From underweight to healthy: A holistic approach to healthy weight gain

January 30, 2024 - By Rachel Kubik, Senior Content Writer for ARC

Despite a lot of discourse about losing weight, especially around the new year each year, some consumers may want to gain weight. There are many reasons for unintentional weight loss, including underlying health conditions, stress and eating disorders.

As a health and wellness professional, it’s crucial to address the needs of those seeking to gain weight or restore weight they may have lost. Recognizing the various causes for unintentional weight loss allows you to identify potential concerns and provide informed support. There are strategies to help your consumer, patient or client safely gain weight, emphasizing a gradual process, nutrient-dense foods and a holistic lifestyle. 

Health and wellness professionals can utilize this knowledge on safe weight gain strategies to offer personalized advice, considering factors such as individual health goals, lifestyle and cultural influences. The inclusion of specific foods and tips enhances professionals’ ability to guide clients, patients or consumers effectively. 

Insufficient nutrition and underlying health conditions can lead to adults being categorized as underweight. According to data from the 2017-18 National Health and Nutrition Examination Survey (NHANES), which utilized measured heights and weights, approximately 1.6% of U.S. adults aged 20 and over are identified as underweight. The NHANES, administered by the National Center for Health Statistics, employs a multistage probability sample of the civilian noninstitutionalized population in the United States. 

To determine if consumers are underweight, the Body Mass Index (BMI) serves as a useful measurement requiring consumers’ height and weight. Utilize the National Institute of Health’s BMI calculator for accurate results. 

It’s more common for men to want to gain weight. A 2017 online survey conducted by the National Library of Medicine found that over one in five men (23.1%) and about one in twenty women (6.0%) attempted to gain weight that year. Reasons for weight gain included being male, perceiving oneself as underweight and certain racial/ethnic identities. 

A different study from the National Library of Medicine explored young men’s perceptions of body image and experiences of intentional weight gain, providing insights into broader sociocultural meanings around food, consumption and male body image. The findings revealed diverse attitudes toward body image ideals influenced by media, with a focus on muscularity and leanness. Some men valued appearance changes, while others experienced negative impacts, emphasizing the complex relationship between weight gain, body image and psychological well-being. 

Reasons for unintentional weight loss 

Abrupt and noticeable weight loss may occur following a period of stress or could be indicative of a severe underlying illness. The following information can provide potential causes of consumers’ weight loss, but it’s essential not to use it for diagnosis. A doctor can provide a proper diagnosis. 

It’s not uncommon to experience a noticeable drop in weight after significant life events, such as job changes, job loss, friendship or romantic break ups, divorce or bereavement. Weight typically stabilizes as consumers regain a sense of happiness, often after allowing time for grieving or adjusting to the change, according to NI Direct. 

If consumers’ weight loss doesn’t align with the mentioned causes, and it wasn’t due to intentional dieting or exercise, consult a medical professional, as it may be indicative of an underlying health condition requiring treatment. Consumers should seek counseling or support if needed to help reach this stage. For stress management concerns, consult a doctor. Substantial weight loss may also be linked to eating disorders like anorexia or bulimia, in which case consumers should seek professional medical assistance promptly. Several organizations, such as the National Eating Disorders Association, can additionally provide information and advice. 

While fluctuations in body weight are normal, persistent, unintentional loss exceeding 5% of consumers’ weight over 6 to 12 months is usually a cause for concern, according to NI Direct. Such weight loss could signal malnutrition, indicating an insufficient intake of essential nutrients. Other symptoms associated with involuntary weight loss may include fatigue, loss of appetite, changes in restroom habits and an increased susceptibility to illnesses or infections. Unintentional weight loss doesn’t always have a readily identifiable cause. 

In addition to the aforementioned factors, it may be attributed to: 

• Depression. 
• Overactive thyroid gland (hyperthyroidism) or excessive treatment for an underactive thyroid. 
• Cancer or other chronic illness. 
• Surgery. 
• Trauma to the body. 

In rarer instances, unexpected weight loss may be linked to: 

• Side effects of specific medications. 
• Alcohol or drug misuse. 
• Heart, kidney, lung or liver disease. 
• Glandular issues (e.g., Addison’s disease or undiagnosed diabetes). 
• Chronic inflammatory conditions like rheumatoid arthritis or lupus. 
• Dental problems, such as tooth loss, orthodontic procedures or mouth ulcers. 
• Conditions causing dysphagia (swallowing problems). 
• Gut-related issues, including stomach ulcers, inflammatory bowel disease (IBD) or celiac disease. 
• Bacterial, viral or parasitic infections like persistent gastroenteritis, tuberculosis (TB) or HIV and AIDS. 
• Dementia, where consumers may struggle to communicate their dietary needs. 

How to gain weight safely  

Weight gain should be a gradual process, incorporating a mix of nutrient-dense foods and engaging in a consistent, healthy lifestyle. Consider having the consumer also consult with his or her doctor in addition to your advice before attempting significant weight gain to ensure safety and effectiveness. If difficulties persist, the consumer should definitely consult a doctor. 

To gain weight, consumers can: 

• Gradually increase calorie intake, aiming for an additional 300 to 500 calories per day. 
• Consume smaller meals more frequently, incorporating healthy snacks between meals. Consumers should incorporate 5 to 6 smaller meals throughout the day, even if they’re not particularly hungry. Tune into the body’s hunger cues, and plan eating times accordingly. The consumer can also add extra meals or snacks, including one before bedtime. 
• Add extra calories by incorporating extras like cheese in casseroles, nut butter or seeds on whole-grain toast or adding dry or liquid milk to foods for extra protein and calories. Nuts, such as almonds, and nut butter are calorie-dense, providing 170 calories per small handful. Adding them to snacks or meals contributes healthy fats and nutrients. 
• Include high-calorie drinks between meals, such as milkshakes. Opt for high-calorie, nutritious ingredients in smoothies or shakes as a convenient option for on-the-go nutrition. Meal replacement drinks can also support weight gain efforts. Protein smoothies with ingredients like banana, chocolate whey protein, peanut butter and dairy or soy milk can provide around 400-600 calories, high protein and essential vitamins and minerals. 
• Avoid relying on unhealthy sources like chocolate, cakes and sugary drinks for weight gain. However, consuming high-quality dark chocolate with at least 70% cacao makes for a snack rich in antioxidants and offers 600 calories per 100g. 
• Refrain from filling up on drinks before meals. While staying hydrated is crucial, consumers should be cautious of beverages that may make them feel full. Avoid drinking during meals or right before, ensuring adequate hydration maintenance throughout the day. 
• Maintain a balanced diet, choosing from various food groups like fruits, vegetables, starchy carbohydrates, dairy and alternatives. 
• Enhance protein intake with beans, pulses, fish, eggs and lean or red meat. Beef or pork, especially in fattier cuts, are effective muscle-building foods, offering 228 calories and 24g of protein per 3 oz serving. 
• Opt for easy-to-prepare snacks like yogurt or rice pudding. 
• Engage in strength training or yoga, as exercise can improve appetite. Especially strength training can build muscle mass, stimulate appetite and contribute to healthy weight gain. Take creatine monohydrate, a muscle-building supplement, to aid in gaining muscle weight. 

Medications that boost hunger may also be recommended in some cases to support consumers’ weight gain journey, according to Health. 

Specific foods 

It’s important to adopt a healthy approach to weight gain rather than relying on soda, donuts and junk food, which may lead to an increased risk of heart disease, diabetes and cancer, according to an article from Healthline. 

Gaining weight in a healthy manner involves a combination of nutritious foods rich in proteins, fats and carbohydrates, depending on individual health and weight goals, according to Healthline. Consumers should eat more calories than they burn, which is essential for weight gain, and incorporating certain foods into their diets can make this process safe and effective. 

Mixing these foods into a well-balanced and enjoyable meal plan can promote sustainable weight gain: 

• Dairy milk: Whole milk is a balanced source of proteins, carbs and fats, promoting muscle growth. Consuming 1 cup of whole milk as a snack or with meals adds 149 calories and 8g of protein. 
• Yogurts made with whole milk: Greek yogurt with whole milk offers a well-balanced mix of protein, carbs and fats, supporting weight gain. 
• Rice: A cost-effective carb source, rice offers 204 calories per cup and can be combined with various ingredients for tasty, calorie-dense meals. 
• Potatoes and complex carbohydrates: Complex carbs like potatoes, quinoa and oats can boost calories and improve muscle glycogen stores. 
• Salmon and oily fish: Rich in omega-3 fatty acids and high-quality protein, salmon provides 155 calories per 3 oz serving, supporting muscle building. 
• Protein supplements: Whey, soy, egg and pea protein supplements, combined with strength training, can aid weight gain by improving lean body mass.
• Dried fruit: Convenient and calorie-dense, dried fruits like dates offer antioxidants and nutrients, contributing to weight gain. 
• Whole grain bread: Combining whole grain bread with proteins like eggs, meat or cheese creates calorie-rich, balanced meals. A source of protein and fats, cheese can be added to meals for flavor and extra calories. Whole eggs, especially the yolk, provide high-quality proteins and fats, contributing to muscle building. 
• Avocados: Loaded with beneficial fats, avocados are calorie-dense, providing 365 calories per large fruit. They are versatile and can enhance various dishes. 
• Cereals: Oatmeal and ready-to-eat cereals offer carbs, calories and nutrients, supporting weight gain. 
• Cereal bars: Portable and nutrient-dense, cereal bars are convenient snacks, averaging 150–200 calories. 
• Fats and oils: Adding healthy fats like olive oil or coconut oil to meals can quickly increase calorie intake. 

The consumer can gain a balanced amount of muscle mass and subcutaneous fat while avoiding unhealthy belly fat. A high percentage of body fat increases the likelihood of developing type 2 diabetes and other health problems, even in consumers who are not overweight. To achieve safe weight gain, the consumer must have a nutrient-dense diet and maintain an overall healthy lifestyle, including regular exercise and stress reduction. Quality, adequate sleep is crucial for muscle growth. 

Emphasizing the consumption of whole foods like fruits, vegetables, whole grains and legumes is essential. However, these foods, being filling, may make it challenging to reach calorie goals. Suggest using spices, sauces and condiments to enhance flavor and opting for energy-dense foods that provide many calories relative to their weight. 

There are additional strategies for the consumer to gain weight faster, complementing high-calorie intake with heavy resistance training: 

• Use larger plates to encourage higher calorie consumption. 
• Add cream to coffee as a simple way to boost calorie intake. 
• Avoid smoking, or if smoking, consider quitting, as smokers tend to weigh less, and quitting can lead to weight gain. 

In summary, health and wellness professionals should be well-versed in this information to offer inclusive, informed and effective guidance to consumers, clients and patients seeking to gain weight or restore lost weight. Additionally, it’s crucial to address the underlying reasons for weight loss, ranging from stress and illness to eating disorders, and to promote a comprehensive approach to weight management. This knowledge ensures a holistic plan of attack, considering physical, psychological and cultural factors, and contributes to healthy weight management practices. Armed with this understanding, health and wellness professionals can empower consumers to achieve their weight goals safely and sustainably, therefore fostering overall well-being and vitality.