People think losing weight is very difficult, but the truth is that gaining weight is more difficult. Being underweight is a sign of poor nutrition. Extremely thin individuals are at an increased risk of certain medical conditions, infections (due to poor immune system) and osteoporosis. They have less energy to perform daily tasks and get tired easily as compared to individuals who are not underweight. In addition to this, underweight is a risk factor associated with early death. Therefore, a complete and balanced nutrition is required to gain weight and lean body mass without increasing the body fat.
Body mass index is defined as the weight of an individual in kilograms divided by the square of height in meters. Body mass index is a very simple tool used to classify an individual as underweight, normal-weight or overweight. It is independent of age and is the same for both males and females. Furthermore, body mass index does not indicate the percentage or degree of fat present in the body.
|Classification||Body mass index cut-off values|
|Mild Thinness||17.0-18.50 kg/m2|
|Moderate Thinness||16.0-16.99 kg/m2|
|Severe Thinness||Less than 16.0 kg/m2|
|Underweight||Less than 10.50 kg/m2|
*As per WHO criteria
Causes of Weight Loss
- Infections such as tuberculosis or gastrointestinal infections
- Diseases of liver or kidney
- Hyperthyroidism or overactive thyroid
- Certain medications that may suppress appetite
- Poor nutrition due to poverty
- Skipping main meals such as breakfast, lunch or dinner
- Eating only out-side food or zero calorie foods without nutrients
- Eating disorders such as anorexia nervosa or bulimia
Side effects of Being Underweight
Poor Immune System
Individuals who are very thin or underweight often have a weakened immune system and are at an increased risk of contracting infections. The main function of the immune system is to fight infections and prevent the entry of bacteria and viruses into the body. However, in case of a weakened immune system, body cannot fight infection and as a result of this, a person may contract infections or fall ill too often. Thus, the quality of life deteriorates.
Dry & Rough Skin and Easy Hair Fall
Being underweight is an important sign of poor nutrition. It indicates that the diet is lacking in important nutrients. Due to lack of nutrients, a person may look dull and the skin loses moisture and starts looking dry, rough and scaly. Not just the skin, but hair also starts thinning. Hair fall and reduced hair volume is very common in such individuals.
Nutrient Absorption Decreases
Reduction in nutrient absorption is common when a person loses weight. Such a condition further worsens the situation. The underweight individual may develop certain nutrient deficiencies. For example, calcium deficiency may increase the risk of osteoporosis and easy fractures, while lack of iron and protein may lead to anemia.
Muscle Strength Decreases
Individuals who are thin usually have low muscle mass and because of this, they have reduced muscle strength. Poor muscle strength further leads to decreased ability to perform daily tasks and thus, such a person gets tired easily.
Females who are very thin or underweight have many complications during pregnancy. In severe cases, females are unable to conceive. Whereas, in some cases though the females have conceived, they are at greater risk of miscarriage.
Healthy Ways to Gain Weight
Eat Small & Frequent Nutrient Dense Meals
Individuals who are thin usually have a small appetite and small stomach capacity. They cannot eat much at a time. Therefore, it is advisable to give them small and frequent nutrient dense meals. Here are some ways to make the meals nutrient dense:
- Add butter to soups
- Ghee can be added to porridges
- Add some chopped nuts to a glass of plain milk
- Replace normal butter with some peanut butter to spread on a slice of bread
- Serve vegetable sticks or salad with cheese sauce
- Serve nuts and dry fruits as snacks
Note: One should not overdo on high-fat foods such as cheese or increase the consumption of fried foods. Such consumption will increase body weight, but may even increase the body fat percentage, which is an unhealthy way to gain weight.
Increase Your Protein Intake
Dietary protein is required for muscle growth and for the development of lean body mass. At least 15 to 20% of total calories should come from protein. A diet rich in carbohydrates and fat are stored in the body in the form of fat, but when high protein diet is consumed, it is stored in the form of lean body mass or muscle. Muscle gain is an indication of healthy weight gain. This will also provide strength to perform daily activities without getting tired early. Vegetarians can increase their protein intake by consuming cereal-pulse combinations. Combining cereals with pulses improves the overall quality of protein. Though red meat and processed meat are rich in protein, their consumption should be limited because they are rich in unhealthy type of fat. (1)
Foods Rich in Protein Include:
- Soy nuts
- Nuts and oilseeds
- Cheese (PANEER)
- Pulses, beans, legumes
- Cereal-pulse combination such as rice and DAL, KHICHDI, IDLI, DOSA and so on
Include Whole Grains in Your Daily Diet
Whole grains are rich in carbohydrate, dietary fiber, vitamins, minerals, phytoestrogens, phenols and unsaturated fatty acid. A research published in 2006 showed that individuals who consumed a high carbohydrate diet for 15 days gained more weight as compared to individuals who consumed high fat diet of equivalent calories. Therefore, it is important to include healthy whole grains in your daily diet to make your diet carbohydrate rich. However, refined food products are also rich in carbohydrates but they should be avoided as they do not contain dietary fiber, minerals and vitamins and are not considered healthy. (2)
Examples of whole grains include:
- Wheat cracks or broken wheat
- Brown rice
- Whole wheat pasta or noodles
- Whole wheat or multi-grain bread
Make Nuts and Oilseeds a Part of Your Diet
Nuts and oilseeds are a dense source of energy and consuming nuts daily helps to maintain positive energy balance. Adding nuts to different recipes increases the bulk and overall caloric content. Nuts when consumed in limited amount (4 to 5 almonds per day) and when made a part of calorie restricted diet helps in weight loss, but when consumed in large amount and added to different meals helps to gain weight.
For example, 4 to 5 almonds when consumed as a snack in a calorie restricted diet helps in weight loss, but 4 to 5 almonds when added to milk two times per day may promote weight gain. However, one should not consume more than 10 to 12 almonds or 3 to 4 whole walnuts per day. Besides this, nuts protect the heart, have low glycemic index and help in maintaining a healthy lipid profile. (3, 4)
Palatability and Variety of Foods
A research published in 2010 showed that reduced striatal activation (striatum is a part of forebrain) is associated with weight gain. In addition to this, research has also shown low striatal responsivity when palatable food is consumed. Such reduced striatal activation is associated with increased eating and positive energy balance. Thus, adding more herbs, spices and condiments improves the palatability of food, which in turn promotes weight gain. (5)
Examples of some herbs, spices and condiments include:
- Cumin seeds
Include More Dairy Products
Dairy foods such as milk, yogurt, buttermilk (LASSI), cheese (PANEER), butter and Ghee are dense sources of energy. These food sources also provide calcium, protein and other vitamins and minerals, which are necessary for the human body. Milk when made a part of energy restricted diet helps in promoting weight loss, but research has shown that children who drank more milk gained more weight. Drinking large amount of milk provides energy and creates positive energy balance. This research further found that milk contains hormone estrone that promotes weight gain. Therefore, individuals who want to gain weight should make milk and milk products a part of their daily diet. Furthermore, cold drinks, sodas, fizzy drinks can be replaced by milk, buttermilk (LASSI) to create a positive energy balance. (6)
Resistance Training (Lifting Heavy Weights) & Muscle Gain
Research has shown that lifting heavy weights is associated with muscle gain and increase in the muscle mass. Start with lifting smaller weights and then gradually increase the weights. Perform resistance training at least 2 to 3 times per week. Such training helps the muscle to grow in size and provides muscle strength too. If you are new to this, take help of a qualified trainer. Individuals with bone problems or some other medical conditions should consult their doctor or health care provider before starting resistance training. (7)
Get Adequate Sleep
Every individual should sleep for at least 7 to 8 hours. A research published in 2011 observed that individuals who sleep for less number of hours lost more muscle mass. Such muscle loss will make you look skinny and weak. In addition to this, muscle strength will decrease and you may get tired easily. Therefore, it is very important to get proper sleep for muscle gain and muscle recovery. (8)
Maintain Positive Energy Balance
To maintain the same body weight, an individual’s energy intake should be equal to his/her energy expenditure. But, to gain weight, an individual’s energy intake should be more than his/her energy expenditure. This creates an environment of positive energy balance in the body. In other words, the positive energy balance is when the calories you consume are more than the calories you expend. For example, a person who eats too little, but exercises more will surely lose weight. Therefore, in order to gain weight, individuals should eat frequent healthy and nutrient dense meals. (9)
Avoid Drinking Water Before or With Meals
Water is the best beverage and drinking adequate water is very important, as water comprises 60% of your body weight. Studies have shown that the time during which individuals drink water may have an impact on their food intake and overall body weight. Many individuals drink water before meals or with meals. A research published in 2010 has observed that drinking too much water before or with meals may suppress the appetite and individuals may eat less. This can be extremely beneficial for individuals who want to lose weight, but individuals who want to gain weight should avoid drinking water before meals. Individuals who eat less may further find it difficult to gain weight. (10)
Sample Menu Plan
Early Morning or Before Breakfast
Drink one glass milk with crushed almonds. Have a glass of milk half an hour before your breakfast rather than having both together.
Reason Behind: If you have a small appetite, you can easily split your breakfast.
- Breakfast option 1: 1 serving cheese vegetable sandwich (2 slices whole wheat or multigrain bread and 1 slice of cheese)
- Breakfast option 2: 1 serving whole egg sandwich (1 whole egg in the form of omelet or boiled egg with 2 slices whole wheat or multigrain bread)
- Breakfast option 3: 1 bowl porridge with chopped nuts or fruit added to it
Reason Behind: Try preparing a different breakfast each day and add more herbs to your savory preparations.
- One bowl fruit salad
Reason Behind: Fruits are a good source of vitamins and minerals
- One bowl salad with crushed peanuts + 1 chicken or Cheese (PANEER) roll
- Chicken or PANEER PULAO + 1 bowl yogurt or 1 glass buttermilk
Reason Behind: Vegetables can be served with cheese sauce. The idea of the entire lunch is to provide a compact meal. Seeing too many different items together may kill the appetite and people may feel full soon.
- One glass protein shake
Reason Behind: Before exercising, consume your glass of protein shake.
- One carbohydrate rich cereal + one glass protein shake.
Reason Behind: After exercise, consume a carbohydrate rich snack. This will provide energy to your muscles.
- One bowl salad with crushed almonds + one bowl DAAL with Chapatti
- One cup milk with crushed almonds
Reason Behind: Milk is a good source of calcium, which will allow your muscles to relax.