What is the best strategy for gaining weight?

Weight loss is a serious issue in the United States. Consumers constantly see advertisements and news reports on trendy diets, flashy products, and magic pills promising to help them lose weight.

Given that the ongoing “battle of the bulge” is front and center for so many people, being too thin may seem like a good problem to have. But the reality is that being underweight can cause health problems.

Path to improved wellness

Fat has a bad reputation for causing people to be overweight and obese. However, not all fat is bad. In fact, breaking down and storing energy [calories] as fat is good. It’s just one of the many ways the body uses food to function, heal, and grow.

Stored energy from fat helps you get through a strenuous job or workout. It plays a key role in brain development, and in preventing inflammation [swelling] and blood clots. Fat contributes to healthy hair and skin as well.

You can determine whether you are underweight by using a Body Mass Index [BMI] calculator. This online tool considers your weight, height, age, and gender to calculate a score. If your BMI is less than 18.5, you are underweight. Your doctor also can help determine if you’re underweight based on your height, weight, what you eat, and your activity level.

Your doctor may put you on a weight gain program if you are underweight. However, this is not permission to go crazy with junk food. Healthy weight gain requires a balanced approach, just like a weight loss program.

Eating junk food may result in weight gain. However, it will not satisfy the nutrition your body needs. Even if the fat, sugar, and salt in junk food doesn’t result as extra weight, it can still harm your body. For a healthy weight gain, the following tips can help:

• Add healthy calories. You don’t need to drastically change your diet. You can increase calories by adding nut or seed toppings, cheese, and healthy side dishes. Try almonds, sunflower seeds, fruit, or whole-grain, wheat toast.
• Go nutrient dense. Instead of eating empty calories and junk food, eat foods that are rich in nutrients. Consider high-protein meats, which can help you to build muscle. Also, choose nutritious carbohydrates, such as brown rice and other whole grains. This helps ensure your body is receiving as much nourishment as possible, even if you’re dealing with a reduced appetite.
• Snack away. Enjoy snacks that contain plenty of protein and healthy carbohydrates. Consider options like trail mix, protein bars or drinks, and crackers with hummus or peanut butter. Also, enjoy snacks that contain “good fats,” which are important for a healthy heart. Examples include nuts and avocados.
• Eat mini meals. If you’re struggling with a poor appetite, due to medical or emotional issues, eating large amounts of food may not seem appealing. Consider eating smaller meals throughout the day to increase your calorie intake.
• Bulk up. While too much aerobic exercise will burn calories and work against your weight goal, strength training can help. This includes weightlifting or yoga. You gain weight by building muscle.

Before beginning a weight gain program, talk to your doctor. Being underweight may be due to an underlying health problem. It won’t be corrected by diet changes. Your doctor will be able to help you track your progress. He or she will make sure that healthy changes are taking place.

Things to consider

People who are underweight typically are not getting enough calories to fuel their bodies. Often, they are also suffering from malnutrition. Malnutrition means you are not taking in enough vitamins and minerals from your food. If you’re underweight, you may be at risk for the following health issues:

• Delayed growth and development. This is especially true in children and teens, whose bodies need plenty of nutrients to grow and stay healthy.
• Fragile bones. A deficiency in vitamin D and calcium, along with low body weight, can lead to weak bones and osteoporosis.
• Weakened immune system. When you don’t get enough nutrients, your body cannot store energy. This makes it difficult to fight illness. It may also be difficult for your immune system to recover after being sick.
• Anemia. This condition can be caused by not having enough of the vitamins iron, folate, and B12. This can cause dizziness, fatigue, and headaches.
• Fertility issues. In women, low body weight can lead to irregular periods, lack of periods, and infertility.
• Hair loss. Low body weight can cause hair to thin and fall out easily. It also can cause dry, thin skin and health issues with teeth and gums.

Many underweight people are physically healthy. Low body weight is due to a variety of causes, including:

When it comes to gaining weight, don’t rush it, experts say. Like weight loss, weight gain [particularly lean body mass] should be done gradually to allow the cardiovascular system to adjust, says Spencer Kroll, M.D., a board-certified internal medicine specialist at the Kroll Medical Group in Marlboro, New Jersey.

“Typically, one to two pounds per week is the maximum amount of weight gain that is indicated,” says Dr. Kroll. “Rapid weight gain can cause excessive stress on the cardiovascular system, leading to cardiac output problems.”

“This can cause blood pressure problems, fluid accumulation in the lungs and lower extremities and can also be toxic to the liver,” he adds. “Additionally, rapid weight gain can cause increases in adipose tissue.”

Before gaining weight, it’s best to seek your doctor’s advice, adds Mary Wirtz, a registered dietitian, board-certified specialist in sports dietetics and consultant for Fit Healthy Momma.

“Each individual is truly very different in terms of appropriate weight gain goals, and weight gain recommendations are contingent on a variety of factors including age, physical activity level, medical history, medications and more,” says Wirtz.

Atkinson adds that if it’s hard for you to gain weight, you may want to “consider staying slightly above a healthy body fat percentage [the percent of total body weight that is composed of body fat in proportion to lean mass, organs, tissues and water], because when you go back to maintenance mode, you’re probably going to drop some body fat naturally.”

Increase Your Calorie Intake

Gaining weight requires a caloric surplus, and that means eating more calories than you burn each day, says Atkinson. Experts also suggest a gain in lean body mass typically requires a protein intake of at least 1.5 grams to 2.2 grams per kilogram of body weight per day.

Because each underweight individual has different nutrient needs, Atkinson also recommends going to a doctor who can evaluate your complete blood count results to check for vitamin B or iron deficiencies.

“Underweight patients often have individual B vitamin deficiencies such as low thiamine, folate and cyanocobalamin levels,” says Dr. Kroll. “They also have low iron levels and can have resulting anemia.”

If you find out that you do have nutrient deficiencies, you and your doctor can discuss whether it might be beneficial to start taking a supplement.

How Many Extra Calories Do You Need to Gain Weight?

Aim to add 300 to 500 calories per day above your maintenance caloric intake to gain weight in a slow, healthy way, advises Dr. Kroll and Wirtz.

Increasing calories slowly allows the body to adjust to caloric demand and thus provide needed energy for safe weight gain, says Chiariello, but the quality of those calories is still important. “Processed foods with high fats and calories are not the healthy choice and can lead to unwanted fat gain,” she says.

Focus on a Healthy Diet

For healthy weight gain, focus on wholesome foods, says Chiariello. These include:

• Whole grains, such as oatmeal and quinoa, which provide essential vitamins, minerals, carbohydrates and fiber.
• Fresh fruits and vegetables, such as spinach, broccoli and apples, which provide essential vitamins, minerals and fiber.
• Lean protein, such as chicken and fish , which provide amino acids for muscle development.
• Unsaturated fats like olive oil and avocado, which are excellent for heart health.
• Adequate fluid intake, specifically water, which is necessary for hydration and bowel regularity.

Overloading on unhealthy fats and sugars isn’t a good idea, even when trying to gain weight, as these food groups can lead to health conditions including high blood pressure and diabetes. “Foods that are fried, contain added sugars and/or salt or are not nutrient dense should be limited,” says Chiariello. “Reading food labels is valuable and provides insight on ingredients as well.”

Throughout the process of gaining weight, be sure to have your cholesterol and lipid profile monitored with regular bloodwork to make sure your levels are healthy, says Atkinson. He also advises using a glucometer to check your fasting blood sugar level to make sure it’s not too high.

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Increase Your Protein Intake

To build muscle mass, people need around 2 grams of protein per kilogram of bodyweight, says Atkinson. “So if we were to calculate that for somebody who weighs 170 pounds, or 77 kilograms, they would consume 108 to 154 grams of protein a day,” he says.

What’s more, higher protein diets have been shown to promote muscle mass, prevent muscle loss and decrease the amount of muscle that is lost with aging, says Oluseun Olufade, M.D., a sports physician who works with a number of organizations and professional sport teams, including Emory University, the Atlanta Hawks and U.S. Soccer. “Protein can be consumed every three to five hours to help maintain muscle mass,” he says. “Food that contains 10 grams of protein include 40 grams of skinless cooked chicken, 50 grams of canned tuna, 120 grams of tofu, 60 grams of nuts, and 40 grams of cooked lean beef, pork or lamb.”

To up your protein intake, consider adding animal-based protein sources, such as poultry, fish, red meat, eggs, greek yogurt and cottage cheese, plant-based sources like beans and lentils, nuts, seeds, tofu, whole grains, and, in smaller amounts, fruits and vegetables, says Wirtz. Protein powders, shakes and bars are also easy sources of protein when on the go.

A health care professional can help you assess the correct amount of protein you need to gain weight based on your body type and needs.