When I tell many people about what I do for a living, they immediately pat their tummies and tell me they need to go on a diet. Louise has written a post before about the 10 Things People say to you when they hear you are a Dietitian and many of our Dietetic readers could relate.

Members of the general population often think helping others lose weight is the main purpose of our role but it is a small aspect. We often see people who need to gain weight. This may be due to illness, such as lung conditions, eating disorders, cancer, infectious diseases and bowel disorders. Malnutrition and weight loss are very prevalent in the elderly and boosting nutritional status and promoting weight gain is vital. NHS choices tells us around 1 in 3 people admitted to hospital or into a care home are underweight.

These may not be the only people who are underweight. What about the members of the population who just can’t gain weight; often underweight despite eating very well?  Those who suffer from stress and cannot eat? People like myself who lost a lot of weight post-natally breastfeeding? These are the types of people who may be seen by Dietitians.

Often being underweight gains as much negative attention as being overweight, which can be tough to deal with. From a personal experience I often get mocking comments at my local gym and get called a “skinny cow” and other names that are not publishable on Dietitans Life!! I’m lucky, laugh and  move on but others may struggle with this. They are popular songs that slate women being slim and many memes on social media that suggest being a slimmer girl is unattractive and undesirable in comparision with being more curvaceous. Obviously, these are totally unacceptable as body shaming is wrong in all cases. These are often aimed at women but men are feeling the pressure to bulk up, tone up and not be seen as “skinny”. I have seen men resort to varying types of protein shakes, excessive training at the gym, desperate to increase muscle mass.

There are some people who are just slim. Their BMIs are less than the recommended 20kg/m2 (which is used for the Caucausian population). On dietary examination they eat quite ludicrous amounts of food but still struggle to gain weight. With some closer investigation, they explain their family are the same. It is just genetic and has always been the case, so we would try and reassure a person who may be very concerned and would still provide healthy weight gain advice.

For some it feels like a strange, almost embarrassing question or statement: “How do I gain weight?” or “I need to put weight on”.  It is not the “norm”.  Most people are desperate to lose weight but if weight gain is needed it is important to do so in a healthy, balanced way. This is what we would suggest:

  • Snack between meals – aim to get some extra calories in this way. Fruit and full fat yoghurt, full-fat hummus and vegetables crudities, crackers and cheese, a handful of nuts and dried fruit, toast and peanut butter, a granola or cereal bar.
  • Fortify your food and enhance the calorie content of what you are eating – use olive oil as a dressing for salads, have some cheese on your pasta, use full-fat milk yoghurts, use more spread on your toast. Louise has written a great pink pasta recipe that can help you increase your calorie intake.
  • Try and have a pudding after a meal – this doesn’t have to be a large piece of cake! You could make home-made flapjack, have full-fat Greek yoghurt and berries or rice pudding.
  • Increase your portions where possible. The carbohydrate and protein components of your meal will provide the most calories, in comparison to vegetables so boost your portions of these. Have more rice, pasta or potatoes or have an extra slice of meat or spoon of lentils.
  • Have a supper before bed – a bowl of cereal and full fat milk, toast and peanut butter, a cereal bar are some ideas.
  • Have milky drinks using full fat milk. You may want to make a milkshake and blitz in a banana for example.
  • Be consistent. It is the changes you make everyday that make a difference so if you are making any of the above changes, keep at it daily.
  • Don’t stop exercising, as the benefits for both physical and mental health are endless. Just ensure you compensate with an extra snack.
  • You may want to speak to your Dietitian or GP about nutritional supplements to boost your intake if you are struggling to eat much more. There are a large variety – milky, juice and puddings; many providing vitamins and minerals in addition.

Gaining weight can be just as tricky as losing weight and can take some time for success. For some people, a whole host of psychological issues associated with being underweight may be presented, needing careful support and guidance.

Dietitians provide advice to all sorts of people, so next time someone tells you that’s what they do have a think before you ask for some advice to “lose weight”.