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Articles March 2017 Issue

Fighting Unwanted Weight Loss

Get to the bottom of unintentional weight loss and back to a healthy weight.

Dreamstime.com

If you're older than 65, see your doctor if you lose 5% or more of your weight over 6 to 12 months without trying.

Seeing you're down several pounds or finding your clothes are fitting looser may sound like a good thing - but not when you aren’t trying to lose weight. Unwanted weight loss is of special concern in aging since it could point to an undiagnosed illness, leave you prone to infections or decrease your independence.

"When people unintentionally lose weight as they age, it can have far-reaching effects," says Kelly Kane, MS, RD, director of nutrition and business operations at the Frances Stern Nutrition Center at Tufts Medical Center. "Unneeded weight reduction contributes to muscle loss, which could impact something as simple as handgrip strength, making it difficult to open jars of food, or it could make you unsteady on your feet, increasing risk of falling and breaking a bone."

Find Out Why:

Work with your doctor to identify the cause of unwanted weight loss and possible solutions. Cancer is a common reason, accounting for 19 to 36% of cases of unintentional weight loss in older adults. Chronic diseases, such as rheumatoid arthritis and Parkinson’s disease, also may underlie unwanted weight loss. Digestive diseases, alcohol-related disease, depression and dementia may provoke weight loss, too.

"Some people may feel they're eating the same amount as usual but still losing weight. That could be a sign they’re burning more calories without realizing it, which can happen in conditions such as congestive heart failure and chronic obstructive pulmonary disease," Kane says. "In the first case, the heart is working harder, and in the second case the lungs are working harder, and that extra effort takes more energy.” An overactive thyroid gland (hyperthyroidism), if untreated, also may lead you to burn more calories than expected.

Another challenge may be poor appetite. "People commonly have decreased senses of smell and taste with age, in addition to decreased thirst, so eating just may not be as enjoyable," Kane says. Plus, over 250 prescription medications can alter sense of taste and/or smell, such as some blood pressure medications and antibiotics. Some medications can cause dry mouth, constipation or nausea, all of which can dampen appetite, too. Your doctor or pharmacist may have suggestions to ease such issues. Being open to new types of food preparation, spices, eating venues and dining companions may help combat poor appetite, too.

Putting Weight Back On:

Even when food doesn't seem to taste as good as it used to, eating is still important for good health," Kane says. "It may help to think of eating as a discipline, just like exercise. Your body needs the nutrients in food."

Certain strategies can make eating more doable. Try to eat regularly-scheduled meals or snacks every 3 to 4 hours. "Going longer than that without eating can make it difficult to get enough food in," Kane says. "It doesn't have to be a big meal. For example, it could just be toast with peanut butter or an egg with juice."

Although it may be tempting to load up a big plate of food to encourage eating more, this can be overwhelming and not helpful. "If you put a more manageable portion of food on a smaller plate and eat it all, that can provide a sense of accomplishment," Kane says.

Make every bite count, too. "Use strategies opposite to what are often advised to lose weight," Kane says. "Don’t focus on choosing low-fat options, especially if it's healthy fat. For example, dip apple slices in peanut butter or use extra mayonnaise in tuna salad. Such approaches add more calories without increasing the volume of food much."

Social Factors:

If a sudden change in living situation or loss of a spouse has made it challenging to eat well, consider sharing meal times with neighbors or family on a regular basis, coupled with a mutually enjoyable activity, such as discussing a book or movie. If transportation to the store is an issue, check if a supermarket will deliver for a small fee. Consider buying more frozen foods to avoid waste and ensure a steady food supply when you can’t shop.

Most importantly, tap into what you enjoy eating and choose nutritious foods that sound good to you.

To learn more: Appetite, October 2016

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