For some, the focus is maintaining weight, not losing it.
By R. Morgan Griffin
Reviewed By Michael Smith
In a society focused on obesity and staying fit, it's important to remember that dropping some pounds isn't always healthy. For some -- particularly people who are coping with medical conditions like cancer or arthritis -- the danger is losing weight, not gaining it.
Some people lose weight without trying because they simply aren't eating enough to maintain a healthy weight. Some types of cancer -- or treatments for it -- can leave you chronically nauseous. Arthritis can make it hard to get to the grocery store, or even to do simple things around the kitchen. Food may just not taste as good as it once did because of side effects of medication.
Any of these problems can cause unwanted and possibly dangerous weight loss, which can leave you malnourished, weak, and vulnerable to illness. That's especially risky for someone who is already sick.
But how do you know if you're losing too much weight? To answer the question, here are some tips on how to keep a healthy weight and get the nutrients you need.
How Do I Know if My Weight Is Healthy?
Obviously, a healthy weight varies from person to person, depending on age and medical condition. But there are some general rules of thumb. You may need to see a doctor and you may be losing weight too quickly if -- without trying to -- you lose:
- 10 pounds over six months or
- 10% of your body weight or
- Five pounds in one week.
The problem is that you may not realize that you're losing weight. Even caretakers may not notice because the changes can be gradual, says Jean Lloyd, RD, national nutritionist for the U.S. Administration on Aging. But if you're at risk of losing too much weight, you have to pay attention.
- Step on the scale. Ask your health care provider for an idea of what a healthy weight is for someone of your height and build. See how you compare. Then get on the scale every week and write down your weight afterward. If you're losing weight, talk to your doctor.
Some older people complain that they can no longer see the display on their old scale. If that's the case, get a new one. "There are a lot of scales now that have huge digital read-outs," says Susan Moores, RD, spokeswoman for the American Dietetic Association.
- Pay attention to how your clothes fit, Moore says. If your pants are suddenly getting loose and baggy, don't ignore it and just tighten your belt. Or if your wedding band keeps sliding off, don't just move it to another finger. These could be signs that you're no longer keeping a healthy weight.
- Look for changes in your eating habits. Although they might be subtle, you should look out for warning signs. "Think about how your appetite might have changed," Moores tells WebMD. "If you used to be someone who really looked forward to breakfast, but now you just have a glass of juice, that could be the sign of a problem."
Since it's often hard for people to pay attention to these details on their own, especially when they're coping with an illness, it's important to get help from the people around you -- family, friends, or caretakers.
What Puts People at Risk of Unintentional Weight Loss?
Any illness that affects your appetite, digestion, mobility, or energy level can put you at risk of losing too much weight. Many types of cancer -- such as cancer of the throat, jaw, mouth, or colon -- can have a direct impact on your ability to eat. But researchers believe that any type of cancer can cause your metabolism to speed up, meaning that you'll need to eat more calories just to maintain your weight. Cancer treatments -- medication, radiation, and chemotherapy -- can also cause a loss of appetite, nausea, and diarrhea. These side effects can cut down on your nutritional intake, Lloyd says.
Medical conditions can also impose physical barriers to good health. If you've got severe arthritis, you know that something as simple as opening a jar or a box of cereal can be next to impossible. Getting out of the house can be tough.
"When you have to start depending on others for your basic needs, like groceries, you're at increased risk of malnutrition," Lloyd tells WebMD. The isolation that can come with some illnesses can be a risk in itself, sometimes leading to depression.
Food might also just not taste as good as it used to. Many medications can cause foods to taste bitter, metallic, or bland.
Tips for Keeping a Healthy Weight
Unintended weight loss is common with certain conditions and treatments, but there's still a lot you can do to avoid it.
- See a health care provider regularly. You should consider seeing a dietitian, especially one who treats people with medical problems. For certain conditions, insurance covers visits to a dietitian.
- Don't ignore side effects. In many cases, loss of appetite is caused by medications. "Go over a list of all your medications with your physician to make sure that you really need all of them," says Lloyd. Ask which ones might be affecting your appetite and see if they can be replaced.
- Eat five to six meals a day. If your appetite is off, you may not be able to eat very much at a single meal. That can make it hard to maintain a healthy weight. Instead of the traditional three meals, think about five to six meals instead -- breakfast, lunch, dinner, and several planned snacks.
- Use nutritional drinks as a supplement. "I'm a big fan of the meal replacement drinks, like instant breakfast drinks or the ones made by pharmaceutical companies," says Moores. They're ideal for people who have trouble eating solid foods. Moores recommends keeping them chilled, since they taste better cold than at room temperature.
I think there's a role for fortified drinks," says Lloyd. "But I don't think they should be used as a replacement for regular foods. They're best as a snack rather than a meal."
- Spice it up. If old favorite foods taste too bland these days, think about adding some spice. Marinate foods to heighten their flavor, or use a tangy barbeque sauce. Moores recommends adding some garlic to plain mashed potatoes. Or try a chicken curry soup instead of staid chicken noodle.
In general, Lloyd says you should opt for pepper or herbs instead of salt, because salt may be a problem for people with high blood pressure. However, she also observes that for people at risk of losing weight, it's often more important to get protein than to stick to a low-salt diet. "If meat just doesn't taste good without salt and you won't eat it, I say add a little salt," she says.
- Use assistive devices if arthritis or another condition is making it hard to use utensils or kitchen appliances. Plenty of devices are designed to provide easier gripping or extra leverage for people with arthritis. Think about a wall-mounted jar opener or an electric can-opener. Lloyd recommends looking for utensils with large handles or thicker plates that make them easier to grip.
- Prepare for bad days. "Often, people will have good days during [cancer] treatment and some not-so-good days," says Moores. "We encourage people to stock their kitchens with very simple-to-prepare foods for the not-so-good days." She recommends instant breakfast drinks, frozen soups, easily prepared pastas, and anything that's simple and you genuinely enjoy eating.
- Don't eat alone. Conditions like cancer or arthritis can be isolating. You may find it simply too difficult, exhausting, or painful to get out of the house or see other people. But you should try to eat some meals with other people. "We eat better when we're eating in a group, or even just with one other person," Lloyd says.
"It's a terrific idea to start cooking and eating with a neighbor," Moores tells WebMD. "You'll get some variety to your diet and it's also fun." Also, think about joining a local meal program -- such as the ones at senior centers -- that will allow you to share meals with others. If getting out of the house isn't possible, ask your doctor about a local meals-on-wheels food delivery program.
- Stay active. "It may sound like a contradiction, but keeping active can help you maintain a healthy weight," says Lloyd. "The more active you are, the better appetite you have." She also points out that activity helps ward off depression and may help connect people. Try to be active whenever you can -- even walking or gardening can make a big difference.
- Build up before starting treatment for cancer or other illnesses that may cause weight loss, Lloyd says. Before treatment, start taking a multivitamin and eat a diet with a good proportion of fat, protein, and carbohydrates. People about to start treatment "should not be on a low-calorie or fad diet," she says.
- Add some calories if your health care provider feels that you've lost too much weight and need to regain some pounds. You might:
- Switch to whole milk instead of skim.
- Add cream to your coffee or tea instead of milk.
- Add a spoonful of sugar in your orange juice.
- Eat foods you like, even some fatty or salty foods.
- Eat whenever you're hungry, regardless of time of day.
- Eat plenty of high-protein foods, such as eggs.
- Add sauces, dips, and gravies to your meals.
Of course, this advice flies in the face of typical nutritional recommendations, so ask your doctor if this diet is safe for you. But in some cases, maintaining your weight is the biggest concern.
A Personalized Approach to Good Nutrition
One important note of caution: There's no one-size-fits-all approach to good nutrition or maintaining a healthy weight, especially for people coping with medical conditions.
"There is no way of telling right off the bat how any one person will react to treatments," says Moores, "so an individualized approach is crucial to improving life during cancer treatment." The same goes for someone with arthritis who also has other health conditions -- like high blood pressure -- and takes medication for them. Each person needs to work out a custom-tailored nutritional approach with a physician or nutritionist, Moores tells WebMD.
But even if the details are different, the basics are the same for everyone.
"Good nutrition is vital to a person's health and sense of energy," says Moores. "Eating food that you like and maintaining your weight is critical to staying healthy and enjoying your life."
Published Aug. 6, 2004.
SOURCES: Jean Lloyd RD, national nutritionist for the U.S. Administration on Aging. Susan Moores, RD, spokeswoman for the American Dietetic Association. American Dietetic Association. Administration on Aging, U.S. Department of Health and Human Services. American Academy of Family Physicians. American Cancer Society. U.S. Department of Health and Human Services.
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