Weight Loss Not Normal for Aging

Do you think it is “just aging” to lose your appetite midmeal, push the plate away half-finished and eventually lose weight? If you don’t challenge this assumption, you or a relative could drop pounds unnecessarily and risk malnutrition.

This mistake was made with my 96-year-old friend Susan, who was already tall and thin. During the last two years of her life, she ate progressively smaller plates of food. Ever so slowly she lost weight. None of us thought to investigate the cause. Everyone thought it was “age.” Then, while Susan was in the hospital for a broken hip, doctors discovered an ulcer. It had been there a long time.

I wish Susan had known Dr. John Morley from St. Louis University’s Division of Geriatrics. He is overflowing with information about seniors’ nutrition problems. During a phone interview he said, “the stomach actually holds less food as we age. Add to that an illness and loneliness, and seniors are at risk for weight loss and malnutrition.”

Morley believes a proper medical assessment should ferret out the causes of an eating decline. He said there are 13 typical reasons for the decline and to help us remember them, he created an acrostic. It is based on the title for the nationwide delivered lunch plan “Meals On Wheels.”

M: Medications can dampen appetite, such as the heart medication Digitalis.
E: Emotional problems, such as depression, elder abuse and neglect.
A: Alcoholism. For example, towards the end of her life, my stepmother only wanted a mixed drink of skim milk and vodka while she adamantly refused nutritious meals.
L: Late in life paranoia, such as fears that their food has been poisoned.
S: Swallowing problems from, say, a stroke.
O: Oral problems, such as lousy dentures or untreated cavities.
N: No money to buy nutritious foods. Seniors with limited cash use their food money to buy their prescription drugs.
W: Wandering from the table due to Alzheimer’s.
H: Hyperthyroid or metabolic problems.
E: Endocrine system malfunctions.
E: Eating difficulties, such as the senior can’t feed himself and needs much assistance.
L: Low salt and low cholesterol meals that are tasteless and may not be needed in your 80s or 90s.
S: Shopping and meal preparation difficulties.

Also, Morley strongly feels that isolated eating is a big culprit. In an experimental study, instead of just delivering the noontime meal, the Meals On Wheels delivery person sat with the elder as she/he ate. With extra human contact, the senior ate more. Morley also did a study that strongly supported communal eating as a boost to appetite.

The bottom line is for seniors to get a thorough medical evaluation. You can also ask for a referral to a registered dietitian through your hospital or a home health agency. For more of Morley’s thoughts on the subject, along with a senior health questionnaire, go online to www.thedoctorwillseeyounow.com. For Meals On Wheels or noontime lunches at senior centers call the area Agency on Aging, 800-510-2020.