Help, I'm Too Thin

Q:  Help! I'm a 40 year-old male, 5'-10" tall, and a very thin 140 lbs (not very height/weight proportionate). I've been eating more than I used to by adding more calories and protein to my diet, but I don't seem to be making any progress. I work as a letter carrier for the post office, so I'm sure that the amount of walking I do each day doesn't help, combined with a fast metabolism.

I recently had a physical and seem to be in good health. I've had my thyroid checked for hyperactivity and was told it was normal. I talked to my physician about gaining weight and was told there was nothing I could do about it. I don't feel that these doctors are taking my problem seriously and I find it hard to believe that there is nothing that can be done to help me. I feel that it's just as bad as being overweight.

So any suggestions? Can't something be done about a fast metabolism? What about those weight gaining powders that are sold at health food stores? Are they a gimmick or do they really work? I exercise and work out with weights, but just can't seem to put on any pounds. Should I see a nutritionist about my diet? Hope that you can help me!

A:  Unfortunately we cannot change the rate of our metabolism--that seems to be genetically programmed. I'm guessing that one or both of your parents is also thin and that you have probably been thin your whole life. Having your thyroid function tested was an important first step since a hyperactive thyroid can result in weight loss.

Most tables list the suggested weight for a person of your age and height all the way from 146 to 188 pounds. Your current weight is slightly less than the ideal range but there is also individual variation in body weights according to body frame. In order to gain weight a person must consume more calories than they expend during the day. Since your job is active, plus you work out with weights, it may be difficult for you to consume adequate calories to gain weight.

Doctors are not trained well in nutritional matters, so consulting with a registered dietitian is a good idea. Your doctor can give you a referral for insurance purposes. I turned to my favorite source of up-to-date nutritional information, Carla McGill, PhD, RD, for advice about your situation. She agreed that a dietitian will be able to evaluate your eating habits and make suggestions for increasing your calorie intake.

Weight gain powders and special formulas do provide calories and varying proportions of protein, carbohydrate and fats, but Dr. McGill says there is no distinct advantage to obtaining calories from these costly supplements compared to well-balanced foods from the grocery store. The supplements are usually much more expensive than food.

You may also need to make some adjustments to your activity level to help you reach your weight goal. Unless you're really self-conscious about how you look, you should realize that no matter what you do, it will probably be hard for you to gain very much weight. The good news is that there is some evidence that thin people tend to live longer.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.