How a diet plan helped one man to gain weight

One year ago, Marvin Walugembe, a student at Ndejje University, discovered his continuous loss of appetite for food was affecting his health. Slowly, he was becoming skinny and weak.
“I skipped meals because I had no appetite for food. My friends told me I could gain weight if I sought medical care,” he says.
It is then that he decided to visit a nutritionist. He made an appointment with Jamiru Mpiima, of Family Nutritionist Uganda, who would help him establish what the problem was, and also help him deal with it.
Previously, Walugembe had visited a doctor who found nothing wrong with him, although later he learnt he was suffering from anorexia. But at 20 years, and only weighing 47 kilogrammes, he knew something was wrong.
“The nutritionist said my weight was too low for my age and that it would affect my health if I ever suffered from a serious health condition,” he remembers.
The nutritionist then put Walugembe on a diet plan that included him having to take energy boosters, fruits and vegetables and also undertaking regular exercises.
“I followed the plan religiously and I then noticing a change in my eating habits. I had better appetite and felt energetic,” says Walugembe.
The diet plan is a table that includes the kinds of food that Walugembe had to eat, the nutrients in each of these foods, the quantity and the intervals he had to eat these foods.
“The first session of the meal plan lasted six weeks. After which I went back to the nutritionist for a review and I was told I was responding well to the diet,” Walugembe says.
Now Walugembe is steadily improving and he says he still follows the diet plan that he has now been on for several months. As a result, he now weighs 62 kilogrammes.
“I used to have a low appetite for food, but these days I get hungry almost all the time. But I make sure I do not eat foods such as chips that may instead make me obese, yet all I want is to be healthy,” says Walugembe.
“We get many people like Walugembe who want to gain weight because they think they are underweight. But often times, many do not know it could be a health related condition,” says Mpiima.
Dr Andrew Ssekitoleko, the director for medical services at International Hospital Kampala (IHK), says there are several conditions that can cause a person to be underweight, including stress, sickle cell disease and anorexia nervosa, an eating disorder where a person has no appetite for food.
“People with anorexia often experience dizziness, headaches, drowsiness and lack of energy because their bodies do not generate enough energy,” he adds.
Dr Ssekitoleko says being underweight should be considered a serious health disorder, as it can be associated with conditions such as organ failure, anaemia and other mal nutritional diseases.
“A person is likely to develop organ failure because most of the body organs do not have enough energy to keep them functioning properly,” says Dr Ssekitoleko.
He says if a woman who is underweight gets pregnant, she is likely to suffer from anaemia and also develop other pregnancy related complications.

When you should worry
Mpiima says a person can tell if they are underweight after measuring their height against their current weight, in what is known as Body Mass Index.
The ideal BMI of a normal person should be between 19.5 and 25. If a person is below 18.5, then they are considered underweight, while those above 25 are said to be overweight. When a person’s BMI is above 30, they are said to be obese.
Besides the BMI, Mpiima says he also examines the person’s blood pressure, diet history and metabolic rate (to establish if they frequently feel hungry).
It is from this point that he then drafts an appropriate diet programme, based on the information that has been provided by the client.
He says more men than women seek advice for weight gain at his centre, although unlike Walugembe who is doing it for health reasons, many do so based on the perception that women are not interested in skinny men. “Gaining weight is a gradual process which cannot happen in one day. A person trying to gain weight should set plans that are long term, but also attainable. There should also be commitment on the side of the person who wants to achieve a certain weight goal,” he notes.
Mpiima says while people are obsessed with losing weight, many more are dying silently because they do not think having a low weight can also be a health risk.
“You can be small-bodied but when you are not actually healthy. A visit to a nutritionist or doctor can help deal with such a problem,” he says.

After age 40
Dr Ssekitoleko, however, says weight gain is more recommended among young people. “If a person clocks 40, it is not advisable because at this age, the body cells do not grow anymore.
“If a person is still underweight by the age of 50, current research shows their life expectancy will be reduced,” says Dr Ssekitoleko.

Regular exercise
Besides the diet plan, Mpiima says regular exercise is crucial. “This can be done through aerobics, which help to convert fats into muscles faster,” says Mpiima.
Other exercises that a person should do include jogging and walking.

Expert say

“Dr Andrew Ssekitoleko, the director for medical services at International Hospital Kampala (IHK), says there are several conditions that can cause a person to be underweight, including stress, sickle cell disease and anorexia nervosa, an eating disorder where a person has no appetite for food.
“People with anorexia often experience dizziness, headaches, drowsiness and lack of energy because their bodies do not generate enough energy,” he adds.
He says being underweight should be considered a serious health disorder.

Foods you can eat

There are basically three important meals that a person can eat every day. Dr Ssekitoleko says in between meals, however, a person can opt for snacks and fruits.
The proportion of food should be heaviest for breakfast, heavy for lunch and light for supper.
Increase the amount of food you eat per meal and aim at a balanced diet. That includes drinking plenty of water, fruits and vegetables, and dairy products and foods rich in fibre. Taking soy porridge is also recommended.
“Eighty per cent of the body is composed of water, so it is important to take a lot of fluids in order to keep your body hydrated,” Mpiima says. Dairy products such as milk, yoghurt, butter, fish and eggs are also good sources of fat and proteins for non-vegetarians. Vegetarians can find such nutrients in foods such as peas and beans.
Vegetable oils such as olive and coconut oil are better than animal oils, because they neither add nor reduce the levels of fat in the body, and are considered cholesterol free.
Dr Ssekitoleko says some people may need more energy, depending on the type of work they do, so it is advisable that they eat high caloric foods. Avoid taking high sugar drinks such as sodas as they can lead to obesity.

What you should know about anorexia

Anorexia nervosa is one of the common eating disorders that makes people lose more weight than is considered healthy for their age and height. People with this disorder may have an intense fear of weight gain, even when they are underweight. They may diet or exercise too much or use other ways to lose weight.
Eating disorders are common among teenagers, but there are indications the condition can develop earlier or later in life.
Causes
The exact causes of anorexia nervosa are not known, but many factors can contribute to the problem, including genes or hormones and social attitudes that promote thin body types.

Risk factors
•Being more worried about, or paying more attention to weight and shape.
•Having an anxiety disorder as a child.
•A negative self-image.
•It is more common in females, but some males may also suffer from anorexia.

Symptoms
•A person with anorexia usually has an intense fear of gaining weight or becoming fat, even when they are underweight.
•They may refuse to keep weight at what is considered normal for their age.
•People with anorexia may severely limit the amount of food they eat, and refuse to eat around other people.
Other symptoms of anorexia may include:
•Blotchy or yellow skin that is dry.
•Confused or slow thinking, along with poor memory or judgment
•Depression.
•Dry mouth.
•Extreme sensitivity to cold (wearing several layers of clothing to stay warm).
•Loss of bone strength.
•Wasting away of muscle and loss of body fat.

Tests should be done to help find the cause of weight loss, or see what damage the weight loss has caused. Many of these tests will be repeated over time to monitor the person for progress.

Treatment
The biggest challenge in treating anorexia nervosa is helping the person recognise they have an illness. Most people with anorexia deny that they have an eating disorder. People often enter treatment only when their condition is serious. Goals of treatment are to restore normal body weight and regular eating habits.
Treatment programmes can help people with anorexia to return to normal weight, but it is common for the condition to reoccur.
Women who develop this eating disorder at an early age have a better chance of recovering completely. Most people with anorexia usually prefer a lower body weight. Long-term treatment may be needed to stay healthy. Cognitive behavioural therapy can be important in managing anorexia. This kind of therapy is more useful for treating younger patients who have not had the condition for a long period of time.
Support groups may also be a part of treatment. In support groups, patients and families meet and share what they have been through.
Different programmes have been designed to treat anorexia. Sometimes the person can gain weight by:
•Increasing social activity
•Reducing the amount of physical activity.
•Using schedules for eating.

Possible complications
•Bone weakening.
•Decrease in white blood cells, which leads to increased risk of infection.
•Low potassium levels in the blood, which may cause dangerous heart rhythms
•Severe lack of water and fluids in the body, leading to dehydration
•Lack of protein, vitamins, minerals, and other important nutrients in the body
•Seizures due to fluid or sodium loss from repeated diarrhoea or vomiting
•Thyroid gland problems
•Tooth decay
Medicines such as antidepressants, antipsychotics, and mood stabilisers can help some anorexic patients when given as part of a complete treatment programme. These medicines can help treat depression or anxiety.

Source: MedlinePlus

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