Home Remedies: Underweight

For many of us, the fun house at a carnival was a real treat. Especially the mirror that made a rather rotund person look tall and skinny. It was an instant, effortless, and ever-so-momentary diet.

Now, decades later, you may have noticed that you really are losing weight. If the undistorted image in the mirror tells you that you are beginning to look a bit gaunt—and you are not trying to lose weight—should you be concerned?

Perhaps, says Jan I. Maby, D.O., director of the Geriatric Medical Home Care program at Mount Sinai Medical Center in New York City.

Weight usually peaks in the early forties for men and in the fifties for women, says Dr. Maby. Then as a person creeps toward 60, the amount of muscle in the body naturally drops. By age 70, a typical woman has lost about 11 pounds of muscle, and an average man has lost about 26 pounds of it.

But a weight plunge may not stop there. Add in chewing difficulties, mobility problems, chronic intestinal upset, alcohol abuse, loneliness, and financial woes that hamper your ability to buy food, and you could be facing a major health problem, Dr. Maby says. In fact, involuntary weight loss or being severely underweight can touch off a host of related problems. As your body loses weight, your bones are also deprived, so bone loss, or osteoporosis, is accelerated. Other possible complications include liver problems, nutritional deficiencies, heart disease, slow wound healing, and arthritis. If you are severely underweight, the deprivation might impair your ability to think clearly, and it can contribute to dry, flaky skin and skin sores.

If you are 15 percent or more below your ideal weight or if you have lost 5 percent of your body weight in a month without really trying, see your doctor for an evaluation, Dr. Maby says. Once you have done that, here are a few tips that can help you regain your appetite.

Try This First

Beef up your diet. Although low-calorie, low-fat meals are great for younger people, they may not be all that terrific for seniors who are underweight, says David A. Lipschitz, M.D., Ph.D., chairman and professor of geriatrics at the University of Arkansas for Medical Sciences in Little Rock. In fact, for seniors who are underweight, the health risks of a low-calorie diet may exceed the perils of being a bit more lax in your eating habits, according to Dr. Lipschitz.

“The rules of good nutrition still apply here—you just need to consume more calories,” says Marilyn Cerino, R.D., marketing director for Allegheny University Executive Health and Wellness Program in Philadelphia. “Carbohydrates are an excellent source of calories and can be combined with lean protein sources and limited amounts of unsaturated fats to help fill the void. Try mixing fat-free milk, fat-free milk powder, low-fat frozen yogurt, and bananas or strawberries in a blender for a high-protein, high-carbohydrate, low-fat drink. A bowl of cereal with fat-free milk and raisins can be a calorie booster as well,” she says.

In conjunction with your doctor or dietitian, choose calorie- rich foods that are also loaded with nutrients, like red meats, milk, and ice cream. Bagels, cornbread, and biscuits also can help you pack on some pounds. Also, consider eating regular portions of potatoes, avocados, nuts, eggs, peanut butter, kidney beans, puddings, custards, fruits such as peaches canned in syrup, and other foods high in calories, Cerino says.

“For a senior seeking to recover from a weight loss that is the result of an illness, you may want to relax the rigid rules of good nutrition during the initial recovery period and indulge in some of the foods that you normally limit to an occasional basis. Milk shakes, cheesecake, full-fat cheeses, and whole milk may appeal to a poor appetite. While they are not the recommended foods for everyday use, I would not deny them to someone who is attempting to recover a lost appetite. Oftentimes, you need to eat to get an appetite, and it is most important to at least get started—no matter what you initially choose. Of course, if there are medical conditions that require some dietary constraints, you must take those into consideration,” Cerino says.

Other Wise Ways

Shoot for six. Frequent small feedings may help the depressed appetite, Cerino says. So instead of the traditional breakfast, lunch, and dinner, try eating six small meals a day, she says.

For instance, you might start your day with an omelet or poached eggs and a piece of toast, then have a midmorning snack like fruit. For lunch, you might have a bowl of soup with added pieces of chopped chicken or lean beef and rice, and a glass of low-fat or whole milk with some milk powder mixed in. In the afternoon, try having some rice pudding with a glass of juice. A good dinner might comprise a  beef chop, a baked potato with butter and sour cream, squash or another vegetable, and milk as a beverage. Then finish off your day with an early evening snack like peanut butter crackers and milk, Cerino advises.

Use a timely reminder. Carry a small pocket alarm clock and set it to go off every three to four hours as a reminder to eat. Even if you only have a piece of bread or fruit, the alarm may help you establish regular eating times and tweak your appetite, Cerino says. If you wait for your brain to tell you to eat, you will lose even more weight, she adds.

Maximize each mouthful. Adding extra calories and nutrients to your favorite meals is actually quite easy, Cerino says. Here are some suggestions.

• Use milk in place of water in soups and sauces.

• Sprinkle milk powder into regular milk, casseroles, and meat loafs.

• Use pureed tofu in spaghetti sauce.

• Mix nuts, wheat germ, beans, cheeses, or cooked or chopped meat into pastas, casseroles, and side dishes.

• Top oatmeal and other hot cereals with melted margarine, pureed fruit, or vanilla ice cream.

Pack in the protein. Your appetite may diminish, as it often does after age 60, even if you are not ill. If that happens, increase the amount of protein in your diet to help your body retain lean muscle and keep your heart and other muscles working efficiently, Dr. Maby says.

She recommends that all adults, unless otherwise directed by their doctors, have at least 1.2 grams of protein for every 2 pounds of body weight. protein content is listed in grams on all packaged foods. If you weigh 110 pounds, for instance, you need about 66 grams a day of protein from animal products such as milk, cheese, yogurt, and other dairy products; meats like beef enderloin; and tuna fish. Other protein-rich foods include kidney beans and soy products like tofu and soy milk, Dr. Maby says.

Forget the rules. Who says that you must have bran flakes for breakfast? If you want leftover lasagna for breakfast, have it, Cerino says. Don’t lock yourself into eating certain foods at certain times of the day. Let your cravings reign until you regain your appetite.

Tune in. One in every three older people lives alone, and loneliness can shrink your waistline, Cerino says. So try watching television or reading an interesting book or magazine while you are eating if there is no one to share your meal with, she says.

Have a before-dinner nip. In moderation, alcohol stimulates hunger, Cerino says. So if you drink, prime your digestive tract by having no more than two ounces of wine or four ounces of beer about 20 minutes before you are going to eat.

Don’t forget the appetizers. Low-fat tortilla chips dipped in low-fat guacamole are a great way to get extra calories into your diet and tweak your appetite for other foods, Cerino says. Plus, low-fat tortilla chips are a good source of fiber.

Managing Your Meds

When you see your doctor about your condition, be sure to take with you any medications—including over-the-counter preparations. It may help your physician pinpoint the cause of your weight-loss or underweight problems, says Jan I. Maby, D.O., director of the Geriatric Medical Home Care program at Mount Sinai Medical Center in New York City. Possible side effects of many medications include cramping, nausea, diarrhea, malabsorption, and anorexia. A doctor’s close examination could help evaluate the cause of your weight loss.

Drugs that can contribute to unintentional weight loss include:

• Certain prescription antidepressants such as fluoxetine (Prozac) and other serotonin uptake inhibitors

• Over-the-counter decongestants that contain phenylpropanolamine or pseudoephedrine, such as NyQuil, Contac, and Dimetapp

• Nonsteroidal anti-inflammatory drugs (NSAIDs) including over-the-counter products like ibuprofen, naproxen (Aleve), or ketoprofen (Orudis KT), which can cause stomach upset and can indirectly lead to suppressed appetite and significant weight loss

Eat with your eyes. Pay attention to how a meal looks, because it really matters, especially after age 60 when senses of taste and smell begin to wane a bit, Cerino says. Use colorful plates, place mats, and napkins. “Make an effort to vary the colors and textures of the foods you eat.”

Spice up your life. If you have noticed a change in your ability to smell, then spice up your foods. Increase the flavor, says Cerino. “A great deal of the food-flavor connection comes from the ability to smell. Use a heavy hand with the seasonings to compensate.” Also, warm foods will taste better than cold foods since the flavors are transmitted better when foods are warm, she says.