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What is a healthy way to gain weight?

Question: I am underweight and would like to gain weight in a healthy way.  Do you have any recommendations?  

Answer:

As explained in my video Eating More to Weigh Less, the key to healthy longterm weight loss is understanding calorie density and eating low calorie-dense foods. When applied in reverse, the concept of calorie density can be used to gain weight. In other words, you would want to eat more foods that are more calorie dense. The idea is to not just add a single one of these foods, but to add several foods into your diet until the amount of calories you take in exceed your energy needs. Examples of higher calorie dense foods appropriate for a whole food plant-based diet include: nuts, nut butters, dried fruits, tofu, avocados, and whole grain breads/crackers/dry goods. Eating more cooked food than raw also helps with calorie intake.

You can incorporate several of these relatively healthy foods into each meal and snack, and eat primarily cooked foods. For example, a person wanting to lose weight will want to use vegetable-based sauces, but you would use nut-based sauces. While a person wanting to lose or maintain weight would include a lot of raw food, say big salads with some lemon juice as the dressing, you might eat smaller amounts of raw food and far more cooked veggies, beans, and grains.

While that’s the answer to your actual question, I would step back and ask, “Why do you want to gain weight?” Are you hoping to gain more fat? Gaining fat isn’t generally healthy unless you are severely fat deficient, which is fairly rare. On the other hand, if you want to gain more weight without gaining fat, then what you are talking about is gaining muscle, and that involves more than just changing your diet … it includes incorporating weight-bearing exercises into your workout regimen.

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Discuss

Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.


29 responses to “What is a healthy way to gain weight?

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  1. Hi There, i have found that most diets incorporating lots of legumes, whole grains and nuts seeds to exceed the daily upper limit for manganese, sometimes by as much as 4-5mg. Is there any harm in eating like this on a day to day basis? as currently i find it hard to get enough calories to support my activity level without doing this!

    1. Yes, I have noticed a similar pattern. I eat a lot of calories, and when getting those from a plant based diet I often end up at around 10-15 mg of manganese a day. Should I be worried?

  2. I recent learned of the mediator release test (MRT) that tests for food sensitivity. even though I have no food allergies, I learned that I have sensitivities to certain foods like wheat, coffee, pinto beans and beets that I would never otherwise be aware of and it is suggested I avoid these items due to their potentially inflammatory effect on my body and their causing my body to retain fat. is there any validity to this blood test? I thought it was interesting and tried it based on the suggestion of a nutritionist. after eliminating the highly reactive items I did lose weight but am skeptical… any thoughts?

  3. Thanks for your question Charu.

    I can’t speak for Dr Greger but I certainly do believe yes, if there is enough evidence for the type of herb of course.

    In regards to Holy Basil, here is a quote from a review:

    “The unique chemistry of Tulsi is highly multifarious. Tulsi contains hundreds of beneficial compounds known as phyto-chemicals. Working together, these compounds possess strong antioxidant, antibacterial, antiviral, adaptogenic, and immune-enhancing properties that promote general health and support the body’s natural defense against stress and diseases. The essential oils in the leaves of Tulsi that contribute to the fragrance and refreshing flavor of Tulsi Tea, are a particularly rich source of valuable phyto-chemicals. It acts as adaptogen (an adaptogen is an agent that helps the body adapt more efficiently to stress. Adaptogens reduce the intensity and negative impact of the stress caused by mental tension, emotional difficulties, poor lifestyle habits, disease and infection, pollution and other factors. Tulsi is one of the most effective adaptogens known.), antioxidant (an antioxidants slow down the process of excess oxidation and protect cells from the damage caused by free radicals. When cells are attacked by free radicals, excess oxidation occurs which damage and destroy cells. Antioxidants stop this process. The cellular damage caused by free radicals can be responsible for causing and/or accelerating many diseases. Tulsi is rich in antioxidants and is recommended to guard against free radicals and protect from damaging excess oxidation.), and as an immuno-modulator which is an agent that balances and improves the immune response of the body in fighting antigens (disease causing agents such as bacteria, viruses, microbes, allergens etc.) and maintaining health.”

    However, caution is also needed since there are toxicity concerns over holy basil oil over 42.5ml/kg bodyweight (see here).

    In regards to Maca powder, one review states that (see here):

    “Experimental scientific evidence showed that maca has nutritional, energizer, and fertility-enhancer properties, and it acts on sexual dysfunctions, osteoporosis, benign prostatic hyperplasia, memory and learning, and protects skin against ultraviolet radiation. Clinical trials showed efficacy of maca on sexual dysfunctions as well as increasing sperm count and motility. Maca is a plant with great potential as an adaptogen and appears to be promising as a nutraceutical in the prevention of several diseases.”

    However, like with everything studies may not be of high quality and therefore I prefer caution and suggest that more evidence is required to rate its effectiveness as a health promoting powder.

    Hope this answer helps.

    1. @Darchite, MSc, R.D.

      Would you know anything about immune boosters and adaptogens in relation to vitiligo? I read I need to avoid immune boosters and perhaps (not) adaptogens. I do notice nutritional yeast and shrooms always cause inflammation. I regularly use garlic though (an immune booster) which does not seem to cause any inflammation for my vitiligo. Neither do a couple adaptogen herbs I have at home. However, this does not mean I am sure it doesn´t worsen my vitiligo.

      1. Hi there. I’m one of the moderators for nutritionfacts.org. Thanks for your great questions. Sounds like you are very aware of what effects different things have on your vitiligo. Unfortunately, we don’t know exactly what causes vitiligo. I believe the top theory is it is autoimmune. Dr. Greger does have some information about other auto immune diseases you may find helpful. Plant based diets have been shown to reduce inflammation and help with autoimmune, inflammatory conditions. See:
        https://nutritionfacts.org/video/why-do-plant-based-diets-help-rheumatoid-arthritis/
        https://nutritionfacts.org/video/sodium-and-autoimmune-disease-rubbing-salt-in-the-wound/

        A lot of spices have been shown to help with inflammation. Dr. Greger is a huge proponent of turmeric for this:
        https://nutritionfacts.org/video/fighting-lupus-with-turmeric-good-as-gold/
        https://nutritionfacts.org/video/which-spices-fight-inflammation/

        I hope that information helps.
        NurseKelly
        NutritionFacts Moderator

  4. My friend Lloyd told me about your Book .. He is an active @70 year male .. he was becoming light headed and passed out a few times .. he had CAT scan at Kaiser and told by his VA doctor that his carotid was 80% blocked and to get the surgery ASAP .. that was five months ago and he is telling me that he wants to do six months on your diet before he has the surgery thinking that your book explains how the diet can reverse his condition and that he will not need the surgery .. I tell him that you did not mean in all cases that the diet is the only or best treatment .. I will send you the report from Kaiser when I get it .. please respond in email to cue to us to your answer .. thank you ..

  5. Off topic, however, I would like to know about Dr. Greger’s opinion about Dr. Burznski’s cancer treatment down there in Texas.

  6. Hi,
    I was wondering how many fats as a teenager on a vegan diet is too much?
    I am having the same underweight issue and was loosing a lot of weight. I am a vegan 17 year old , I went from 95 to 85 pounds in 3 months, and lost my period. When looking up what was going on, I discovered I needed more fats. So I began incorporating more nuts butters into my diet and now the weight is back on! However, I eat about 3 to 3.5 tablespoons a day and am worried this is too much. I want to be as healthy as I can (obviously why I read your amazing book) and am worried this is too much fat to be considered a healthy amount.

    1. Miranda Ehrichs: I’m not an expert, but I have some thoughts for you. First, it is really good that you fixed the problem right away. When a woman does not get enough calories, she can lose her period and based on what I heard Dr. Greger say in a recent interview, this is a serious health risk. Foods that are higher in fat, like the nut butters, are more calorie-dense and thus can help you maintain your weight.

      Are you familiar with Dr. Greger’s Daily Dozen? The Daily Dozen includes 2 tablespoons of nut butters plus 1 tablespoon of flaxseed every day. So, I’d say you are right on target. Also consider that an active, growing teenager may have more relative calorie needs and thus sticking to the higher calorie dense foods is the way to go. In other words, you may need more than the average person that the Daily Dozen covers. Have a bit extra of something as healthy as a nut butter in order to maintain weight is a fantastic choice and nothing to worry about in my lay person’s opinion.

      I have some resources for you that might help. First, the Vegetarian Resource Group (VRG) is a great resource for these types of questions. They are well researched and have a section for kids with lots of information about teenagers. They may have some information that you would find helpful, including a Vegan Nutrition For Teens document: http://www.vrg.org/family/kidsindex.htm

      Another resource I recommend is the book, Becoming Vegan, Express Edition. They have a chapter for kids. I don’t have the book in front of me right now. So, I don’t know how much they have regarding teenagers, but this is a book that Dr. Greger also recommends and is good to have in your back pocket for long term reference.

      Best of luck to you.

  7. As a certified personal trainer, I would recommend a well designed, personalized resistance training program for anyone wanting to gain lean muscle mass instead of body fat.

  8. I am having a similar question. I went on a plant-based diet last year and lost a bunch of weight from “the wrong places”. Are there any whole plant foods I can focus on to get my curves back?

  9. Hello Chrystal and thank you for your question,

    I am a family doctor with a private practice in lifestyle medicine and also a volunteer support person for this website. First of all, you should know that weight loss is generally a good thing, and is associated with longer life, and decreased incidence of diseases like diabetes, hypertension, and many types of cancer.

    In order not to lose weight from “the wrong places”, you will probably need to lift weights to get back the curves you want — e.g. chest, and legs. There is no food that will put weight back only in the places you want it.

    If you are actually clinically under-weight, meaning your body mass index (BMI) is below 18.5, then you might need to start eating foods such as nuts and seeds, which are calorically dense, yet still healthy.

    I hope this helps.
    Dr. Jon
    PhysicianAssistedWellness.com
    Volunteer health support person for NutritionFacts.org

  10. Hi there,

    I”ve been trying for years to gain weight. Actually, I suffer from candida, dysbiosis and IBS and it seems to prevent me to gain weight… I changed my diet 2 months ago to a whole plant based diet and it helps me with PMS and pain in my lower right abdomen (I would say only 10% of pain remains). But I still have a hard time with carbs. Eating carbs made me feel pain/irritation on the vulva (sorry for the details) and it stops when I stop eating them for some days. Moreover, when I eat fruits, my skin starts to get itchy.

    I’m 167 cm and only 48 Kg. I was wondering how I could adjust my diet to gain weight and get rid of these symptoms. Can I eat more than 50g of fat if it comes from whole plant based food?

  11. Carbohydrates are the main fuel source of our bodies but not all carbs are created equal with unrefined complex carbohydrate sources being optimal for health. Could it be that you have certain food intolerances rather than intolerance to a macronutrient? Food journalling and meeting with a registered dietitian might help solve some of your food related concerns. As long as your lipid profile is optimal, you could consider adding more plant based fat sources to your diet including nuts, seeds and avocados in order to maintain an optimal weight.

    1. Thanks for your reply.

      Actually, it is a bit more complicated. During 8 years (from 15 to 23), I took contraceptive pills and it made me very sick (vomiting, nausea, dizziness for 2-3 days every month). I didn’t know it was the pills until I stopped taking them. Since the first month I stopped them, I have never been sick again. But some months later, I noticed vaginal discharge and started feeling pain in my lower right side abdomen. I wasn’t eating healthy at that time so I guess I created an important imbalance of good/bad bacteria + yeast infection. That’s why when I stopped carbs, my symptoms go away but it cures nothing.

      I know my intestinal tract has yeast inside because three years ago, it went away in the toilets (like the vaginal white discharge but coming from my intestines) after eating I realize it now mostly grains and vegetables and a bit of protein powder. After it went away, oral thrush disappeared in 3 days and I managed to gain 5 Kg in 2 months.

      But at this moment, I wasn’t eating a lot. Maybe it helped cured that condition. I think I was eating around 100-150g of carbs per day for a month (no sugar, just 2-3 fruits in a week). Unfortunately, I came back to a unhealthy diet and everything came back in 6 months.

      Do you think it is okay if I try for some time to eat this amount of carbs to reduce the bad bacteria and yeast? I was thinking of eating more beans, vegetables, nuts, tempeh and red berries to get fibers and less grains and fruits?

  12. Hi Laura – I do think the best way to get personalized advice is to find a registered dietician or doctor in your area who utilizes plant-based nutrition as part of an overall treatment strategy. Here is a great resource to connect with a practitioner: https://www.plantbaseddoctors.org/find. In general, I do think that it is not just ok but great to focus on eating more beans, vegetables including starchy vegetables, nuts, etc as long as you feel you are able to consume an adequate number of calories in order to prevent weight loss.

  13. Off topic but very important for me: have Spherocytosis/ Hemolytic Anemia. Need advice to boost hemoglobin. Please help me. Thank you!

  14. Dear Ted; You asked about increasing hemoglobin. Perhaps it’s best to back up and clarify what causes spherocytosis/hemolytic anemia. I assume you’re done some research and are aware this is a genetic condition, often diagnosed at birth,and severity of the condition can greatly vary, so that some may not need treatment, just monitoring and a healthy lifestyle. Just in case you’d like to learn more or confirm what you’ve learned, here are two article that cover definition, diagnosis, and treatment of this condition, one basic and the other more in depth:
    https://medlineplus.gov/ency/article/000530.htm/
    Congenital spherocytic anemia

    https://www.ncbi.nlm.nih.gov/books/NBK190102/
    EPB42-Related Hereditary Spherocytosis

    You will notice that neither article speak about a dietary approach other than to note that iron supplementation is to be avoided and that about half of affected individuals develop gallstones..
    so I’d encourage you to check out this video.
    https://nutritionfacts.org/video/cholesterol-gallstones/ Cholesterol gallstones

    Because a whole food plant based diet can promote appropriate hemoglobin levels I’d encourage vigorously following a healthy plant-based diet which will include iron rich foods. See https://nutritionfacts.org/video/the-safety-of-heme-vs-non-heme-iron/ The Safety of Heme vs. Non-Heme Iron
    I hope this helps.

  15. Hi Kristi,

    I know it was a while ago but I went to a plant based doctor and he had no idea how to fix my problem. However, another doctor suggested I might have gastroparesis. I have to do the gastric emptying test in March. That would explain why I can’t gain weight no matter how much I eat, why I feel nauseous for a long time after meals and why I got this vulva pain. The carbs I eat feed the bacteria because it stays too long in the stomach so when I don’t eat carbs, I have no symptoms.
    But it’s not sustainable long term so I hope there’s something doctors could do about it.

    I’m currently trying a low fat diet to not slow the gastric emptying as suggested in one the latest video from Dr. Greger for upset stomach. Do you think it could help?

  16. Hi Laura, You mentioned you saw a Dr that suggested you might have gastrogastroparesis and you are awaiting a test for in.
    Meanwhile you are trying going to try low fat diet. I would recommend avoiding processed fat however having some nuts and seeds and avocado depending on your tolerance with supplementing for essential fatty acids. I would include two of Dr Greger videos to make sure you get all the nutrients required for healthy diet while being on plant based whole food regimen.
    I would like to explain Gastroparesis means that the stomach’s emptying is delayed, which can result in symptoms of nausea, vomiting, bloating, abdominal pain and reflux. Dietary therapy therefore focuses on strategies and foods that speed up gastric emptying. Seeing a Dietitian would be a good idea to prescribe a diet for your individual needs, but the following are some general recommendations for gastroparesis:

    Eating small and frequent meals

    Not having fluids with meals and space it in-between meals.

    Chewing food well helps the stomach to break the food down.

    Remain upright for at least 1 hour after eating

    Avoid high fat foods:avoid fried foods, take away, pastries, and rich, creamy sauces.
    I hope these information are useful to you.

    Daily Dozen Challenge

  17. Hi Spring03,

    Thank you for your answer. Yes I got all these symptoms + the weight loss. Even a single meal of pasta with veggies can hurt my stomach for the next 6 hours with reflux. I usually have nausea or vomiting when I eat too much fat.

    Thank you for your recommendations, I’m trying them.

    The diet that worked best for me was the gaps diet with some adjustments like no oil and not too much fat. But it’s too much animal products and I know it won’t be good for me long term. But what is sure is when I stop eating grains and high sugar fruits I feel a lot better.
    I really hope I could get better in the future to enjoy them as much as I want.

    Thank you. All these informations are really useful!

  18. Hi,
    I was wondering.. is the daily dozen an “at least amount to eat” or a “maximum amount to eat” list?
    I do suffer a fat deficiency caused by a long period of being sick.
    Nowadays I am working very hard to recover but I am not gaining weight by following the daily dozen checklist..
    What is the maximum amount of each food group that is still healthy to eat?
    I really hope someone can help me with my questions!

    1. Hi Jip,

      It is more of a general minimum recommendation for everybody, but it’s no question that people are going to vary with how much they can eat, how much they want to eat, etc. You’re welcome to adjust as needed and of course eat more beyond the Daily Dozen if you would like. You can eat any of the food groups generously, although since nuts are high in calories, you may want to consider limiting those if you are watching your weight.

  19. Hi there, I have gained 6 pounds since january and currently at 5,3 and 112 pounds currently, I recently did a bad diet that resulted in loss of female period and was told that to get it back I needed to increase calories and nutrients so i reverse dieted with an increase of fats and now have horrible gut symptoms and acid build up. As an athlete that trains 1.5hours a day 5 days a week heavy lifting and 15 min of steady state cardio 3 times a week on 62 percent carbs, 18 percent fats and 20 percent protein at 2540 calories. Since the food increases and increases in fat. I have had unusual neuropathy in my face, hands legs and feet and severe indigestion and stomach cramps. Any tests you would reccommend? Or nutritional recommendations? I’m vegan but body is still not responding positively with all the food and training.

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