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Taking the 'Very Underweight' trait does two things.
One, It lowers your fitness value by 2. Default fitness is 5 iirc, and your various trait choices can raise or lower this. Fitness controls endurance.
And Two, It lowers your starting character weight from 80 to 60.
Having a character weight ranging from 50-65 is considered to be 'Very Underweight' and confers the following effects:
Melee damage reduced by 60%
+20% chance to trip by while run/sprint vaulting a low fence or from lunging zombies.
75%x chance to fail a tall fence climb.
and 10 more fall damage.
You can gain weight however to get out of that 50-65 range, at which point you will no longer be afflicted by the various associated effects of being very underweight- Similarly, should you ever lose weight and fall back into the 50-65 range, You'll suffer them once more.
So it's not the fitness that causes the effects- It's the weight itself.
However, you'll gain the regular UW trait with the same penalties but to a lesser extent. The two missing fitness points however don't reappear when you lose VUW or UW.
Once you gobbled down enough chips, soda and burgers you'll also lose the UW penalties, but you'll still be at 3 Fitness (+ whatever other traits you picked)