A good diet...

I was scanning my school's newspaper today when I ran across an article from the AP that was, surprisingly, personally relevant:

Underweight People Work to Put on Pounds
By ALICIA CHANG
Associated Press Writer

With Americans' obesity driving the focus on weight loss, scant attention is paid to the other side of the scale - underweight people who are trying to put on pounds.

Being underweight is not a common problem in the United States, affecting only about 2 percent of adults, compared to two-thirds who are overweight or obese. But people who are too thin can be vulnerable to disease because they may have weakened immune systems; they are also at higher risk of osteoporosis.

There are varying reasons why a person may be underweight. Some may have fast metabolism and burn calories off quickly. Others may be recovering from an eating disorder like anorexia or bulimia or from the side effects of disease such as cancer or AIDS.

People looking to shrink their waistlines often have a wealth of information to reach their goals from diet books to weight-loss programs to support groups. But for those wanting to fatten up, it is often a lonely struggle.

"We are so preoccupied with the idea that people might gain too much weight that we almost don't want to admit that any weight gain is normal," said Joanne Ikeda, the co-director of the Center for Weight and Health at the University of California, Berkeley.

Erika Wallace, a 27-year-old media transcriber from Atlanta, found this out firsthand. Whenever she confides to her friends about the hardship of gaining a mere pound, they shrug her off, telling her she does not have a "real problem."

Wallace has been naturally thin all her life. At 5-foot-4, she weighs only 100 pounds. That gives her a body-mass index of 17.2. Anything under 18.5 is considered underweight.

Wallace scarfs down three meals a day - grits, eggs and bacon for breakfast, sandwich, chips and fruit for lunch and chicken and vegetables for dinner - and snacks between courses.

"I eat all day when I'm in front of the computer. I'm constantly stuffing my face to gain weight," she said. "You get tired of eating sometimes."

Despite her efforts, Wallace struggles to maintain the extra pounds. She would gain a fleeting three pounds only to revert to her regular weight if she missed a meal. Wallace recently joined an online chat room for underweight people on WebMD, a commercial health Web site, where she posts her food diary and gets feedback from like-minded peers.

"Everyone is so obsessed with trying to lose weight that there really isn't much out there for people trying to gain weight," said Martha McKittrick, a staff dietitian at the New York Presbyterian Hospital and a health expert at WebMD.

While there isn't a one-size-fits-all plan to weight gain, the key is to take in more calories than you burn. Consuming an extra 500 calories a day usually leads to a gain of a pound a week.

People suffering from eating disorders or the side effects of disease must first break through mental and physical barriers before they can start counting pounds. For the naturally underweight looking to beef up, health experts advise eating five or six times a day, spacing the meals throughout the day to avoid feeling stuffed and keeping in mind that not all foods are created equal.

Choose nutrient-rich foods like bread, cereal and pasta and dairy-based products like milk, cheese and yogurt. Snacking on high-calorie avocados, nuts and dried fruits is also a good option. Lay off the sugary soda and junk food, which only add empty calories.

"You still can't eat cookies in front of your television willy-nilly," said Cathy Nonas, a spokeswoman for the American Dietetic Association and director of the obesity and diabetes programs at North General Hospital in New York City.

Exercise is important too. Not only does staying active help stimulate appetite, it helps build muscle and avoid flab.

Most of the article is chaff, as usual for health related pieces. But it does bring to light an interesting issue that faces some of us. Just how does one gain weight - particularly of the healthy variety?

I can speak from personal experience in saying that it is not an easy task. For one thing, if one can pretty much eat any food in any amount without directly noticeable deleterious effects, one tends to fall into horrible eating patterns. Too-large meals, unhealthy and unbalanced diets, etc. Furthermore, adding pounds is extremely difficult. Even when one is exercising regularly and eating quite a bit, the calories tend to just... disappear. With a busy schedule, one can easily not eat enough, and actually lose weight.

My own experience is a bit extreme. I'm a bit over 1.85 or 1.86 m (that's around 6'1" for you Americans), and weigh less than 60 kg (~130 lb). One can quite easily count my ribs across a room. Now, to me, my morphology isn't that odd, since I've been like this as long as I could remember (though I am told I was one fat baby), but it tends to startle most other people.

The most concerning part is, of course, my bone mass. No one's bones are supposed to be as small or light as mine are, and though I don't have the enormous risk of osteoporosis that women "enjoy", bone density will certainly be an issue in the future. (For reference, my wrist is thinner than some six year olds'.) Other concerns involve my rather small muscle mass that refuses to increase no matter how much I exercise. To be fair, though, I most explicitly do not lift weights, which would probably bulk me up slightly. I never really have much in the way of strength troubles, but the situation is still somewhat annoying.

There are other complaints about being thin, too. Finding clothing is a bitch, particularly in the pants department. I lose heat extremely rapidly, so end up being cold much of the time. My fast metabolism makes me jumpy and fidgety. Yadda, yadda, yadda.

So how can one gain weight in a healthy manner? A BMI of 17 or so just isn't healthy, but there doesn't seem to be much of a way to change things. Eating like a "grazer" (ie, frequent small meals) simply isn't an option for most people who are on the move or at work all day. One could try taking directions from swimmers (who eat ridiculous amounts of food every day), but the real problem is that my body isn't craving more energy than what I currently supply it with. Sure, I'm hungry more or less all of the time, but I'm not starving.

Any suggestions? I know that most people reading this are likely pissed at me for whining about being underweight (sorta like people complaining about the travails of being devastatingly attractive), but I think I'm justified in saying that this degree of emaciation just can't be healthy. So there. *smiles*