General responses to selected questions from Joel Braunstein, MD, of Johns Hopkins University and Joseph Toscano, MD.

Question:

Everywhere you look, you can find information about how to lose weight. Many people don't realize how many underweight people there are. I am one of those underweight people. I have been to many doctors who all tell me that I am just lucky and I have a fast metabolism. I am 5'7" and only weigh 101 pounds. I eat all day long and it is usually fattening things. I have had my thyroid checked and there is nothing wrong with it. Is there any way to slow down my metabolism or to just gain a few pounds? Thanks for your time.

Answer:

Indeed, being underweight is not a frequent concern among physicians or patients. However, as you state, your weight is quite low for your given height. As you have already briefly alluded, it is important to rule out medical conditions that may explain being excessively underweight. Thyroid abnormalities, uncontrolled diabetes, eating disorders like bulimia and anorexia nervosa, and a whole host of other conditions may explain your excessively low weight. In the absence of these conditions, however, it may be entirely appropriate to want to gain some weight. Unfortunately, consuming "fattening things" (despite their frequent great tastes) is not the optimal approach to healthy weight gain. A much more reasonable approach is to build muscle mass through sensible eating and exercise (as you may know, muscle weighs more than fat).

Here are some tips for sensible weight gain:

1) Exercise regularly with a combination of resistance and aerobic activity. Resistance training is a great muscle mass builder and will slowly lead to weight gain after several months of activity.

2) Keep a log of your dietary habits and your food consumption. You might be surprised to find that you are either regularly skipping meals or eating small portions of food throughout the day.

3) Avoid skipping meals or rationing only small portions of food during each meal. Eating 3 major meals (beginning with a hearty breakfast) and 2 minor meals throughout the day is an approach to optimizing the amount of food that you can tolerate.