Dear Doctor,

Since I was a child people made fun of me because of how skinny I am. No matter what I eat, I can’t seem to gain any weight. My sisters think I look anorexic. How can I gain weight in a healthy way? Is there something wrong with me? Barbara

Dear Vanessa,

Whether one is skinny or obese is just a visual impression based on how a person looks. But whether he or she is really underweight or overweight is determined by the body mass index (BMI), which depends on height and weight. A BMI of between 18 to 25 is normal, whereas less than 18 is considered to be underweight. A BMI above 25 indicates obesity. Genetic factors also influence one’s overall body build. Malnutrition, especially deficiency of proteins and calories, can make one skinny.

Recurrent worm/protozoal infestations, uncontrolled diabetes, hyper functioning of the thyroid gland pituitary disorders, liver and kidney disorders, are some of the conditions that cause weight loss. Among serious medical problems, chronic infections like tuberculosis HIV/AIDS, chronic disease like cancer, cause weight loss.

So if one is healthy, eating and sleeping well, has good appetite, does not have any problem, and does not fall sick frequently, there is no need to worry.

Regarding the aesthetic look, a skinny person can try to put on some weight by changes in the diet. A diet rich in calories and proteins can help one to gain weight. An experienced dietitian can guide a person as to what kind of food he/she should take, in how much quantity and how frequently. Amount of necessary calories can be worked out, depending on the person’s age, gender, height, weight, level of physical activity and any illness if present.

Any suspected sickness or hormone disorder, causing weight loss can be identified by suitable tests and treated.