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10 Basics of Gaining Weight With Cystic Fibrosis

Do you have any tips for me to help me gain weight?

Porking outThis question keeps popping up via my contact form, so I guess it’s time to put my best tips that are spread out in various articles into one place to make it easy. Keep in mind that these are general tips for CFers that are approved for me by my doctors and nutritionist, so please check with your team if there’s anything here contrary to what you’re doing or what you’ve been advised of in the past. Shoot, check with them no matter what, okay?

Having a healthy BMI is crucial to having a healthy lung function. Check out this study summary for a fresh look at how you can turn your life around by gaining weight.

I don’t have CFRD, but I do my very best to keep my sugars as low as I can while still getting enough carbs to help boost my caloric intake some. The overall rule to gaining weight is: bring in more calories than you burn – exactly the opposite rule of losing weight. It’s really more of a second full-time job if you already have one or a first full-time job if you’re in school or on disability – make it a priority.

  1. The first step to to try to find out over the course of a week how many calories it takes to add some weight, any weight, without losing any. You absolutely must be consistent with your liquid intake or you will significantly throw off your calculations with water weight, especially if you’re on a high sodium diet like many of us are. We are probably NOT talking about 2,000-3,000 Calories here. For me to gain weight, I need to pack away 4,000-6,000 Calories per day. You’ll want to use a phone app or spreadsheet to track your intake for accurate numbers.
  2. Make absolutely certain you’re taking enzymes that work for you (for me, it’s Zenpep), in the numbers you need for increased eating, and in correctly spaced out times while you eat a prolonged meal… and don’t neglect them with snacks, either.
  3. Concentrate your calories around protein and liquid forms of fat, such as those found in oils (especially light olive oil – where light is about the flavor, not calories), fish, dairy, etc. On a 6,000 Calorie day I was getting 200g of fat and protein each with 150g of each being the low end for a 4,000 Calorie day.
  4. Start eating big calories early in the day lest you get tired of eating, distracted with work, or caught up with changes in plans for the rest of your day that potentially (and often) derail your eating schedule. Very, very rarely, dinner doesn’t happen around here when life happens, so it’s good to have had a full day’s worth of eating in by 3pm and let the rest be bonus.
  5. Try to eat 1,000 Calories for breakfast and make it a high-protein meal so you don’t crash by 10am. I eat a huge omelet and often bacon and fruit – here’s a sure-fire way to down a 1,000 easy.
  6. Double that effort with at least 1,200 Calories for lunch. It’s really not that hard, as I tested at Taco Bell this week: 1 crunchy taco, 1 chicken quesadilla, and 1 beef enchirito came out to over 1,100 with a water, which would have been 1,500 with a 32oz drink. Here are two (one / two) high-powered lunches I enjoy.
  7. When you’re at the grocery store, check out the labels of things you like and things you would like to try. You will be surprised at how few calories are in some things you like and how many are in some things you don’t eat. For me, I was surprised at how awesome boiled Cajun peanuts and peanut butter are. Look for calories per dollar and calories per ounce/serving, while being careful to not load up on empty sugar calories. A bag of Combos is a nice compromise.
  8. Meats, meats, meats. You can’t get enough in my opinion, especially steak/beef and salmon. Put meat in everything you can: omelets, Hamburger Helper, Lunchables (when on sale), personal-size frozen pizza (sales, too), and those awesome frozen stir-fry bags are often buy-one-get-one-free (BOGO). Also, who wouldn’t want to eat bacon several times per week for breakfast or snacks? Yum!
  9. Exercise! It seems counter-intuitive to burn calories when you need to take in more than you spend, but exercising makes it so much easier to eat big, plus, muscle weighs more and contains huge amounts of energy.
  10. Eliminate stress and infections as much as possible. Infections burn so much energy fighting them – higher heartrates are present with both bad situations, which is a constant source of energy burning. When I’m near-sick or sick, or stressed from business, my heartrate is a constant 90 bpm, but down around 60-70 bpm when I’m healthy and able to chill out – a considerable savings.

I hope you find these helpful in your quest to gain weight. What works for you?


  1. Kristi Bowers says

    Kaleb has had a hard time with weight since he was little so we have a gtube. That makes it easier on all of us because I know he is getting a certain amount of calories a night and it makes what he eats in the day less stressful. He is VERY picky and he changes his mind often. He goes through phases of chocolate, mac n cheese, burgers, fries and ice cream, meaning he will pick one or two and only eat those for a month or so. I have heard conflicting opinions about CF kids and what they eat. Some say they need to eat a normal balanced and healthy diet, just more of it, others (and our docs opinon) is to eat anything and everything they want. Sometimes I feel like a bad mom when I let Kaleb eat chocolate for breakfast, but it is better than nothing, right?

    • In some respects, it’s fine, but sugar will ultimately lead to issues at my
      age, if not before. Adult diabetes already runs in my family, so my high
      simple sugar diet had to go bye-bye… and my dentist and bank account thank
      me for that, too. One year I had 14 fillings to do after a cleaning, so we
      had to divide it up into 3 visits of drilling.

      I was about as picky of an eater as you’d ever find (as my mom would attest
      to), but there is a point where you have to lay down the law to be sure he’s
      getting a “normal balance, plus” as I’d call it. Build a pyramid, make it
      bigger, and them mutate it with the extras that he eats. Now, I eat far, far
      more things than my dad will, having become pretty adventurous in my eating
      in the last 10 years trying to discover new things to get addicted to for
      easy calories.

    • Yup, Jesse was picky all right! His Dr. in Toledo suggested an NG tube a few times, but Jesse really dug in his heels at that. We didn’t think it would be productive to force it on him so he never got one.

      It’s great that Kaleb accepts the tube. I’ve heard that it’s a big help. Hopefully, he’ll get interested in a broader food pallet as time goes on.

      If Jesse liked a food at Kaleb’s age, he’d eat a super-tanker load of it. If he didn’t like it, he’d die keeping it out of his mouth. So keeping weight on him as a child was a real challenge, but he somehow survived. We just kept feeding him beef and pizza. 😉

      BTW, I think he just said that about now eating a wider variety than I do because I won’t eat raw fish. But I don’t think he’s ever had conch soup or fried iguana. LOL! J/K. His weight gain efforts have sent him foraging wider & wider for helpful foods.

  2. Piper Beatty says

    my dad once decided to encourage me to cut out empty calories and my peds doc at the time (now considered by the CFF to be the best in the country) came down really strong against it. ultimately what he said is that i should be eating a full healthy diet with whatever sugar and carb-heavy snacks i wanted to supplement it. looking back that seemed to work for me — i was a solid 18-19ish BMI in high school — but i was one of the few kids who could probably handle (and enjoy!) eating both a full regular meal and then the ice cream and soda on top of it. i was also fed whole milk like nobody’s business and the habit of drinking milk has stayed with me even to now. i just really really love the stuff.

    when i got older and became more conscious of what i was putting in my body i started to lose weight. i was working out more, eating less sugar (but still a large diet high in fats), and just generally getting sicker. i now find that i have to eat lots of carbs to even maintain weight, but i do try to get them from healthier sources where possible. i developed CFRD, but only with the transplant (which is extremely common), so now i make a point of avoiding simple sugars where possible.

    your tips are awesome! thanks for the help and advice…i’ll be definitely checking out labels tmw at the grocery store.

    • Thanks for your history, Piper! You’re always a good read.

      I was always a whole milk with Meta-something powder in it for extra
      calories with my cereal and still get a share of whole milk, but I have cut
      out cereal in exchange for eggs and bacon stuff. I should revise my advice
      after your statement by saying that empty calories are great if you’re
      coming up short, but really should be shored up with a balance underneath. I
      can attest to how hard it is to come up with 4k+ Calories in a day without
      empty calories, but I have learned how with these tips. I believe protein
      plays a bigger role than fat because fat is so poorly absorbed, unless in an

      Since the diabetes scare, I still get my carbs/starch from potatoes, rice,
      and pasta, but I try to make them as complex on the carb scale as
      possible… and my diet altered drastically since Beautiful found out she’s
      allergic to wheat and corn, which makes up many high-calorie foods. Shopping
      now takes us 2-3x as long as before when we used to only slow down to save
      money. Now it’s money AND labels in great, great detail.

      Maybe I should publish my food diary for everyone to see how my weight gain
      was conducted.

  3. This is excellent; keep up the good work.