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How to gain weight

poshnialloposhniallo Registered User regular
edited May 2012 in Help / Advice Forum
I am posting this on behalf of my wife - she's heard me mention H&A before, but her native language isn't English, so she asked me to write this.

She has been suffering from some form of mental health problem (perhaps Social Anxiety Disorder, perhaps Post-Natal Depression) for three years or so, and she's gotten very very thin.

She's always been thin, and a very good eater. She used to eat loads, but stayed thin for two reasons. Firstly, her metabolism is super-fast. She burns calories like crazy. Secondly, she's Japanese, so even though she eats a lot it tends to be pretty healthy stuff.

Since she got sick, though, she's been slowly but steadily losing weight. She didn't have any to spare, and is now underweight according to her doc and BMI, and anaemic, presumably from poor nutrition. She started taking iron tablets a week or two ago but they don't seem to have any effect yet.

Yesterday she had her period (she always has heavy periods and terrible PMT - before I lived with her I thought PMT was just a sexist myth) and she got so dizzy and sick that she couldn't walk. She semi-collapsed on the way to work and I had to go get her and bring her home. Which brought me to a new level of worry.

So, I am at my wits end with this. How can she gain weight, what should be be doing? She's clearly very underweight, with all the obvious physical signs of poor health and stress (saggy skin, bags under her eyes, dull thinning hair). She agrees she needs to gain weight, but doesn't know how. She eats snacks and sweets now (my bad influence) but it's nutritious weight-gain she needs. She doesn't feel hungry enough to eat more. She's very passive/depressed, so she finds it hard to address problems - usually she denies there is a problem. This one she is trying to address, but it's still hard for her.

Two things to consider - we live in Japan, so we probably have roughly the same products as wherever you live, but the brand names will be different. Also, I find her psychiatrist to be kinda useless - he gives her lots of meds and is unrelentingly positive in the manner of a kid's TV presenter. I think he is too in love with his own treatment choices to consider changing anything.

Thanks.

I figure I could take a bear.

Posts

  • lessthanpilessthanpi Registered User regular
    Some of my older relatives who have had problems keeping enough weight on to be healthy have had luck with ensure

  • GnomeTankGnomeTank Registered User regular
    If you feel that way about her psychologist, find a new one. I don't know what the state of the psychological industry in Japan is, but there have to be some good ones there somewhere.

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  • FantasmaFantasma Registered User regular
    Hello,

    My wife used to take the following product, and she said it got good results:

    http://www.amazon.com/Universal-Nutrition-System-Vanilla-5-1-pound/dp/B00166FAVQ/ref=sr_1_1?s=hpc&ie=UTF8&qid=1336439394&sr=1-1

    Hear my warnings, unbelievers. We have raised altars in this land so that we may sacrifice you to our gods. There is no hope in opposing the inevitable. Put down your arms, unbelievers, and bow before the forces of Chaos!
  • Pure DinPure Din Rhode Island Registered User regular
    edited May 2012
    Does she take any hormonal contraceptive? Weight gain is a common side-effect, plus she could get one that gives fewer/lighter periods to help with the iron deficiency.

    In my experience eating lots of sweets is a bad idea if you want to gain weight; it's easy to fill up on sugar without eating real food. I think cooked vegetables are better than raw, because you can eat more before you get full, and can add olive oil or broth or other healthy fats. Ensure tastes horrible, sometimes I'll have this stuff mixed with whole milk instead but that's not really much better in terms of taste. :\

    When I'm getting too thin my bf makes a really good stew dish with leeks and dark chicken meat and mushrooms that makes a ton of tasty broth that is good to drink when you're not hungry. But I don't have the recipe right now, but I can ask if you want it.

    Pure Din on
  • iRevertiRevert Tactical Martha Stewart Registered User regular
    Fantasma wrote: »
    Hello,

    My wife used to take the following product, and she said it got good results:

    http://www.amazon.com/Universal-Nutrition-System-Vanilla-5-1-pound/dp/B00166FAVQ/ref=sr_1_1?s=hpc&ie=UTF8&qid=1336439394&sr=1-1

    No offense intended but theres quite a bit of crap that isn't needed in that. If she were to start on a whey I'd recommend Optimum Nutrition.

    http://www.amazon.com/Optimum-Nutrition-Protein-Vanilla-Cream/dp/B001G7QXIY/ref=sr_1_22?s=hpc&ie=UTF8&qid=1336441330&sr=1-22

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  • BethrynBethryn Registered User regular
    I can't say this will work (since it's never been amazing for me), but as someone with a super-fast metabolism who's been to more than a few dieticians, the standard advice is, "eat slightly less more regularly." So go with 6 meals a day rather than 3, and keep to it. Essentially this is what she's already doing with the snacks, except she's faking out on 3 of the extra meals.

    You also need to track your intake compared to the GDA. A food diary isn't a bad start here.

    bethryn.png
  • Aoi TsukiAoi Tsuki Registered User regular
    This sounds pretty damn serious. She needs a referral to a nutritionist and a new psychiatrist and/or talk therapist, just for starters.

    You say she's seeing a doctor--what exactly has (s)he told you, advice-wise? Sounds like you might need a new one of those, too.

    Some people already have said stupid things, but I'm ignoring them because I just found a potato in my fridge that looks like it's smiling.
  • BethrynBethryn Registered User regular
    Aoi Tsuki wrote: »
    She needs a referral to a nutritionist
    Dietician.

    Not nutritionist.

    bethryn.png
  • poshnialloposhniallo Registered User regular
    Her psychiatrist is the doctor I mentioned. And it was a lot of work to get her to start seeing him. She doesn't feel able to change at this point.

    My question is about ideas for her weight and nutrition, if I could affect the rest I would. I mentioned the doctor specifically to try and get advice that wasn't 'ask her doctor'.

    Thanks for all the advice so far though.

    I figure I could take a bear.
  • Aoi TsukiAoi Tsuki Registered User regular
    edited May 2012
    Dietician, then.

    So...she isn't seeing a physician or gynecologist, only the psychiatrist? I totally understand not being able to force your spouse to go see someone if they're not willing - Christ, do I ever - but if she's weak to the point of literal collapse and continuing to physically and mentally go downhill, then you really, really need to get her to a doctor, in addition to tips people give you here. It's sounding less like "she could use a few pounds" than "her long-term health is at risk."

    Aoi Tsuki on
    Some people already have said stupid things, but I'm ignoring them because I just found a potato in my fridge that looks like it's smiling.
  • Muse Among MenMuse Among Men Suburban Bunny Princess? Its time for a new shtick Registered User regular
    Bethryn wrote: »
    I can't say this will work (since it's never been amazing for me), but as someone with a super-fast metabolism who's been to more than a few dieticians, the standard advice is, "eat slightly less more regularly." So go with 6 meals a day rather than 3, and keep to it. Essentially this is what she's already doing with the snacks, except she's faking out on 3 of the extra meals.

    You also need to track your intake compared to the GDA. A food diary isn't a bad start here.

    All of that

    I have been very underweight my entire life. My metabolism works against me. There are some things that have worked for me:

    1. no more fruits or veggies. They have a lot of good things in there but they are filling without providing enough calories. Fruit shakes and small portions of vegetables should be enough. Yeah there are all sorts of good things in them but she can afford to sacrifice some vitamins in place of calories, because calories are easier to 'make up' than calories are. This was really hard for me and may be for her but I have to admit that fruit fills me up too quickly. I get by on calorie dense fruit shakes now. The exception is dried fruit! Dried fruit is great. Check the nutritional labels, because not all fruits are as dense as others.

    2. Unless you are eating fatty fish, make your animal protein beef, pork, chicken, or eggs.

    3. Unless she's drinking calorie dense shakes or energy drinks, don't let her drink too many liquids. Drinking water is a great way to quell your appetite. Juices and sodas are marginally better for calories but there are good reasons to not drink those either.

    4. If drinking liquids with meals, drink the liquids after you have eaten.

    5. Pasta! Italian food is great because it combines pasta and rich sauces and has a short enough list of basic ingredients you should be able to find easily in markets.

    6. Olive oil and butter. If you are underweight and unhealthy, gaining weight is your top priority. Butter is your friend in this case. Maybe you feel more comfortable with olive oil, whatever. Cook EVERYTHING in olive oil or butter. It is so easy to sneak into stuff. A nice snack is french bread with olive oil dip. Yum.

    It is tough to eat enough when you aren't hungry. For now the best you can do is have her increase how many times she eats per day and make everything calories dense. She might feel uncomfortable eating so much but you have to stretch your stomach out, in essence. I can eat a lot more than I used to be able to, but it takes time. You notice a difference in your eating within a month. You may end up incredibly lethargic after any meals. You may end up with your appetite going into overdrive and you need to eat every hour. It sucks. But eventually it starts to even out. As such, she is going to need to want this, because the changes in energy and appetite can be very distressing and make you want to quit.

  • usukerausukera Registered User
    Some solid advice coming in here. I'm in somewhat the same boat with being underweight and anemic. I'm moving up on the weight, but require iron infusions.

    Iron Stuff
    The iron issue gets serious if it starts to drop cell production. A doctor will request tests for iron in the blood, iron store and red cell count. If it's urgent, you'll be sent for an iron infusion or blood transfusion. If not, you'll be advised to use iron tablets. As mentioned above, hormonal contraceptive is an effective option for females. As for diet, eat your iron sources with vitamin c but away from calcium. Vege sources are best absorbed with meat sources. Clams and other shellfish are the best for iron punch, followed by red meat. Keep in mind it can take years for iron stores to change.

    Getting Fatter

    Eat slowly, eat more. This will likely mean sitting alone at a table when everyone else is finished, but it gives time for the stomach to expand.

    Aim for 5-6 meals a day. They don't all have to be big, but an idle stomach is a wasted opportunity to lay down some calories.

    Up fat intake. It's the most energy dense thing you can eat. Muse. has this well covered. I also go for cheese as a snack. Nothing is more nutritious - Jarlsberg is my tip.

    Try new things and find things you like. Filling out a day with food can get tiresome so actively pushing for new foods can help in the long run.

    Lastly, don't feel bad about eating more than others. Jealousy is the most common response, but we know that's misplaced.

  • Gabriel_PittGabriel_Pitt Damn you, eidetic memory! Registered User regular
    Not the cheapest way to do it, but are there any nearby places that offer tabuhodai yakinikku? Kaitenzushi? :lol: Upping the fat of dishes with butter and olive oil is not a bad idea, but she has to be eating the stuff in the first place.

    And honestly, ganbarou yo. Mental health care in Japan tends to be a really big pile of shit. Also, this is a medical issue now. Try and find out if there any local clinics that come recommended, or go with your wife to the hospital, get a doctor there to see her and see if they can recommend a local doctor, a mental health expert who isn't worthless, and what she should do with her diet to put weight on.

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  • Muse Among MenMuse Among Men Suburban Bunny Princess? Its time for a new shtick Registered User regular
    edited May 2012
    usukera wrote: »

    Lastly, don't feel bad about eating more than others. Jealousy is the most common response, but we know that's misplaced.

    There are mental aspects to gaining weight, and that is one of them. I'd feel bad about eating more than everyone else but once it turned out I was actually gaining, I didn't feel so bad and my family didn't hold it against me.

    Other things I just thought of that tie into that:

    Sometimes she'll feel like she needs to scarf down her food fast, once the feeling of fullness sets it in can be hard to continue. If I feel that I can, I'll eat a lot of food really fast, to 'cheat' so to speak. Beat it to the punch and eat more food than I normally would be able to.

    Sometimes I have to take my time and eat slowly. And sometimes this will be what your wife needs.

    So don't rush her, and don't rag on her for not eating in a ladylike manner.

    The only good multitasking you can possibly do while eating is watching tv. It is passive and you don't notice yourself eat, so you can eat more. And this probably sucks to hear, but try to not converse so much while you are eating. I eat a lot less when I am eating with people because I really like to talk, and I lose my appetite that way. It slows down eating, and eventually people get restless and think to themselves, 'a sufficient amount of time has passed at the dinner table, time to clean up'. I normally eat alone for dinner (my biggest meal) because I can better focus on eating, but this is only okay because I'm an unattached college student. Your wife isn't, so if she needs to take her time and seems to start finishing once you're done, maybe stay at the dinner table once you're done eating so she won't feel alone. Do some crosswords or something, I dunno, you have to realize how big an influence other people can have on your eating habits, I certainly 'finished' meals before I felt full because everyone else was ready to go but that wasn't any good for my health. Maybe your wife does this too because she sees you getting fidgety.

    Muse Among Men on
  • DemerdarDemerdar Registered User regular
    I would try and see how much she is really eating in a day. I have a feeling it is a lot less than you think. She just needs to eat. Sure, you can be underweight with a high metabolism and eat like a normal healthy adult, but it sounds like she is in some very serious stuff, and that she is probably not eating enough. That is, she is eating a meal a day (or less). It's hard to eat when you aren't hungry, though. Maybe there is an underlying symptom we aren't seeing?

    parabol
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  • Blake TBlake T Registered User regular
    The other thing I'd do is have her alarm go off at say 10 and three.

    In addition to lunchtime as well this is when she will eat.

    She needs to get out of the, only eat when I'm hungry idea. Eat at pre-meditated times a pre-meditated meal (even if it's a calorie dense shake). You can help by pre-planning meals (for both of you) for the week.

    The simplest high calorie snack meals (for ten and three) would be, shakes, curried eggs, and nuts.

  • Jimmy KingJimmy King Registered User regular
    iRevert wrote: »
    Fantasma wrote: »
    Hello,

    My wife used to take the following product, and she said it got good results:

    http://www.amazon.com/Universal-Nutrition-System-Vanilla-5-1-pound/dp/B00166FAVQ/ref=sr_1_1?s=hpc&ie=UTF8&qid=1336439394&sr=1-1

    No offense intended but theres quite a bit of crap that isn't needed in that. If she were to start on a whey I'd recommend Optimum Nutrition.

    http://www.amazon.com/Optimum-Nutrition-Protein-Vanilla-Cream/dp/B001G7QXIY/ref=sr_1_22?s=hpc&ie=UTF8&qid=1336441330&sr=1-22

    Whey in general is not really good for this situation. Whey passes through your body more quickly than it can be used aside from a serious immediate need for protein (to be fair, her body could be in that condition right now). It also doesn't really provide much else in the way of nutrients. Something like Ensure, which was recommended above, is going to be much better because it's intended to provide more nutrients.

  • bowenbowen Registered User regular
    edited May 2012
    poshniallo wrote:
    Since she got sick, though, she's been slowly but steadily losing weight. She didn't have any to spare, and is now underweight according to her doc and BMI, and anaemic, presumably from poor nutrition. She started taking iron tablets a week or two ago but they don't seem to have any effect yet.

    Yesterday she had her period (she always has heavy periods and terrible PMT - before I lived with her I thought PMT was just a sexist myth) and she got so dizzy and sick that she couldn't walk. She semi-collapsed on the way to work and I had to go get her and bring her home. Which brought me to a new level of worry.

    @Poshniallo How badly do you want to have kids? I'd say for now she needs to be on a hormonal birth control until she can get her BMI, anemia, and heavy periods under control. This is pretty much the main use, aside from baby making, that birth control is used for. I don't know what the taboo is like in Japan for stuff like this though. I imagine cultural things are heavy influence and I'm sure her doctor is very prideful in his own handiwork. They are probably 100% related, especially with an underweight person.

    Diet wise, she needs to increase her iron intake. Spinach, red meat, most beans (usually kidney beans), etc. For putting on weight it's just as simple as making more food and eating it.
    So, I am at my wits end with this. How can she gain weight, what should be be doing? She's clearly very underweight, with all the obvious physical signs of poor health and stress (saggy skin, bags under her eyes, dull thinning hair). She agrees she needs to gain weight, but doesn't know how. She eats snacks and sweets now (my bad influence) but it's nutritious weight-gain she needs. She doesn't feel hungry enough to eat more. She's very passive/depressed, so she finds it hard to address problems - usually she denies there is a problem. This one she is trying to address, but it's still hard for her.

    Two things to consider - we live in Japan, so we probably have roughly the same products as wherever you live, but the brand names will be different. Also, I find her psychiatrist to be kinda useless - he gives her lots of meds and is unrelentingly positive in the manner of a kid's TV presenter. I think he is too in love with his own treatment choices to consider changing anything.

    Thanks.

    Drop the psychaitrist and get a GP/PCP or whatever they are in Japan. And that last sentence is what I was worried about. I think the BCP will be your best bet to be honest. Most women put on weight when they take it, as well as fixes issues with heavy periods and anemia resulting from that which I'm almost positive your wife is getting it from (not poor nutrition), and it fixes a lot of hormone issues and might actually help the depression.

    Also it gives bigger boobs.

    PS, how long do her periods last, longer than 3-5 days? Or are they just super heavy?

    bowen on
  • HotandnerdyHotandnerdy Registered User
    If you want to gain weight got to a body buildi g store and buy a weight gainer. I am korean and have a really hard time gaining weight also.

    Golden Gains by Controled Labs is wonderful and tastes great!

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  • poshnialloposhniallo Registered User regular
    This is really great advice (and support) here - thanks so much.

    We had a good talk now about doctors - she took some time off work to rest, so she is calmer and easier to talk to than usual.

    We are thinking to get her psych to refer her to a dietician/nutritionist (whichever is the proper professional one, perhaps someone who is also an MD - we'll be using Japanese terms and the Japanese system so the English term isn't important.)

    We are also talking about her seeing a gynaecologist and talking about the pill. Part of the problem is that she's just so sick of seeing doctors and spending all her free time at the doctor or group session. And I can understand that completely, having been in that situation myself sometimes.

    But I am still interested in more food advice if anyone has any!

    I figure I could take a bear.
  • FantasmaFantasma Registered User regular
    Well, consumption of Gavage has been used for centuries for feeding purposes, she could try that too.

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  • JebusUDJebusUD Registered User regular
    Add a peanut butter sandwich on top pf normal meals. Its what the military does to get peoples weight up. It is high in protein.

    You haven't given me a reason to steer clear of you!
  • Muse Among MenMuse Among Men Suburban Bunny Princess? Its time for a new shtick Registered User regular
    Oh yeah, peanut butter is great. I keep a jar around to just snack on, spooning right from the jar.

  • Marie AugustMarie August Registered User
    My step father had a similar problem last winter. He was very sick, so he never wanted to eat and he ended up losing too much weight. You might be tempted to eat junk food in order to gain weight, but I wouldn't advise it. Eating junk can create other health issues if she already has difficult health. I would go for food that has a high amount of healthy fat and calories. Like avacados. They are very good for you, but high calorie, and can be easily added to a lot of meals. Nuts can also be a good source of condensed calories. You can also make smoothies with fruit and coconut oil in it if she doesn't like eating.

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  • PriestPriest Registered User regular
    Protein Protein Protein. Limit use of Diuretics (Coffee, Tea).

    And above all: Seek a Dietician. If you have insurance, and get a referral from your primary physician, you can usually get 1-5 visits at no charge or at least a $25 deductible.

  • Twenty SidedTwenty Sided Registered User regular
    edited May 2012
    My dad's pretty knowledgeable about these things gaining some lean muscle mass is a good way to stabilize weight. It's something he swears by almost-religiously. Not surprising for a scientist interested in exercise physiology.

    It's advice he gives me constantly because of my rail-thin body build. It's not advice I follow but still . . .

    Well maybe it's less applicable if you're malnourished.

    Twenty Sided on
  • ThanatosThanatos Registered User regular
    Priest wrote: »
    Protein Protein Protein. Limit use of Diuretics (Coffee, Tea).

    And above all: Seek a Dietician. If you have insurance, and get a referral from your primary physician, you can usually get 1-5 visits at no charge or at least a $25 deductible.
    There may be some teas that are diuretics, but coffee is not. And caffeine is not.

  • bowenbowen Registered User regular
    edited May 2012
    Thanatos wrote: »
    Priest wrote: »
    Protein Protein Protein. Limit use of Diuretics (Coffee, Tea).

    And above all: Seek a Dietician. If you have insurance, and get a referral from your primary physician, you can usually get 1-5 visits at no charge or at least a $25 deductible.
    There may be some teas that are diuretics, but coffee is not. And caffeine is not.

    For instance, you'd have to drink 500 mg of caffeine to get a diuretic effect... which is 3-7 cups of coffee (depends on type)... and you've drank enough water to offset that. Now if you add 500 mg of caffeine to your food because you like the buzz...

    bowen on
  • Pure DinPure Din Rhode Island Registered User regular
    Warning though, some of this weight gain advice is going to make the PMS symptoms worse. Typical PMS-friendly diet is tons of water, high-fiber, lots of fruits and veggies, increased calcium and iron (not at the same time of day, of course), and decreased salt and sugar. Mild diuretics and caffeine help as well; those are basically the active ingredients in drugs like Midol. You can definitely still work in the healthy fats and protein, just be careful not to focus on the weight gain at the expense of other health issues.

  • PaladinPaladin Registered User regular
    edited May 2012
    ah, Japan doesn't have general practicioners. Has she gotten bloodwork done? Endocrine problems are part of the differential.

    Paladin on
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  • chrishallett83chrishallett83 Hi! Registered User regular
    Once she changes her diet and starts pounding down a bunch more protein, get her a weight set so she can put on a bit of muscle, not just fat...

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  • sportzboytjwsportzboytjw squeeeeeezzeeee some more tax breaks outRegistered User regular
    I know I generally maintain a fairly steady weight, but if I start ripping into the Ice Cream I pack on the pounds like instalty. Protein is fine and all, but if she actually just can't maintain a healthy weight, load up on the Tillamook.

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  • sportzboytjwsportzboytjw squeeeeeezzeeee some more tax breaks outRegistered User regular
    Oh and if a period is knocking your wife over like that, red meat is super-important.

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  • bowenbowen Registered User regular
    edited May 2012
    Oh and if a period is knocking your wife over like that, red meat is super-important.

    Yeah any iron dense foods are great in this instance.

    posh's lady likely has undiagnosed menorrhagia ... not sure how that works in Japan but in the US usually a GP/PCP can figure that out pretty quickly. Judging by the PMS/PMT comment too, I'd say dysmenorrhea too. But I'm no doctor. Maybe a gynacologist since there's no PCPs?

    bowen on
  • KarrmerKarrmer Registered User regular
    edited May 2012
    I know I generally maintain a fairly steady weight, but if I start ripping into the Ice Cream I pack on the pounds like instalty. Protein is fine and all, but if she actually just can't maintain a healthy weight, load up on the Tillamook.

    This is because of the sugar - cheese won't really help here.

    But yeah, if she wants to just "gain weight" in general, she needs to eat more carbohydrates and add in some fats. Proteins are obviously important but for someone with her body mass, she can get her required protein without eating much of anything.

    Pasta, potatoes, fatty treats like ice cream, throw some delicious fatty red meat in there (some good ribeyes would be both delicious and great for her) - weight gain won't be an issue. Considering how thin she is, this seemingly sub-par diet will probably actually be good for her, and it's hard to imagine a person not enjoying some ice cream and pasta.

    Obviously don't let this become her gaining 100 pounds or anything.

    Karrmer on
  • EiryDicksonEiryDickson Registered User
    edited May 2012
    Some people aren’t getting fat due to hormone imbalances, so it’s better if she take a hormone therapy from a qualified doctor.

    EiryDickson on
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