I often get messages from people, particularly on instagram, who are looking for advice on how to gain weight in a healthy way. There are so many ‘tips’ out there in regards to losing weight (but do keep in mind if found on instagram they may not be the most reliable ways to ‘lose weight’). When it comes to your health and weight, please do not consult Google or social media as your reliable source. Your health is not worth sacrificing so please make sure you seek advice from a Registered Nutritionist or Dietitian.
Talia, is a lovely friend of mine and Registered Dietitian currently working on an inpatient eating disorder unit, so I thought she was an amazing person to ask to write this blog with me. She dedicates her job to helping individuals who are very underweight, restore their weight in a safe way. Here we are going to provide you with some information in regards to weight gain.
Is it simply a case up of upping your portion sizes?
You will need to increase the amount of food that you’re eating to gain weight, but the type of foods eaten need to be considered as well. What you are currently eating will influence what dietary changes might need to occur, for example, if you’re cutting out a food group or avoiding particular foods this will need to be addressed to ensure you are taking in the right balance of nutrients from all food groups. Normalising eating behaviours can be challenging so simply being asked to increase portion size is not as straight forward as it might seem for many people, especially as hunger and fullness signals can’t always be trusted if you have been restricting dietary intake for a while. It is likely that activity levels will need to reduce too so that your body can divert energy to restoring weight.
Should you just ‘binge’ until you restore your weight?
No, this isn’t recommended. Intake should increase gradually so that weight gain is steady and better managed from a mental health and physical health perspective. ‘Binging’ to restore weight can actually be very harmful to your health if you have a severely low BMI and have restricted your carbohydrate intake over an extended period of time. This increases your risk of developing re-feeding syndrome which although rare, can be critical due to a shift in fluids and electrolytes. It is best to consult your Doctor or Dietitian to assess this before starting weight restoration.
Is there a certain food group you should be focusing on?
I see a lot of clients that are very focused on meeting their 5-a-day of fruit and vegetables during weight restoration. For weight gain, these foods are of a lower priority as they don’t provide the main fuel source and building blocks your body needs to gain weight. Getting a balance of macronutrients (carbohydrate, fat and protein) from enough wholegrains, starchy foods, meat and alternatives and added fats should be emphasised in the initial stages.
Is there a certain amount of kilos that is considered ‘safe’ in regards to gaining weight gradually?
Yes, generally between 0.5kg-1kg of weight gain per week is considered safe. Weight gain can be more rapid at the beginning due to fluid shifts, increased gastrointestinal content and the development of oedema (swelling due to build-up of fluid). It is not uncommon to gain up to 2-3kg in the first couple of weeks as a result of this which can be distressing but it is important to know that the rate of weight gain does normalise. It is difficult to know how your body will respond during weight restoration as weight gain can fluctuate and some weeks you might even experience weight loss which can be confusing, but is a normal part of the weight gain journey.
Should you cut out exercise whilst restoring weight?
This really depends on your weight/BMI and your physical health (heart rate, blood pressure, blood tests etc). The amount and type of exercise allowed should be decided in collaboration with your Doctor (either your GP or Psychiatrist) and Dietitian. We know that physical activity has a positive impact on anxiety, depression and social connections but at a severely low BMI, minimal exercise or “bed rest” is generally recommended to allow the body to conserve energy, start restoring bodily functions and re-build muscle tissues. The next step once some weight gain has been achieved would be to incorporate low intensity activities such as a gentle, short walk or yoga and continue to build up from there. High intensity activities like HITT, running, gym classes and team sports should be avoided until BMI is back within a healthy weight range, your physical health is normalised, and you get the all clear from your Doctor. For some people, it can take several months or years to return to this level of activity. It is also important to note that when activity levels increase (this might even be returning to work or studies), the amount of food you need to continue gaining weight will likely increase.
Do I have to eat high sugar/high fat (“junk foods”) to gain weight?
Although it is not 100% necessary, most of the time the answer is yes and there are a few reasons why:
- To gain weight you have to eat more food and increasing portion size can be quite challenging. Incorporating nutrient dense foods that are high in energy, or high fat/high sugar within a balanced diet can help to reduce the volume of food required
- These foods are part of a normal diet so there is no reason why they should be avoided
- These foods can be targeted (falsely) as the cause of weight gain and can be feared and cut out of the diet. Gradual exposure to these foods and regular inclusion in your diet will help to develop a more positive relationship with food over time as this fear decreases
What are some of the common side effects of gaining weight?
It is very common to experience several physical and psychological side effects during weight restoration. You may experience an increase in anxiety, abdominal pain and bloating, feeling full all the time and constipation and/or diarrhoea. These physical symptoms can occur as a result of the abdominal muscles and muscles of the gastrointestinal tract losing tone and strength after a period of undereating. The stomach is hyper-sensitive to larger portion sizes, food takes longer to empty from the stomach and due to loss of muscle tone, the abdomen can appear rounded after eating.
Some strategies to help make this process more comfortable include wearing clothes that are lose-fitting, using distraction and self-soothing activities after meals, limiting fluids consumed with meals (have them between instead), including energy dense foods to reduce portion.
If you are suffering from an eating disorder, having support can be an essential part of recovery. https://www.beateatingdisorders.org.uk have some excellent resources.