I have a horse that is an extremely easy keeper who just gets grass, hay and ration balancer. She’s been out of work for a long time and I’m planning on slowly working her back into it. She has a pretty poor topline currently. Will she be able to build it back up with just slow, correct work or should I change her diet to include some more fat and protein?
Toplines are built by slow and correct work. Feed is used to provide the energy and fuel to build those muscles, but feed alone won’t provide the muscle conditioning needed to build a topline.
I’d put the horse into work and see how she does. If she is an easy keeper, she may not need the extr calories. I have had horses in training on just ration balancer. If If you see any dip in weight you can always add more calories.
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Unless your hay/grass is really low quality and low in protein, that diet is providing plenty of protein, especially if you’re feeding the ration balancer according to her weight
Put her into correct, solid work, and see what you have in 6 months. Take a conformation type picture monthly to help gauge things you won’t remember otherwise 
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Topline comes from two things: genetics, and body condition (nutrition).
It is always a red flag to me when a horse is out of work and has a poor topline. It is worth investigating why the topline is not there, as sound horses should not lose topline when they are out of work. In my experience, some management component is at play: the horse is barefoot but not comfortable, is not getting sufficient nutrition, or is not being turned out enough to keep good body condition. A horse out of work should not lose or have poor topline provided all else is met.
One of the best things you can do for topline is high quality forage, as much grass as possible, and as much turnout as possible. It may be your horse’s current feed program does not have enough protein and fat in it.
It is difficult to know without knowing what you are feeding, your region, and the turnout conditions for your horse. If you are increasing work, you may need to increase calorie intake as your horse’s work ramps up. There are people who swear by supplements like TriAmino, added Lysine, or rice bran oil – but these things may not be a miracle fix if a base need is not being met.
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I have seen some horses “lose” topline when out of work, for no reason other than when they were in work, they were overfed, overweight and the “topline” was fat. I’ve seen this especially in Hunters, where there’s a reason the phrase “Hunter fat” exists 
Once show season is over, and they’re in little or no work, they aren’t “fed up” like they used to be.
But that still points to a management issue as Beowulf said, just from the reverse perspective.
It’s probably more common to lose topline when out of work because “no work = no feed”, and forage alone isn’t enough for a lot of horses to have that optimal topline even out of work. That’s probably not the case here, with the ration balancer, it’s just an example of what often happens.
I would love to see a conformation-type pic of the horse in question. That always helps get people on the same page - is the actually a bit underweight? Does she look like she’s been putzing around by pulling herself along, building “bottomline” muscles instead of maintaining top line?
The current diet is conducive to supporting muscle development. It’s up to the rest of things - feet, the right kind and duration of work, etc - to do the rest.
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Feed must be adequate. Riding must be accurate. Work should be incremental. Soundness must be adequate. In order to build topline, the horse must be ridden correctly, hind end engaged and “working” his body correctly. If he’s not sound enough to do this, it won’t happen, it can’t happen. Because he’s holding his body to protect his soundness issue. Pelvic issues, spinal issues, often that don’t show up as actual “lameness” show up as carriage issues, and often lack of topline.
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