The total of human body systems (bone, muscle, nervous, endocrine etc.), through their basic structures, are common to all humans, but through genetic inheritance, each individual bears specific peculiarities in physical, functional and psychological terms. The emergence and development of a certain body type is the result of a cause-effect interaction where the cause resides in genetic imprinting and the effect is the emergence of a body type bearing certain somatic proportions, psychological, mental, metabolic and hormonal manifestations, according to the gene and which are to be modelled by other factors that determine a body type. 

Deepti Khatuja, Chief Clinical Nutritionist, Fortis Memorial Research Institute, Gurgaon explained that the importance of factors in the family and social environment has an overwhelming impact on the phenotype, producing major changes even among members of the same family. 

Causes Of Not Gaining Weight Despite Diet

Intake of foods of High Nutrient Density & High Energy Density in Small Amounts- Underweight people should be given nutritious and well-balanced food in small quantities, at a slow pace to avoid refeeding syndrome, especially in patients living with anorexia

Nutritional Supplements- This can be used as a very effective nutritional therapy for underweight people or malnourished patients. These oral nutritional supplements are not just energy-dense formulas but also contain micronutrients, vitamins, minerals and fibre. Various nutrient-dense bars, multivitamins and minerals pills, fortified foods, medical foods, beverages, healthy snacks & shakes are also used to supplement the nutrient needs individually. In addition, full-fat milk or full-fat yoghurt, high in calories and various nutrients, can also be given.

Increase Food Frequency and Snacks- Eating six small meals instead of two or three very big meals is also very helpful. Healthy snacks should be given after the main meals to help in weight gain and to fight the underweight problem. 

Increase Organoleptic Properties of Food Served- The sensory appeal of food (good appearance, improved flavour-smell, aroma, & taste) as well as food texture (softness, hardness, mouth feel) improves the consumption of foods. 

Programmed Exercise- Training the underweight person in strength and flexibility exercises using weights such as dumbbells or resistance bands can build and tone muscle. Playing outside regularly and getting exposed to sunshine helps to absorb the sun’s rays necessary to make vitamin D for absorbing calcium from food, building strong bones and muscles as well as for bone growth. 

Rest and Relaxation -In addition to exercise, people living with underweight issues need frequent rest and relaxation to regain or improve their energy levels.

Smoking- Cessation Smoking has an anorectic effect on smokers, so anybody who wants to gain weight should stop smoking.

Alcohol - Eating caloric nutrients while avoiding or minimising alcohol intake can improve appetite and weight gain and reduce underweight.

Use of Medications that Stimulate Appetite or Build Tissues- Appetite stimulators (e.g. megestrol, dronabinol), or tissue-building medications that boost anabolism (e.g. growth hormone, testosterone) are sometimes recommended and should be checked with the prescribing physician and licensed nutritionist before they are taken.

Don’t Skip Meals - This is the time when adequate intake of macro and micronutrients is important, one should not skip meals. 3 major meals with 3 healthy snacks is the key. 

Avoid FAD diets - They are quick/short Fixes and can lead to various health concerns. Follow the advice from the professionals – Nutritionist/dietician / medical as and when required.  

Always Eat fruits and vegetables with meals – at least 5 -8 servings of seasonal fruits and vegetables should be consumed in a day. This not only helps in providing various vitamins and minerals but also helps in providing adequate fibre. 

Hence even though one is not gaining weight strength and immunity are important components of a healthy balanced diet. A healthy diet with stress management and regular physical activity is the key to a healthy lifestyle.

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