Note: The information provided is not intended to help diagnose, cure or prevent any disease or illness. Always check with your GP before beginning a program of exercise, especially if you are recovering from illness. All advice offered assumes that the reader has fully recovered from any disease or illness and simply wishes to regain body mass lost whilst ill.
I typically deal with athletes or generally healthy members of the public who wish to increase their fitness levels, get ready for sport or improve their sports performance and so forth. As you would probably expect, most of these people are concerned with losing or maintaining their current bodyweight but there are a few who wish to put on weight. In the past I have written extensive articles regarding how to determine calorie needs, how to train for increased muscle mass and so forth but I have always pitched these articles at competitive athletes. I would like to take a look at the opposite end of the spectrum...gaining weight following illness.
Major Problems...simple solutions.
The main problems encountered by convalescents attempting to regain lost bodyweight are:
Fatigue.
Loss of appetite.
Nausea.
Disruption of regular eating patterns.
Appetite Stimulants
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Anabolic steroids
Oxandrolone 20 mg/day PO (men and women)
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Testosterone
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Effective in increasing lean body mass; preliminary results suggest efficacy reversing the fat accumulation ascribed to PIs ( AIDS 1999;13:1373). |
Megestrol ( Megace ) 400-800 mg/day So, the options from Hopkins are
a) Use appetite stimulants that cause increases in weight gain from fat.
b) Use anabolics or androgens (testosterone and other testosterone derivatives AKA "steroids" to increase muscle mass.
c) Use resistance training (weights!!!) to increase lean body mass.
I am heavily in favour of option "C" as a basis for regaining lost muscle mass and general health. In addition to the use of resistance training I would also recommend simple dietary changes as follows:
1. If you have trouble with appetite then eat when you are most hungry! If you are ravenous at 6am then have a large meal at 6am. Forget the traditional "3meals a day" approach and eat whenever you want to.
2. Eat smaller meals, more frequently. The use of small liquid based feedings in between solid food meals can allow for a significant increase in caloric intake without a noticeable effect on appetite. This can be as simple as taking a glass of milk or a protein + carbohydrate drink mix (Power Protein Plus or similar) between meals or it can mean preparing 5-8 small meals per day in advance instead of 3 bigger meals.
3. Perform light cardiovascular exercise for 5 - 15 minutes before you eat. Going for a brisk walk outdoors is a classic appetite stimulant.
4. Avoid fizzy juices, caffeine, cigarettes and other environmental factors (including people and places!) that you know decrease your appetite.
5. If you don't have a problem with appetite but can't seem to gain weight then start eating by the clock. Eat every 2 - 3 hours when awake, alternating a proper meal with a smaller snack, sandwich, piece of fruit etc. Most people (whether ill or not) who have trouble gaining weight simply do not eat enough food on a daily basis and eating small amount more often is the most effective way increase total caloric intake.
So, what kind of resistance training?
Assuming there are no limiting factors such as joint pain, high blood pressure or such like then the weight training program should be build around movements that utilise several joint simultaneously through a large range of motion. This means using exercises that involve a large number of muscles at once as opposed to attempting to build up individual muscles separately - this is more time efficient and allows for shorter sessions that don't overly interfere with day to day living and it also has a greater effect on the muscles in questions. In the gym this kind of routine would be performed with free weights but if you are going to be training at home it is perfectly acceptable to begin by using your bodyweight as resistance.
A basic program to begin with...
The following is a basic program of freehand exercise that requires no equipment other than a broom stick to perform. The aim is to encourage strength gains and subsequent increases in muscle tissue without overly stressing the body. Once you become proficient with the movements you can begin to consider beginning genuine resistance training with added weight. However, for a person attempting to regain weight after illness the following routine as presented will provide a sound starting point.
The routine will be performed 3 times a week at first, with all repetitions being performed at a slow and controlled pace. The number of repetitions will be determined by your own feelings of fatigue. You should continue with each exercise until it begins to get tiring and then stop immediately. Do not push any exercises to the point where you become exhausted or pained. Over time you will attempt to increase the repetitions performed in each exercise, building up slowly and never becoming exhausted.
Free Squats.
Lunges.
Crunches.
Pushup or half push up.
Broomstick Rowing.
Toe raise.
To begin with you will do each exercise only twice i.e. you will go through the exercises one at a time and then repeat the whole sequence a second time. After a couple of weeks you can add extra sets if you feel able, performing both more repetitions per set and more sets of each exercise. After a few weeks you may find that these bodyweight exercises no longer provide a challenge or sufficient stimulus to increase muscle mass. At this point I recommend that you seek the services of a qualified instructor and get your self in to the gym.