This topic is about someone who has an ileostomy and is finding it challenging to gain weight after losing it. Despite eating frequently and choosing healthy foods, they struggle to consume the extra calories needed for weight gain. They have tried desserts and calorie-dense foods without success and are looking for practical ways to add calories without overwhelming their digestive system.

Here are some helpful suggestions:

1. Consider reintroducing ice cream and sweet snacks in moderation if they were previously cut back.

2. Since many commercial protein powders or weight-gainer products are not well-tolerated, look for options that are gentle on sensitive digestive systems.

3. Due to limited fiber tolerance, focus on low-fiber foods that are easier to digest.

4. Currently, the person is consuming about 2,100–2,400 calories a day and drinking two protein drinks, while also starting strengthening exercises.

5. Use calorie-dense treat foods in moderation, such as cakes, donuts, cookies, ice cream, dark chocolate, tiramisu, and steak pie.

6. Add high-fat, high-calorie staples to everyday meals:
- Nut butters, especially peanut butter.
- Cheese and full-fat milk.
- Avocado.
- Butter or olive oil added to all cooked foods.
- A spoonful of powdered milk stirred into yogurt or cereal.

7. Drink or blend extra calories:
- Smoothies with protein powder and peanut butter.
- Ready-to-drink shakes like Premier Protein, Ensure, and Kate Farms, which are nondairy and about 600 calories per shake.
- Weight-gain powders that provide over 1,000 calories per serving when mixed with milk or water.

8. Eat small, frequent meals—more than four times a day—to make each sitting manageable while increasing total intake.

9. Use a calorie-counting app, such as MyFitnessPal, to ensure you maintain a calorie surplus. Remember, 3,500 calories roughly equals 1 pound, so even an extra 130 calories daily can add 1 pound per month.

10. If protein powders are problematic, try different brands or use whole-food add-ins like peanut butter, powdered milk, or avocado for extra protein and calories.

11. Don't worry about consuming sugar or "junk" food in the short term if it helps you reach your weight goals; you can adjust your diet later.

12. Fiber tolerance varies among individuals with an ileostomy. Some find moderate fiber helpful, while others need to limit it. Adjust your intake gradually.

13. Work with a registered dietitian and your physician to create a plan that balances calorie needs with other health concerns, such as cholesterol, potassium, and kidney function.

14. Combine increased calorie intake with light strength training to help ensure the weight gained is lean body mass rather than just fat.