Who might need to gain weight?

Your registered dietitian (RD) or healthcare provider may have recommended a high-calorie and high-protein diet because your body is currently burning more calories than you are taking in. This can cause you to lose weight. Medical conditions and other causes that make it hard to gain weight include:

• Cancers.
• Eating disorders.
• Type 1 diabetes.
• Hyperthyroidism.
• Stress, depression or anxiety.
• Infections including HIV/AIDS, tuberculosis, parasites and others.
• Celiac disease.
• Genetics (you were born with a high metabolism rate).
• Medicines that cause nausea and vomiting, including chemotherapy.
• Diarrhea.
• Active calorie burner (you burn a lot of calories at your job, are very physically active, frequently workout).

Other circumstances in which weight gain is recommended include:

• You’ve had a long stay in the hospital and have lost weight.
• You’re an athlete and want to gain muscle weight and strength.

How is underweight defined?

You are considered to be underweight if your body mass index (BMI) is below 18.5. (See the reference section for link to easy-to-use BMI calculator.) About 2% of the population is underweight. Women are four times more likely to be underweight than men. Age groups most affected are young people ages 18 to 24 and those over the age of 65.

What are the health risks of being underweight?

While obesity is more frequently in the news as a major health problem, being underweight can also result in health problems. Health risks can include:

• Fertility problems (there may be difficulties in a woman’s ability to conceive if she is underweight).
• Osteoporosis from not getting enough calcium and vitamin D in your diet.
• Anemia from not getting enough iron in your diet.
• Weakened immune system.
• Thinning hair/hair loss, teeth and gum problems, dry skin.
• General tiredness from lack of energy.
• Delayed growth and development in children.
• Poor wound healing.
• Hypothermia.
• Hypoglycemia.
• Heart rhythm problems.
• Poor sleep.

What are some general concepts about how to gain weight?

The main concept to gaining weight is that you have to eat more calories than the amount your body burns. Aim to eat 300 to 500 more calories per day if you want to gain weight slowly. It’s better for your body to gain weight slowly than to put on weight quickly. Eating a surplus of 500 calories a day more than you burn results in a new pound of body mass per week. General rules include eating more often (five to six times per day), eat more fat and eat more protein.

What should I NOT do to gain weight?

Don’t eat junk food. Eating chips, sugary sodas, donuts, and candy will add pounds but not be the source of a healthy weight gain. This weight will mostly end up around your belly, which puts you at risk for diabetes and heart disease. Instead, eat healthy foods that build muscle, such as protein-rich foods.

What are some popular calorie-rich healthy foods choices?

Examples of calorie-rich foods include:

• Proteins: Red meats, pork, chicken with skin on (roast or broil don’t deep fry for your health), salmon or other oily fish, beans, whole milk, eggs, cheese, full-fat yogurt.
• Carbohydrates: potatoes, brown rice, whole grain pasta, whole grains, whole grain breads.
• Fats: Nuts and nut butters, olives, avocado, butter, salad dressings, mayonnaise, high-fat cheeses.

What are some helpful tips for gaining weight?

• Eat small meals every three to five hours and snacks throughout the day to help you to consume more without feeling overly full.
• Avoid drinking water or other fluids 30 minutes before meals to prevent you from feeling full. Also, drink a reduced amount of liquids with your meals.
• Drink beverages that add calories, such as whole milk or cream, juice, shakes and smoothies, rather than water, tea, black coffee, and diet beverages that contain no calories.
• Add condiments or ‘extras’ whenever you can. Top your food with dried fruit, chopped nuts or seeds, honey, bacon bits, cheeses, mayonnaise, and salad dressings. Prepare your food with extra virgin olive oil or coconut oil or butter to add calories. Try adding hummus or avocado to sandwiches or crackers/veggies.
• When eating cereal use whole milk, half and half and add powdered milk. You can also use alternative milks if you find you are sensitive to lactose (lactose intolerance). Do the same when making scrambled eggs, soups, gravies, casseroles, and desserts.
• Choose breaded meat, chicken, and fish. Choose higher fat meats such as chicken or turkey thighs and legs, pot roast, short ribs, salami, and sausage.
• Choose fruit canned in syrup rather than juice and tuna canned in oil rather than water.
• If you are vegetarian, vegan, or lactose-intolerant, use soy/almond/coconut or rice milks, nut or seed butters, tofu, olives, avocado, and vegetable oil to add calories.
• If you prefer not to cook, or want portable snacks, stock up on individual pudding, yogurt, or cottage cheese cups, string cheese, granola bars, vending packs of trail mix, beef sticks, nuts, sunflower seeds, juice boxes, and chocolate milk cartons.
• Commercial supplements such as meal replacement bars are also options.

Snack Ideas

The following charts present snack ideas and calorie counts.

Snacks with 100 to 250 calories include:

SnackNumber of caloriesApple slices and 2 tbsp. caramel dip2001/4 block tofu and 1 tbsp. butter or olive oil for sautéing200Edamame (1 cup) and 1 tbsp. olive oil200Hummus (2 oz.) and serving of crackers200Tortilla chips and salsa and 2 tbsp. sour cream or 2 oz. silken tofu2001/2 cup Jello® and 2 tbsp. whipped cream100-150Roasted chickpeas (1/2 cup) and salt and pepper1501/2 avocado on 1 slice toast250McDonald’s 4-piece chicken nuggets150McDonald’s small low-fat ice cream cone150Medium Chai latte made with soy milk2401 frozen waffle with 1 tbsp. butter and 1 tbsp. syrup250English muffin and 1 tbsp. nut butter250Zucchini or pumpkin bread slice and 2 oz. cream cheese or honey2501 egg baked in 1/2 avocado250

Snack ideas with 300 to 400 calories include:

SnackNumber of
Calories6 oz. container sweetened yogurt and 1/2 cup granola3001/2 cup Greek yogurt with 1 tbsp. honey and 1 tbsp. chopped nuts/seeds/dried fruit/chia or flax3001/2 cup rice/noodles with 1 tbsp. butter/olive oil and 1 tbsp. Parmesan cheese3001 sliced apple or banana with
2 tbsp. peanut butter and chocolate chips3003 chocolate chip cookies and
1 cup chocolate milk300Plain bagel and 2 tbsp. cream cheese300-4001 chicken drumstick and 1/2 cup mashed potato4001 envelope instant oatmeal cooked with 1/2 cup 2% milk, topped with 1 tbsp. brown sugar, 1 tbsp. butter, and 1 tbsp. raisins3501 one-half ounce chocolate bar (milk or dark) and 1/4 cup of almonds400

Snack ideas with 500 to 700 calories include:

SnackNumber of calories1/2 cup tuna or egg salad sandwich and 1 cup 2% milk600-7001/2 cup trail mix and 8 oz. juice5202 tbsp. peanut or almond butter, 1 banana, 1 cup chocolate milk, and 1 scoop protein powder (blended shake)650Grilled cheese sandwich or quesadilla: 2 slices bread or tortilla, 2 slices cheese, and 2 tbsp. butter650Snack wrap: 1 flour tortilla, 2 slices ham, 2 slices cheese, 1 tbsp. mayonnaise, and 1 cup chocolate milk700Pita bread spread with 1/4 cup hummus, stuffed with sliced avocado, olives, tomatoes, and 1 cup chocolate soy milk500-600Large bakery blueberry muffin and 1 medium vanilla latte500-700

Condiments and 'extras' to increase calories:

"Extras"Calories1 tbsp. jam, jelly, marmalade, apple butter, maple syrup, chocolate syrup, honey, agave nectar, sugar, cream cheese50-602 tbsp. hummus, guacamole50-601 slice of bacon50-608-10 olives50-601 tbsp. butter, margarine, vegetable oils (canola, olive, etc.) peanut butter, almond butter, tahini, mayonnaise, and sour cream100¼ cup shredded cheese, raisins or other dried fruit, croutons100¼ cup nuts or trail mix, pumpkin, or sunflower seeds2001 dark or milk chocolate bar2001/2 cup granola200