Q: I am a 31-year-old woman in good health but I can’t gain weight. My primary doctor told me I am about 20 pounds under. I’m 5’9” and weigh 110 pounds. I have a very healthy appetite and do normal exercise (household and work). I’ve had my thyroid tested and it was normal. I’ve always been this way since childhood. The only time I did gain weight was with my pregnancies. What else can I do to gain weight or find out why I can’t?
A: I can already envision countless individuals who will respond with “boy, I wish I had her problem”. We are so focused on losing weight that we forget to consider those individuals who cannot gain weight and this is a major issue for those involved. The rate at which people burn energy has a great deal to do with body weight. Those with a high metabolism might discover they burn energy from the foods they consume very rapidly, preventing weight gain. While exercise is extremely important, you might consider strength training that will increase your muscle density and your appetite.. This form of exercise can be as easy as adding weights to an exercise routine. And, while the thyroid gland is one consideration, you have already ruled that out. Considerations for this inability can include having liver disease, infection, or a metabolic disorder. While it appears extremely easy to eat more in an effort to gain weight, it’s important to consume the right foods such as peanut butter, eggs, avocados, nuts, cheese, and pastas – the very items overweight individuals should avoid. The trick here is to eat the proper foods and add to muscle tissue rather than fat deposits in the abdomen, thighs and buttocks. If you currently eat three meals a day, you might consider increasing healthy snacks between those meals, or eating four to six meals each day. If you find yourself otherwise involved in doing laundry or vacuuming, you might consider setting a kitchen timer that will be a reminder to snack. There are cases where malabsorption is to blame for an inability to gain and maintain weight. This can be the result of inflammatory intestinal conditions, ulcerative colitis, a parasitic infection, or even gluten intolerance. In many instances, malabsorption can be determined through blood tests that can determine proper levels of zinc, beta carotene, vitamins B and D, and more.
Exercise is vital to our health, as long as it isn’t taken to extremes. You don’t specify other than being a mother (which is gigantic in the big picture) what your work entails. If you are physical at your place of employment, you may actually burn more calories than you consume.
You appear to be healthy and I wouldn’t worry, especially because this has been a life-long issue but I would be remiss if I didn’t point out that such conditions as an autoimmune disorder, specific forms of cancer, chronic obstructive pulmonary disease and other conditions should be investigated as a possible cause for your inability to gain weight. Therefore, a visit to your primary care physician is the place to begin. He or she can take a history, examine you, order appropriate testing and be assured nothing is amiss. You might then be referred to a nutritionist and/or dietician who will review your meal plans and make appropriate recommendations.
Other readers who are interested in learning more can order Dr. Gott’s Health Report “Eating Disorders” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.
