Co-written by Talia Cecchele & Sophie Bertrand
We often get messages from people, particularly on Instagram, who are looking for advice on how to gain weight in a healthy way. There are so many ‘tips’ out there in regards to losing weight - whether or not they are reliable tips. When it comes to your health and weight, please do not consult Google or social media as your trusted source of information. Your health is not worth risking so please make sure you seek advice from a Registered Nutritionist or Dietitian.
Sophie, is a lovely friend of mine and Registered Nutritionist with a passion for intuitive eating. She helps people to discover a balanced approach to eating and trust in their body again. Here we are going to provide you with some information in regards to gaining weight in a healthy way.
Is it simply a case up of upping your portion sizes?
You will need to increase the amount of food that you’re eating in order to gain weight, but the type of foods eaten need to be considered as well.
Your current eating habits will influence which dietary changes might need to occur, for example, if you’re currently cutting out a food or food group this will need to be addressed to ensure you are taking in the right balance of nutrients from all food groups. Normalising eating behaviours can be challenging so for many people, simply being asked to increase portion sizes is not as straight forward as it might seem for many people. Particularly, as hunger and fullness signals can’t always be trusted if you have been restricting dietary intake for a while. It is likely that activity levels will need to reduce too so that your body can divert energy to restoring weight.
Should you just ‘binge’ until you restore your weight?
No, this isn’t recommended.
Intake should increase gradually so that weight gain is steady and better managed from a mental health and physical health perspective. Many people in eating disorder recovery can benefit from this gradual approach to overcome the fear of weight gain. Binge eating to restore weight can actually be very harmful to your health if you have a severely low BMI and have restricted your carbohydrate intake over an extended period of time. This increases your risk of developing re-feeding syndrome which, although rare, can be critical due to a shift in fluids and electrolytes. It is best to consult your doctor or eating disorder dietitian to assess this before starting weight restoration. Read up on other occurrences in the weight restoration phase such as hypermetabolism.
Is there a certain food group you should be focusing on?
I see a lot of clients that are very focused on meeting their 5-a-day of fruit and vegetables during weight restoration. For weight gain, these foods are of a lower priority as they don’t provide the main fuel source or building blocks your body needs for weight gain. Getting a balance of macronutrients (carbohydrate, fat and protein) from enough wholegrains, starchy foods, meat and alternatives with added fats should be emphasised in the initial stages.
What is a safe rate of weight gain?
Generally between 0.5kg-1kg of weight gain per week is considered safe. Weight gain can be more rapid at the beginning due to fluid shifts, increased gastrointestinal content and the development of oedema (swelling due to build-up of fluid). It is not uncommon to gain up to 2-3kg in the first couple of weeks as a result of this which can be distressing but it is important to know that the rate of weight gain does normalise.
It is difficult to know how your body will respond during weight restoration as weight gain can fluctuate. Some weeks you might even experience weight loss which can be confusing, but is a normal part of the weight gain journey.
Should you cut out exercise whilst restoring weight?
This really depends on your weight or BMI and physical health (heart rate, blood pressure, blood tests etc). The amount and type of exercise allowed should be decided in collaboration with your Doctor (either your GP or Psychiatrist) and Dietitian. We know that physical activity has a positive impact on anxiety, depression and social connections but at a severely low BMI, minimal exercise or “bed rest” is generally recommended to allow the body to conserve energy, start restoring bodily functions and re-build muscle tissues.
The next step once some weight gain has been achieved would be to incorporate low intensity activities such as short, gentle walks or yoga and continue to build up from there. High intensity activities like HIIT, running, gym classes and team sports should be avoided until BMI is back within a healthy weight range, your physical health is normalised, and you get the 'all clear' from your Doctor. For some people, it can take several months or years to return to this level of activity. It is also important to note that when activity levels increase (this might even be returning to work or studies), the amount of food you need to continue gaining weight will likely increase. We've shared a separate blog if overcoming unhealthy exercise is something you could benefit from.
Do I have to eat high sugar/high fat foods to gain weight?
Although it is not 100% necessary, most of the time the answer is yes and there are a few reasons why:
Nutrient density: To gain weight you have to eat more food and increasing portion sizes can be quite challenging. Incorporating nutrient dense foods that are high in energy, fat or sugar within a balanced diet can help to reduce the volume of food required
All foods fit: These foods are part of a normal diet so there is no reason why they should be avoided
Addressing food fears: These foods can be targeted (falsely) as the cause of weight gain and can be feared and cut out of the diet. Gradual exposure to these foods and regular inclusion in your diet will help to develop a more positive relationship with food over time as this fear decreases
What are some of the common side effects of gaining weight?
It is very common to experience several physical and psychological side effects during weight restoration. You may experience an increase in anxiety, abdominal pain and bloating, feeling full all the time, constipation and/or diarrhoea. These physical symptoms can occur as a result of the abdominal muscles and muscles of the gastrointestinal tract losing tone and strength after a period of undereating. The stomach is hyper-sensitive to larger portion sizes, food takes longer to empty from the stomach and due to loss of muscle tone, the abdomen can appear rounded after eating. Digestive issues are common in eating disorders and eating disorder recovery but there are strategies you can use to help alleviate discomfort.
Tips to gain weight in a healthy way
Some tips to help make the weight gain process more comfortable include wearing clothes that are loose-fitting, using distraction and self-soothing activities after meals, limiting fluids consumed with meals (have them between instead) and including energy dense foods to reduce portion sizes.
If you are suffering from an eating disorder, having support can be an essential part of recovery. BEAT has some excellent resources and we would love to support you towards a healthy relationship with food and weight in the TC Nutrition clinic.
Talia Cecchele Nutrition (TCN Clinic) is a team of registered dietitians that specialise in eating disorder recovery, disordered eating, gut health and sports nutrition. We aim to bring balance back to nutrition, help you to break free from food rules and find food freedom. We offer virtual consultations and group programs so whether you are based in London, the United Kingdom or around the world we would love to support you. To enquire please fill out a contact form.