Most of us would struggle with losing excess weight. We envy those who are slimmer. Did you know, however, that there are people at the other end of the weight spectrum who are equally struggling with weight problems? Skinny does not always equate to being healthy.
Being underweight poses a lot of health risks, one of which is osteoporosis, a bone disease resulting from decreased bone mineral density and decreased bone mass. When the structure and quality of the bones change, the bone strength diminishes, thus increasing the risk for fractures or bone injuries.

Dr. Jiwon Park and colleagues conducted a study on participants included in a nationwide regular health checkup conducted by the Korean National Health Insurance Service in 2009. Dr. Park’s team followed the participants from 2010 to 2018. The result of their study “Underweight as a risk factor for vertebral fractures in the South Korean population,” published in June 2023, concluded that being underweight is a risk factor for vertebral fractures in the general population. 

Being underweight is also related to malnutrition and nutrient deficiencies. Iron and other B vitamins needed for red blood cell production may be lacking in the diet. Perhaps these nutrients may not be well absorbed. Cases like this would lead to anemia or low red blood cells and hemoglobin that is essential in carrying oxygen all over the body. Anemia causes fatigue, dizziness, and headache. You will feel exhausted all the time. 

Women who are underweight may experience absence of menstrual period, also known as amenorrhea, or may have irregular menstrual cycle. This will be a problem, especially for women who are trying to conceive. Furthermore, pregnant women who are underweight have a higher risk of preterm labor, giving birth before the baby reaches full term. The baby may also be low birth weight. 

Being underweight can also manifest externally. The skin may appear dry and unhealthy looking, the nails may be brittle, and hair loss is evident. Every cell in the body requires nutrients for growth and repair. 
If you are underweight and having a difficult time gaining those much-needed pounds, it is important to determine the root cause of your weight problem. While genetics play a role in our body shape and even weight, some medical conditions hamper our ability to gain weight, therefore a medical checkup must be done.

Have yourself screened for diabetes or insulin resistance. Contrary to what we think, diabetes does not only affect overweight individuals. Even skinny people can have diabetes. Have you ever heard of skinny fat? A person may be underweight or may seem fit on the outside but the visceral or abdominal fat is high. This is the type of fat that covers internal organs and increases the risk for diabetes. 

A person with diabetes can lose weight since the hormone insulin that carries sugar from the blood into the cells can’t enter. The cells will end up starving, utilizing muscle and fat resulting to weight loss. In addition, elevated blood glucose can make a person frequently urinate. This may cause dehydration and weight loss.

If you don’t have diabetes, have your thyroid health checked too. An overactive thyroid or hyperthyroidism increases the body metabolism. Since the individual burns energy more than it can conserve, weight loss results in addition to other complications that affect the heart, bones, fertility, immunity, and more. 

If you don’t have a medical condition but still having a difficult time gaining weight, here are some tips that could help you bulk up.

Fix your gut.

You may have an imbalanced gut microbiome and a leaky gut. This prevents you from efficiently absorbing nutrients causing malnutrition. Stress and lack of sleep, frequent use of medications and antibiotics, and decreased intake of fresh produce are some of the causes of a compromised intestinal permeability or leaky gut. Repair your gut by consuming fruits, vegetables, and whole grains, specifically those that feed the good bacteria (prebiotics) and help them proliferate. These are bananas, apples, eggplant, psyllium husk, oats, onion, garlic, honey, green tea, soy and soy products, beans, and legumes. Taking a probiotic supplement for a few weeks or months will also help but this must be taken with the guidance of a registered nutritionist dietitian.

Add energy and nutrient dense food to your diet.

This is not the time to indulge in junk food that’s laden with calories, fat, and sugar. Rather it is helpful to incorporate whole food and plant-based food that’s packed with nutrients and calories. Snack on nuts and seeds, add honey to your beverages, add chia seeds to your water, have some avocado smoothie, and cook vegetables and fish with coconut oil or pure olive oil. Adding healthy fats into the diet will increase calories. Choose grains that have higher calories and protein content than rice such as adlai and quinoa. You can also have 100 percent fresh fruit juices instead of water during meal or snack time. 

Do some weight training exercises. 

Build muscle mass and decrease body fat by doing weight training exercises regularly. Increased muscle mass will lead to increased healthy weight.

Begin your weight gain journey in a healthy way. Consult with your physician for proper diagnosis and consult a registered nutritionist dietitian to help you correct nutrient imbalances and determine your nutritional requirements.

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