Gaining Weight the Healthy Way

Western media is plastered with messages about how to lose weight fast, from fad diets and herbal supplements, to exercise programs and fitness equipment. But when you have chronic diarrhea and abdominal pain, have spent weeks laid up in a hospital bed, or have had extensive intestinal surgery, you don’t find weight loss to be much of a challenge. In fact, weight gain is likely quite the struggle. But you don’t see any ads on the subway for the latest weight gain diet, or commercials on TV for a pill that guarantees you can put on pounds and inches in weeks. In fact, if you Google “healthy weight loss methods”, you get 21.3 million results but “healthy weight gain methods” only yields about 6.7 million. Not to mention the fact that your Google search will likely get you a lot of conflicting information from many unscientific and less-than-trustworthy sources. So how is a girl supposed to know what to eat when the world is telling her everything she shouldn’t, and her body isn’t letting her eat half of the things she wants? Well I hope I can help answer that question.
But first of all, how do you know you should be gaining weight? Chances are you already know based on your own assessment of your body. Even without getting on a scale, you probably know how you feel physically, mentally and emotionally when you’re at your “healthy weight” and how you feel when you’re below that. On the other hand, your doctor may just outright tell you that you need to gain weight to improve your health. Unintentional weight loss during a prolonged flare or hospitalization is common with IBD and can be dangerous depending on the amount of weight lost, the usual body weight of the patient, and the time frame during which the weight loss occurred. For some, the goal may be to simply avoid any further unintentional weight loss and maintain current weight. For others who may be underweight or show signs of fat and muscle wasting, gradual weight gain is recommended to promote strength, increase energy and strengthen the immune system.

When it comes to your personal health goals, discuss things with your primary doctor, GI or surgeon. It is always a good idea to consult your doctor if you plan to make any significant changes to your diet or lifestyle, and my advice here does not substitute their recommendations. You and your doctor know your body and your disease best.

Now let’s get to the tips:

1. Small, frequent meals.

I am all about small, frequent meals. There is no rule that says we need to eat three meals a day and especially for those with IBD and ostomies, eating smaller amounts throughout the day can have a ton of benefits. For those with poor appetite or who feel full quickly, eating more frequently provides more chances to obtain calories, protein and other nutrients.  Plus, when the amounts are smaller, the task of eating might seem a little less overwhelming. And don’t let the word “meal” intimidate you. I’m not saying you need to have meat, starch, veggie at each sitting. You just want to take more opportunities to put nourishing foods in your body. Some examples might be cottage cheese and fruit, an apple with peanut butter, or even a smaller portion of some leftovers from last night.

2. Focus on whole foods

By whole foods, I’m referring to foods that are as close to their natural state as possible like fruits, vegetables, meats and fish, eggs, nuts, seeds, dairy, etc. Think about foods that have very few ingredients on the label or no label at all. This is really a good tip for everyone regardless of if you’re trying to gain, lose or maintain weight. More and more research is showing that highly processed foods, especially those high in fat, salt and added sugars, are contributing to the prevalence of chronic illness in America. If you’re trying to gain weight, you may think “I need all that added fat and sugar to help put on the pounds!” and use that as an excuse to eat whatever you want. I know that’s what I did before I knew better. My go-to’s were instant mashed potatoes and peanut butter and Nutella sandwiches. I also lived dangerously close to a Buffalo Wild Wings. Yes, I gained the weight back but I felt sluggish and fatigued a lot of the time. And I was missing out on all of the nutrients I could have been getting from those whole food sources. So stick to the edge of the grocery store when you’re shopping because in most stores, the center aisles have the most processed foods while the outside has all of those great whole foods.

3. Get the most “bang for your buck”

This tip is especially true for those who are struggling to gain weight because of poor appetite. If you don’t feel like eating, you want to try to pack as many calories and nutrients into the small amount that you’re able and willing to eat. So, even though you might eat a large bowl of chicken noodle soup and some crackers and feel like you’ve had a satisfying meal, how much nutrition are you really getting apart from a tiny bit of protein from the chicken, a few carbohydrates and a lot of salt? Some good high-calorie, high-protein foods include

• Dairy products like yogurt/Greek yogurt, cheese and cottage cheese. Use whole milk or cream in place of recipes that call for water (like in oatmeal or cream of wheat) to add extra calories without physically having to eat more. Melt cheese on top of vegetables or use cream cheese as a base for a dip
• Eggs are so versatile and are not just for breakfast! Make a quick egg salad or keep some hard boiled eggs in the fridge. Make a large egg bake with cheese and veggies, cut it into small squares and freeze them. Then you can heat up the portion that you want whenever you want.
• Beans, nuts and legumes. Add beans to soups and chili. Use nut butters with fruit or veggies as a dip, or add it to smoothies. Put sunflower seeds, walnuts or pecans on a salad.
• Meats and fish. Make chicken salad or tuna salad with full-fat mayo to have with crackers, in a sandwich, or by itself. Add shredded chicken or puree it into homemade soups and stews.

4. Pay attention to what you drink

Staying hydrated is SO important, especially for those with ostomies or who have had any kind of colon resection. However, drinking water all day long might fill up your stomach with liquid when that space could be used for nourishing food. Instead of always having water, you may think about alternating between water and something like milk or a homemade protein shake or smoothie. This way, you’re using your beverages as another way to get in some extra protein, vitamins and minerals. During a flare, this can become especially important because you may not have the energy to prepare or eat a meal. Commercial nutrition supplements like Ensure, Boost or Carnation Instant Breakfast can be helpful in this situation, but if you have the time and the means, I recommend making your own healthy shakes and smoothies. You can choose from a variety of protein sources including nut butters, yogurt/ice cream or protein powder, and then add in whatever fruits or veggies you like for vitamins and for flavor. If you’re really desperate for additional calories, throwing in an extra fat source like coconut oil or avocado can help. I realize it’s very cliché for the dietitian to be promoting kale but seriously guys, throw that in with some plain Greek yogurt, peanut butter and banana and you’ve got a tasty smoothie.

5. Get exercise when you can

When you’re trying to gain weight, it’s still very important to be as active as you can. Using your muscles will help to rebuild lean body mass instead of gaining all of the weight back as fat. Try to do some kind of cardio as well as strength training a few times a week to ensure the extra energy that you’re putting into your body is going to good use.

I hope that this has given you some ideas and inspiration to make your own healthy-weight-gain eating plan. Remember to keep your food simple, keep moving, and treat yourself every once in a while.

Happy eating!