Body Mass Index
The term fatness has different connotations across time, societies, and cultures. Furthermore, medical fatness is often distinct from the previously mentioned contexts and aims to present itself in a standard way. Most health care facilities use the body mass index (BMI), a metric that calculates the optimum weight range of its population, based on height and occasionally age and sex. It is a beneficial tool in weight management as it allows individuals to set goal weights and helps to track their progress.

BMI is considered a primitive indicator of well-being by many primary health workers, as it does not account for fat distribution in different body sites. The BMI metric also does not capture the muscle mass of an individual.

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It is also unwise to ignore the importance of BMI as it is a crucial test in evaluating risks for developing potential diseases. At a cellular level, changes in BMI strongly influence normal physiology. Studies show that specific BMI ranges can alter or cause insulin insensitivity, inflammation, and cognition.

When weight is not maintained and is either over or below the BMI, individuals are overweight and underweight, respectively. If the BMI is above 30, it falls in the range of obesity.

Underweight Management
Obesity and its devastating consequences are well known. However, falling below the normal BMI range has its risk factors. Additionally, underweight individuals may have an underlying psychological disorder such as body dysmorphia, that skews their perception of healthy body weight. Similarly, as the BMI does not account for muscle mass, few of the underweight individuals may not require an intervention. The most straightforward approach to gain weight is the increased consumption of calories. However, the nature and origin of the calories matter, and being underweight does not excuse individuals from complications related to unhealthy dietary patterns.

Increasing the meal portions even by a small amount significantly contributes to weight gain. Use of bigger plates aids with increasing portion size. One must include plenty of whole grain carbohydrates and polyunsaturated fats such as olive oil.

Similarly, instead of eating three meals, splitting daily food intake into 5-6 meals and making snack provisions helps increase body mass.

Protein is an excellent food group found abundantly in meat, legumes, and nuts such as almonds. Protein-rich meals are energy-dense and can increase energy consumption without the need for overeating.

Increasing snacking with nutrient-dense foods such as almonds, yogurt, fruits, and milk is also a healthy alternative for weight gain. Fruit and vegetable smoothies are excellent calorie-rich snacks.

Apart from dietary changes, increasing muscle mass through supervised training sessions is an essential component of weight gain. However, one should approach protein supplements with caution and always consult the dietician or physician before consuming external nutrient additives.

If an eating disorder is suspected, one must seek professional help immediately. In addition, treatment of underlying psychological disorders is vital, without which other interventions may prove to be ineffective.

Obesity and Overweight Management
Many reasons contribute to weight gain, and an often-underappreciated factor is socio-economic and genetic constraints. Eating disorders such as binge eating due to stress and underlying health conditions can also lead to weight gain. However, the most common reason for obesity is the imbalance between energy consumption and energy usage.

A dietician will recommend the implementation of the following lifestyle alterations:

It is crucial to set realistic goals that motivate patients rather than present before them a daunting task.

The Dietary Guidelines of America (DGA) provides detailed recommendations on the five food groups and their portion sizes. Following the guidelines will not only promote weight loss but will also reduce the risks of obesity-related complications.

Individuals with a high BMI may benefit from a low-calorie diet prescribed by a dietician to decrease energy intake.

One must regularize set meal times and avoid unnecessary eating in between. Frequent snacking is one of the principal factors for weight gain that adds to daily caloric intake and reduces consuming healthier meals.

Almost all soft drinks, juices, and alcoholic beverages are of no nutritional value. Therefore, it is best to avoid any drinking beverages and choose water instead.

Portion sizes are integral to weight management, and smaller plate sizes help to reduce food intake.

Most organizations recommend 30-60 minutes of moderate to heavy physical activity three to five days a week for the average individual. Obese people need at least 45-60 minutes of activity five days a week to prevent additional weight gain, and afterward, 60-90 minutes of moderate activity to lose weight. Physical activity does not always mean strenuous exercise or attending the gym. Activities can include walking, gardening, climbing stairs, or mowing the lawn.