Jul. 10. 2014
Nutrition Articles
McKel Hill, MS, RDN, LDN

McKel Hill, MS, RDN, LDN

Dietitian, Founder

If you’re underweight and want to reach a healthier body size, a few strategies will help.

My top pieces of advice for any of you out there who wants to learn how to gain weight—the healthy way—would be to push for whole foods instead of resorting to a lot of processed foods or “junk” items that may make you feel worse.

Many of you may be wondering why I’m not talking about weight loss or referring to it here, but we all need to keep in mind that not all of us are after weight loss! Many of you out there have emailed me about sharing tips and advice on how to gain weight healthfully, especially those who are athletes, naturally underweight, or recovering from disordered eating habits. I commend each and every one of you who email me about this issue because I think it’s something we nutrition professionals don’t speak about enough — the flip side of weight loss and the obesity epidemic.

Why a Healthy Weight is Important

I know many clients who are looking for weight gain come because of a wide range of issues and backgrounds. Some conditions are health-related, such as Celiac or a myriad of digestive problems, while others suffer from health issues that contributed to weight loss or have “always been thin” and are natural ectomorphs. I also hear from athletes or recreational athletes looking to put on lean body mass, while others who inquire are recovering from disordered eating habits. No matter what the cause or reasoning behind wanting to gain weight, you can apply these tips.

First, let me preface this with what underweight really means. According to the BMI guidelines, anyone under 18.5 is considered “underweight.” Keep in mind, in my opinion, the BMI system is flawed when it comes to assessing overweight/obese qualifications and sometimes it’s flawed when assessing underweight conditions as well. This is because it doesn’t take into consideration one’s lean body mass, body fat ratios, genetics, or bone structure. In general, it’s a guideline and only should be used as such.

Being underweight has many signs and symptoms that differ from each person, and some include reduced appetite, emaciated features (especially around the shoulders, collarbone, knees, and other joint points), sunken eyes, hormonal imbalance (especially in women), very low body fat percentage, poor vital signs, losing hair, feeling cold, lack of energy or feeling tired, and more.

Being underweight can also result in several health consequences, such as hormonal changes, decreased muscle mass, decreased bone density, lowered immune system function, slow wound healing, sleep issues, irregular heartbeat, vitamin/mineral/nutrient deficiencies, impaired gut function, heart disease, anemia, and high risk for further malnutrition.

BMI and What It Means to Be at a Healthy Weight

A person’s “healthy weight” depends on several things, but I always take into consideration metabolism, body type, genetics, bone structure, body fat percentage, and weight trends over time. You can use the BMI chart as a guideline and then adjust to your history of weight, body type, etc. You should also be in close communication with your doctor about your blood work, vitals, and body fat percentage to get the full picture of your health and healthy weight. For example, let’s say you have someone who is “on paper” underweight (i.e. according to the BMI chart), but they’ve always been that way and have small bone structure. If they feel great and are otherwise healthy, then this is an entirely different situation. In this case, reaching a “normal” weight according to BMI may not apply to them as their current weight is their normal.

Views on Weight Gain or Loss and Body Image

An important note: Just as you wouldn’t comment on someone who is battling an eating disorder or struggling with being obesity, the same goes for those who are underweight or thin. The reality is that all too often we hear the media, friends, family, or even complete strangers comment on those who are thin and think that it’s okay. You might hear “gosh you’re so thin!”, “I wish I could eat like you and look like that,” “oh, you don’t have to worry about eating healthy,” “eat a hamburger,” etc. Struggling to gain weight is the flip side of wanting to lose weight, so keep that in mind when engaging with our friends who may be struggling here.

We all need to act out of love, compassion, and kindness regardless of someone’s body shape and composition, but especially for those who are struggling with how to gain weight. Someone may be suffering from an underlying health issue or mental/disordered eating issue. A comment such as some I mentioned above can easily trigger a downward spiral and reverse all the hard work they’ve done emotionally, to gain weight. Comments such as those may also reinforce that somehow the way they are isn’t “good enough.” I see this is especially true for those individuals who are naturally thin and technically “underweight” by BMI measurements and with those suffering from disordered eating thought patterns.

The next time you hear a thought buzz around in your head about commenting on someone’s body, whether overweight or underweight, I challenge you to say the mantra “act with love.” It’ll turn your thoughts 180 degrees around and for that moment you may realize you don’t know the full picture of that person, and judging them or verbally commenting doesn’t represent a loving attitude.

We all universally share the same goal, to feel and be healthy. We all have to keep this in mind and bring a new awareness and compassion to all sides of the spectrum, whether under or overweight.

How to Gain Weight: 10 Smart Strategies

Now that we’ve addressed overall body image, let’s discuss how to gain weight to reach a healthy size. I’ve compiled my top pieces of advice for any of you out there looking to put on healthy weight with whole foods instead of resorting to a lot of processed foods or “junk” items that may make you feel worse.

1. Start Slow

Going from eating 1,000 calories one day to eating 3,000 calories the next is a recipe for disaster, not to mention digestive distress. Ease into increasing your portions sizes and servings of food gradually, allowing your stomach to stretch and for your body to get used to the number of calories and nutrition.

2. Go For Nutrient and Caloric Density

Always be on the hunt for whole foods that are not only nutrient-dense but also calorically dense. Some examples include coconut oil, nuts/seeds, avocados, grass-fed butter, olive oil, coconut milk, fruits, dried fruit, and starches like sweet potatoes.

3. Eat Smaller Meals

Eating smaller meals more frequently may help cut down the volume of your meals so you don’t feel so full all the time. Your body will adjust to the number of foods over time.

4. Sneak Foods In Smoothies

Smoothies are incredibly easy to sneak in heaps of good calories without making you feel incredibly full. The trick here is volume. In other words, opt for high calories in a small size. Use things like nut butter, coconut oil, fruit, and avocado to boost the calorie count.

5. Change Up Your Exercise Routine

If you’re engaging in a lot of cardio exercises (say, running, aerobic classes, sports), you may want to consider limiting these types of workouts. While working on weight gain, adjust this temporarily until you’ve met your healthy/goal weight. Also adding in body weight exercises, weight lifting, and resistance training is going to be crucial for helping maintain and build muscle mass. Check out this post to find an example bodyweight exercise routine.

6. Seek Support

Share your experience with friends and family so they can keep you accountable in eating all of your meals, sneaking in high-calorie add-ons, and helping you stay on track. This is key! Also, as mentioned earlier, rely on your health professional care team to keep you accountable and to allow them to check in on your health.

7. Try A Food Diary

For those who are suffering from disordered eating issues, I often don’t recommend tracking your food intake or logging your meals. That’s because this can become another outlet for the disorder or turn into an obsession. However, this can be a smart choice when done with a healthcare professional who is looking out for you. Those who are trying to gain muscle, recover from illness, etc. are more likely to benefit from tracking their meals. I recommend the app, MyFitnessPal because it’s simple, easy to use, and has an app. As always, use calorie counting as a tool – don’t let it use you!

8. Work With A Dietitian

Find a local dietitian in your area who can help you come up with a plan for foods you should be consuming, how many calories you need, the best ratio of macronutrients, and an expert who can monitor your progress. To set up a time with me, check out my nutrition coaching services.

9. Get Emotional Support

If being underweight is caused by an underlying emotional/mental challenge, seek a professional to get on a path for your overall wellbeing and health. Remember to always be in communication with your physician, and keep an open mind about professionals who might be able to help you.

10. Share The Love

I would love if you all would share this blog post with someone you know who is looking to get their health on track and who may find this blog post helpful. Again, one-on-one nutrition coaching sessions with me will help get those who need more guidance and a plan with gaining weight healthfully. I’d be happy to help!

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