Healthy Ways to Gain Weight

Last Editorial Review: 1/31/2005

If you're one of the few Americans who are underweight, you know how hard it can be to pack on the pounds. But just as it is in losing weight, a little planning and attention to good nutrition can help you gain weight.

By Dulce Zamora
WebMD Feature

Reviewed By Brunilda Nazario

Do you find it hard to gain weight? If so, you're probably the envy of family and friends. It seems as if you can eat as many cheeseburgers and chocolate bars as you would like, and still not register an ounce.

Yet little do people know how much you'd love to put meat on your bones, perhaps to feel less lanky, to be able to wear certain clothes without appearing scrawny, or to just be healthier.

Ken Chuk is one such person. He is a 32-year-old finance manager who wishes he could put on a business suit without looking like he just got out of college. His fast metabolism and tendency to feel full with smaller portions, however, make it hard for him to add anything to his 5' 11", 140-pound frame. He's tried to lift weights, suck down protein shakes, and stuff himself with ice cream, cookies, or cereal at bedtime -- all to no avail.

"Everyone in my family is thin," explains the New York native. "I've given up trying to gain weight because I figure it will happen eventually."

Chuk is right in that all of us will tend to become heavier as we age, but health experts say there are plenty of things people can do now to build critical mass.

The Skinny on the Underweight

What's so wrong with being too thin when it seems to be a non-problem compared with obesity? The truth is that being underweight has its own risks.

Those who are extremely lean tend to have weaker immune systems, making them prone to infections, surgical complications, and slower recovery times for illness. They tend to have low muscle mass, and less than ideal hair, teeth, and skin composition. They may have disruptions in the ability to regulate hormones and protect bone health, and women could become unable to menstruate.

All of this could be avoided by maintaining a healthy weight, a measure that obviously differs from person to person. As a rough rule of thumb, women should be at least 105 pounds for the first five feet of height, and another five pounds per inch after that; men should be at least 106 pounds for the first five feet, and an added six pounds per inch, says Dan Heinemann, MD, a board member of the American Academy of Family physicians.

Another gauge could be an individual's body mass index (BMI), which is a system to categorize size based on a person's height and weight. The National Heart, Lung, and Blood Institute reports that people with normal weight have a BMI of 18.5-24.9. Anything below that is underweight, and anything above is overweight (25-29.9) or obese (30 or greater).

Why So Thin?

There are many reasons why people may find it hard to gain weight. Genetics can obviously play a role, but individual personalities and the environment can be strong factors.

"Sometimes people think they just have a fast metabolism, but that's not always the case," says Cindy Moore, MS, RD, director of nutrition therapy at the Cleveland Clinic Foundation, and a spokeswoman for the American Dietetic Association (ADA). "They just might be more physically active."

For example, there are people who tend to move around more, burning more calories than they take in. They're either always the first ones to volunteer to pick up after a spill, to do the chores, to walk everywhere, or to play a lot of sports. This level of physical activity is not a bad thing, says Moore, but being aware of it is important in understanding the factors affecting one's weight.

Then there are others who lose their appetite, experience a change in metabolism, and/or lose poundage and muscle mass fast because of various reasons, including illness, chronic pain, depression, stress, and side effects from drugs.

In children, the inability to gain weight may signal a condition known as "failure to thrive," which means a kid is not growing appropriately for his/her age. This may be caused by an illness, or eating patterns dictated by a parental idiosyncrasy. According to Wahida Karmally, DrPH, RD, spokesperson for the ADA, there have been kids who have not developed properly because they did not receive enough nutrients from being on a raw food, macrobiotic, or vegan diet.

Assuring Healthy Weight Gain

Whatever the suspected cause for being underweight or for unexpected weight loss, and as much as some people may be happy about being thin -- as opposed to being fat -- it's important to discuss the matter with a medical professional.

"If somebody's losing weight, and they're not trying to lose weight, they need to talk to their doctor to find out what's going on, because that is not a normal phenomenon," says Heinemann, noting weight loss may signal a disease such as diabetes.

Being able to eat anything with abandon is also deceiving -- even the skinny need to worry about having too much sugar and fat for good health. Poor diets can lead to ailments such as heart disease, stroke, and cancer. Plus, people who gain weight eating anything and everything tend to retain it as fat, and in much more undesirable places. For a more ideal distribution of weight, it's best to stick to nutrient-rich foods, and to exercise at the same time.

"If you want to have a nice shapely body to go along with this extra weight, you're going to need to work out so that you put the weight on in the form of muscle as opposed to the form of fat," says Heinemann, recommending a combination of aerobic exercise and strength training for the whole body.

Heinemann, Moore, and Karmally have more advice for people wanting to pack on the pounds in a healthy manner. In following their suggestions, it's important to do things in moderation and to have patience. Healthy weight gain, just like healthy weight loss, takes time and requires a conscious effort to apply good habits.

Recommended Ways to Gain Weight

  • Have meals with the right balance of proteins, carbohydrates, and the right kinds of fat (such as unsaturated and monounsaturated fats, olive oil, canola oil, pistachios, almonds and walnuts). Heinemann suggests the following ratio: 60%-70% carbohydrates, 10%-15% protein, and a small amount of fat.
  • Eat foods higher in calories, vitamins, and minerals, as opposed to higher in fat or sugar.
  • Pack more nutritious calories in each serving. For example, you may add grated cooked eggs to mashed potatoes, ground chicken to soups and gravies, cheese in casseroles, eggs, and soups, and nonfat dried milk in soups, shakes, milk, and mashed potatoes.
  • If you get too full too fast, try having more high-calorie foods or slices of foods as opposed to consuming the whole thing (raisins versus grapes, granola and Grape Nuts versus corn flakes, mango slices versus the whole mango).
  • Limit drinking beverages to a half-hour before and after a meal.
  • Drink mixed juices (apple/berry, peach/orange/banana as opposed to one juice beverages) for a higher calorie intake.
  • Try a small amount of alcohol (4 ounces of wine, 6 ounces of beer, or a half-ounce of liquor with juice) before a meal, as it could stimulate appetite. Moore warns, however, that this recommendation must be cleared with your doctor, especially if you are on any medication. Too much alcohol can be detrimental to health, and could lessen your resolve for eating healthy.
  • With moderation, you may add in good fat sources to meals such as nuts, avocado, olives, and fatty fish (salmon and mackerel).
  • Snack in between meals. Nuts, dried fruits, and yogurt are good options, but it's also important to find nutritious foods that you will enjoy.
  • Have a nutritious snack before bedtime, such as a peanut butter sandwich.

Published Sept. 2, 2003.

SOURCES: Ken Chuk. Dan Heinemann, MD, board member of the American Academy of Family Physicians. National Heart, Lung, and Blood Institute. Cindy Moore, MS, RD, director of nutrition therapy at the Cleveland Clinic Foundation, spokeswoman, American Dietetic Association. Wahida Karmally, DrPH, RD, spokesperson, American Dietetic Association.

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