The stigma associated with bodyweight largely revolves around obesity – the woes of being overweight and related struggles. But there is another side to bodyweight too, one that is equally complex. Being underweight comes with its own set of physical and psychological burdens, not to mention stigma. And, like the struggle at the heavy end of the spectrum (how to cut weight healthily), those who are underweight have a torrid time gaining kilos, often ending up with unhealthy body mass.
Gaining weight is an intricate process with variables including genetics, the body type of the individual, diet and exercise all having a say. The attempt should be to gain muscle mass with minimal or the right proportion of increment in fat percentage. This would require a nuanced approach maintaining a combination of diet and exercise, after prior assessment to ascertain if there is an underlying physiological or genetic predisposition to remaining underweight.
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Genetics, diet and physical condition
From hereditary predisposition to thyroid issues and more, there are many factors that lead to being underweight.
“The predisposed hereditary condition runs in families where individuals have moderate-to-low BMI [body mass index] genetics,” says Dr Suguna S (PhD, quality of life and renal nutrition), a Bengaluru-based holistic wellness and nutrition coach, and founder of Suphala Care. “Second is the nutrition aspect, which starts right from the time of pregnancy. If nutrition is not taken care of during pregnancy, the child will be born with a less-than-optimal weight. As the child grows, he or she may remain underweight as the damage in terms of growth has been done right at the beginning.”
Underlying health issues such as hyperthyroid chromosomal condition (in which a person has a high metabolism rate), endocrine disorder, predisposed nutritional disorders, anorexic conditions, IBS (irritable bowel syndrome) and food intolerance also lead to a person remaining underweight.
Dr Suguna recalls the journey of two of her clients — both of them chronically underweight, but due to different reasons. Karthik (name changed), who was in his late twenties, weighed around 50kg despite having a 6ft frame. Karthik’s weight loss was sudden. He was diagnosed with IBS, which was the primary reason for his drastic weight reduction. Pritha (name changed), meanwhile, had a thin frame since childhood, inherited from her parents. She weighed less than 50kg and, being underweight, had trouble conceiving when she and her partner were planning a child.
Dietary weight gain
To gain weight healthily, one of the first things to get in order is diet. Protein-rich food, balanced with carbohydrates, is essential for muscle gain.
Muscle-building food, which are rich sources of minerals, vitamins and proteins, includes:
- dairy products (milk, butter, cheese, yogurt and cottage cheese)
- nuts (almonds, walnuts, pistachios, cashews, etc)
- seeds (pumpkin seeds, flax seeds, etc)
In addition, food rich in vitamin K (green leafy vegetables such as collard, turnip greens, kale, spinach, broccoli, Brussels sprout, cabbage, lettuce); Vitamin D (mushroom, soy milk, etc for vegetarians and oil-rich fish including salmon, sardines, herring and mackerel for non-vegetarians) should also be incorporated in the diet. These add essential vitamins and antioxidants to the diet.
For non-vegetarians, meat is a natural source of protein. However, lean meat is recommended – seafood or poultry being ideal. Regular consumption of eggs – a good source of proteins, minerals and all vitamins except vitamin C – is also advised. For vegetarians, legumes, lentils, beans and soya are good sources of minerals and proteins.
One should refrain from consuming junk or calorie-rich food such as pizzas, burgers and fries along with all types of packaged food.
It is also a good idea to adopt a diet in consultation with an expert to ensure the right balance is maintained. Too much protein, for instance, could lead to other distresses or conditions, ranging from constipation to a rise in uric acid and many other ailments.
| FOOD ITEMS | CONSTITUENTS |
| Dairy products
(milk, butter, cheese, yogurt, cottage cheese) |
Lipids, proteins, amino acids and vitamins, and minerals such as calcium, potassium and phosphorous |
| Nuts and seeds
(almonds, cashews, walnuts, pistachios, pumpkin seeds, flax seeds) |
Minerals such as calcium, magnesium potassium, vitamins B and E, and proteins |
| FOOD FOR VEGETARIANS | |
| Green leafy vegetables
(collard, turnip greens, kale, spinach, broccoli, Brussels sprout, cabbage, lettuce) |
Vitamin K |
| Mushroom, soy milk | Vitamins B and D |
| Soya, legumes, lentils, beans | Proteins |
| FOOD FOR NON-VEGETARIANS | |
| Oil-rich fish
(salmon, sardines, herring, mackerel) |
Vitamins and antioxidants |
| Meat | Proteins |
| Eggs | All types of vitamins (except vitamin C), along with proteins and minerals |
Lifestyle changes
Food intake alone would not work and should be complemented with lifestyle changes and exercises to ensure wholesome weight gain through muscle building and better bone density. Regularising food timings and incorporating an exercise routine, along with an adequate amount of rest/sleep, are essential.
An individual who intends to gain weight should refrain from doing sustained cardio workouts such as long-distance running or cycling. The focus should be on strength-training exercises with moderate amounts of cardio.
In a 2015 paper, ‘The cortisol response to exercise in young adults’, by Henning Buddle et al, published in Frontiers in Behavioral Neuroscience as a commentary on the executive function and endocrinological response to acute resistance exercises (in adults including adolescents of late-puberty stages), the authors say that the concentration of cortisol after acute bouts of exercise is intensity dependent. Cortisol, a stress hormone, is detrimental to muscle growth.
Guwahati-based master personal trainer and nutrition coach Ashish Baruah recommends a 20-30-minute workout schedule. He says that steady-paced cardio activity, for 40-45 minutes, stimulates production of cortisol, which is catabolic in nature and leads to atrophy and loss of muscle mass.
“For a physically inactive person, a moderate-intensity workout of 20-30 minutes per session for three to four days a week should be done, and the intensity of exercise should be increased with time,” says Baruah. “For those who intend to gain weight, along with diet and exercise, rest is the key for recovery and result. So, a strength-training session for three to four days a week followed by sufficient rest/recovery along with an adequate nutrition plan matching the exercise intensity are recommended.”
A light cardio workout (around 20 minutes), maintaining moderate intensity, with a weekly schedule primarily revolving around resistance and weight training, is ideal. That makes exercising under supervision or guided by an expert important because the intensity, and the duration, should be customised based on the individual’s physical state and physiological response.
Takeaways
- Gaining weight healthily is a major challenge, especially for those with a physiological predisposition to remain underweight.
- Gaining weight is a complex procedure which depends on identifying underlying causes of being underweight, ranging from genetic factors to health issues.
- To facilitate healthy weight gain, eating a protein-rich yet balanced diet, and getting into an appropriate exercise regimen which focuses on gaining muscle mass is essential.
