suffering, can make those who are in charge of feeding.
FTT in Adults
As already mentioned in the introduction, the term FTT is also used in geriatrics or, more briefly, in adult medicine, to describe a state of malaise in a non-specific way.
The manifestations of this condition are: weight loss, decreased appetite, poor diet and motor inactivity.
In patients with FTT, four syndromes are prevalent and predictive of adverse events: impaired physical function, malnutrition, depression and cognitive impairment.
