Struggling to Gain Weight: Nutrition and Digestive Health

Weight gain

Hello Doctor,
I have a question regarding my height and weight.
I am 180 cm tall and weigh 65 kg.
According to the BMI calculation, my weight falls within the normal range; however, anyone with common sense can see that I am actually too thin.
Some relatives and friends say my body is just right, while others say I am too thin, but those who say I am thin outnumber those who say I am just right.
Gradually, I have come to realize that I am indeed too thin.
I have tried to make a commitment to gain weight several times, and sometimes I eat more.
However, I have slowly come to realize that I might be doing it all wrong.
People say: "Eat a good breakfast, have a filling lunch, and eat less for dinner," but I tend to eat a small breakfast, a filling lunch, and a hearty dinner.
I think that if I eat like this, of course, I won't gain weight.
But then I wonder, if others eat the same way, why can they gain weight? This confusion has left me perplexed.
I also understand another reason why I might not be gaining weight: I have bowel movements twice a day, both after breakfast.
Strangely, I feel the urge to go right after finishing breakfast, and after the first bowel movement, I feel the urge again, which accounts for my two times.
I can't think of any way to improve this situation.
It seems that my food hasn't even been digested before it reaches the rectum, ready to be expelled.
I am also speculating whether my thinness is causing my body to be weak, or if my weakness is leading to poor digestion.
These are my thoughts regarding my thinness so far.
I really want to gain weight because I see that those who are robust seem to be very healthy, and I envy them.
Perhaps it is indeed because I am too thin that I often feel low on energy, which makes me uncomfortable.
I hope you can provide some answers.
Thank you!

Mr. Chen, 20~29 year old female. Ask Date: 2004/08/23

Dr. Shi Guimei reply Nutrition

Hello! According to the BMI calculation, the ideal weight range is between 64 to 78 kilograms.
As you mentioned, your weight falls within the standard range, but it is at the lower limit.
This weight is a dream for many girls because it appears not overweight while still being within the standard range, reducing concerns about being too thin and the risks of malnutrition or weakened immunity.
Since you are male and wish to appear stronger, the best approach is to increase your exercise to build muscle mass.
I believe no one wants to have excess body fat (including those who are underweight)! Given your age, you likely have not yet served in the military.
I think the training after enlistment will help you develop a more masculine physique! At this stage, you don't need to worry too much about being underweight.
Besides exercising more, learning stress management is very important, as accumulating too much stress can lead to irregular bowel movements (including both frequent stools and constipation) and can also reduce nutrient absorption.
Additionally, having two bowel movements in one day may indicate that the first one was not complete.
If you feel there are issues with your gastrointestinal function, you should consult a gastroenterologist.
Sincerely, Dietitian Shih Kuei-Mei, Director of the Nutrition Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2004/08/23

More Info

Gaining weight can be a challenging endeavor, especially for individuals who naturally have a lean physique or struggle with digestive issues. Your height of 180 cm and weight of 65 kg gives you a BMI of approximately 20.1, which is within the normal range. However, as you mentioned, many people perceive you as being too thin, and this perception can lead to feelings of inadequacy or concern about your health.
To begin with, it's essential to understand that weight gain, like weight loss, is fundamentally about the balance between caloric intake and expenditure. If you want to gain weight, you need to consume more calories than your body burns. This can be achieved through a combination of dietary changes and possibly adjustments to your exercise routine.

Dietary Adjustments
1. Increase Caloric Intake: Focus on consuming calorie-dense foods. This includes nuts, seeds, avocados, whole grains, dairy products, and healthy oils. For example, adding a tablespoon of olive oil to your meals or snacking on nuts can significantly increase your caloric intake without requiring you to eat large volumes of food.

2. Frequent Meals: Instead of three large meals, consider eating five to six smaller meals throughout the day. This can help you consume more calories without feeling overly full at any one time.
3. Protein-Rich Foods: Incorporate more protein into your diet, as it helps build muscle mass. Foods like lean meats, fish, eggs, dairy, legumes, and protein shakes can be beneficial. Aim for a protein-rich snack or meal after workouts to aid muscle recovery and growth.

4. Healthy Snacks: Include snacks between meals that are high in calories and nutrients. Options like Greek yogurt with honey, smoothies with protein powder, or peanut butter on whole-grain toast can be effective.

5. Limit Empty Calories: While it might be tempting to consume high-sugar or high-fat junk foods to gain weight, these can lead to unhealthy weight gain and do not provide the nutrients your body needs. Focus on whole foods that provide vitamins and minerals.

Digestive Health
Your concern about frequent bowel movements, especially after breakfast, may indicate a few things. It’s not uncommon for some individuals to have a strong gastrocolic reflex, where the act of eating stimulates bowel activity. However, if you feel that your digestion is too rapid, it may be worth considering the following:
1. Fiber Intake: While fiber is essential for digestive health, too much can lead to increased bowel movements. Ensure you are consuming a balanced amount of fiber from fruits, vegetables, and whole grains.

2. Hydration: Staying well-hydrated is crucial for digestion. Sometimes, inadequate fluid intake can lead to digestive issues. Aim for at least 8-10 cups of water a day.

3. Probiotics: Consider incorporating probiotics into your diet, either through supplements or fermented foods like yogurt, kefir, or sauerkraut. Probiotics can help balance gut bacteria and improve digestion.

4. Consult a Professional: If your digestive issues persist, it may be beneficial to consult a healthcare professional or a registered dietitian. They can provide personalized advice and may suggest tests to rule out any underlying conditions that could be affecting your digestion and weight.

Lifestyle Considerations
1. Strength Training: Incorporating resistance training into your exercise routine can help you build muscle mass, which can contribute to healthy weight gain. Aim for at least two to three sessions per week, focusing on major muscle groups.

2. Monitor Your Progress: Keep track of your weight and dietary intake. This can help you identify what works for you and make necessary adjustments.

3. Mental Health: It’s also important to consider the psychological aspects of weight gain. If you find yourself feeling anxious or stressed about your weight, speaking with a mental health professional can be beneficial.

In conclusion, gaining weight healthily involves a combination of dietary changes, attention to digestive health, and possibly adjustments in your exercise routine. By focusing on nutrient-dense foods, increasing meal frequency, and incorporating strength training, you can work towards achieving a healthier weight while also addressing any digestive concerns you may have. If issues persist, seeking professional guidance can provide further clarity and support.

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