Sunday, January 27, 2013

Tidbit: What if you can’t gain weight?

This time of year is “all diets all the time” on the TV, in magazines and in pharmacies (take this product or join this program to lose all the weight you want!).  I have found that many people who wish to lose weight have a good idea what to do (cut portions down, stop the liquid calories, and move their bodies more), but they need someone like me to help hold them accountable, and to make sure they are not getting off track and harming themselves with extreme measures.  

But what about the people who can’t hold their weight and are too thin? You may think by looking around general society (especially in the U.S.) that everyone is overweight. But I have a number of clients who need to gain weight.  They are in just as much angst about their weight as the overweight person. 
For example, one woman I worked with was 6 feet tall and just 97 pounds (BMI 12). She was a good eater, no problems with appetite, and has had other medical problems ruled out. But apparently she was a high calorie burner.  She wants to get back to her normal weight of between 110 and 120 pounds.
Other clients lost weight due to no appetite from surgery, others have had long-standing dental issues, while others have had GI problems that don’t allow them to absorb nutrients from their food.

So what can an underweight person do to gain weight? And what can a friend or family member do to help?
  • First off, no nagging. Even if I figure a calorie goal, a person can’t start the next day at that level; you have to start where you’re at, and add a little more food each day. I have witnessed family members being so judgmental about food choices (i.e. “you shouldn’t eat that pudding, it has sugar in it, it’s poison”) that I’m sure their loved one is not helped (and is likely discouraged). Sorry, but two days after surgery is not the time to introduce heavy-duty soy protein bars, organic trail mixes and other so-called “healthier” options.

While there are lots of reasons for weight loss, here are other ideas to use as a starting point to help gain weight. Remember, it’s just as difficult for an underweight person to gain weight as it is for the overweight to lose, so they have to keep working at it.
  • Make every calorie count. Drink juice instead of water (you still get the water value).
  • Choose the higher calorie food option, such as real mayonnaise and salad dressing (not the light version).
  • Aim to increase calories by at least 500 per day. This will require keeping a food record for about a week, adding up normal daily calories, then adding 500 to that.
  • Any chance you can, add calories. Put peanut butter on toast, leave a bowl of nuts or dried fruit in full view for random snacking, and always add butter or margarine to bread, rice, noodles and potatoes.
  • Consider adding a liquid supplement between meals such as Ensure, Boost, Carnation Instant Breakfast (or the store brand equivalent).
  • Desserts are OK right now because you need the calories and the calories add up fast (a medium piece of pie or cake can be 400-500 calories, while a medium cookie is about 100 calories).

And if you are the one who would like to gain weight, be sure to check with your physician or health provider to make sure you don’t have other medical problems (thyroid, diabetes, cancer, GI malabsorption, etc.) as the cause of the weight loss.

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