How To Lose Weight With Parkinson’s Disease

Causes Of Weight Loss In Parkinsons Disease

Weight loss in relation to Parkinsons disease can occur for a number of reasons. Decreased appetite, additional energy output, and changes in digestion can slow your food intake. And this ultimately can cause a shift in body weight.

It makes sense, really. Dads tremors cause him to expend energy 24 hours a day. Thats a substantial amount of time that is spent in motion. And the body needs fuel to maintain this motion.

Dad seems to eat about the same amount, but what he chooses to eat has changed. My little sister makes sure theres a constant supply of densely packed foods, such as avocados. They juice every morning, squeezing the nutrients out of a shocking amount of produce.

Sometimes I giggle to see him eating a midnight bowl of ice cream or a handful of chocolate. Weight loss almost seems like an opportunity to eat his favorite treats. Dad looks thin, but his doctor seems to think his weight is stable.

Why Worry About Weight Loss Associated With Pd

Weight loss has been linked to a poorer quality of life and more rapid progression of PD. The reasons for this are two-fold. On the one hand, as outlined in the list above, weight loss can be a hallmark of advancing disease as it could be a consequence of more swallowing difficulties, worsened mobility, more impaired gut function etc.

On the other hand, having weight loss can further lead to poorer health. Inadequate food intake can contribute to malnutrition and vitamin deficiencies. Malnutrition can subsequently be the cause of increased susceptibility to infection, increased fatigue and increased frailty. The situation can spiral with more fatigue and frailty causing a further decrease in activity and function.

Osteoporosis, or porous and fragile bones, is more common in under-weight people since bone structure is dependent on weight-bearing. Since osteoporotic bones are more prone to fracture during a fall, this too can be a contributor to more disability and frailty. Bottom line is that it is important for your health to maintain a healthy weight.

How To Eat Well

Eat a variety of foods from each food category, like fruits, vegetables, and lean meats. If you think you need vitamin supplements, check with your doctor first.

Keep your weight in the healthy range for your age and height with exercise and a good diet.

Load up on fiber with foods like broccoli, peas, apples, cooked split peas and beans, whole-grain breads, cereals, and pasta.

Cut down on sugar, salt, and saturated fats from meat and dairy, and cholesterol.

Drink 8 cups of water every day.

Ask your doctor you can drink alcohol. It may keep your medications from working right.

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Where Can I Find Support If I Have Parkinson’s Disease And Want To Exercise

You can find exercise support in your community. For example, many gyms and community centers offer seated exercise classes for people who struggle with balance. Ask your healthcare provider for ideas if you have Parkinsons disease and want to exercise.

A note from Cleveland Clinic

Exercise is an important part of managing Parkinsons disease. Talk to your healthcare provider about your exercise program and choose activities you enjoy so you stay motivated to get up and move every day.

Last reviewed by a Cleveland Clinic medical professional on 04/08/2021.

References

What Kind Of Exercise Can I Do If I Have Trouble Standing Or Walking

Even with advanced Parkinsons symptoms, you can still reap the benefits of some activities. If you have trouble walking or balancing, hold a bar or rail to exercise and stretch. If standing or getting up is tough, exercise and stretch in a chair or bed. Physical exercise performed in a seated position, such as biking on a recumbent bike can allow you to exert yourself in a safe manner.

Facial exercises may help combat difficulties speaking or swallowing:

• Chew your food longer and more vigorously.
• Exaggerate your face and lip movements when you speak.
• Make faces in the mirror.
• Sing or read out loud.

Mental exercises give your brain a workout and can improve memory. For example:

• Name as many animals as you can in 1 minute.
• Play brain games and do puzzles.
• Solve math problems in your head.

You can also add activity in small bits throughout your day:

• Park further away from stores so you walk longer distances.
• Stretch or do leg exercises while watching TV.
• Swing your arms more when you walk, and take long strides.
• Take the stairs instead of the elevator.

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Can I Drink Alcohol

Theres no definite answer as to whether alcohol has any effect on the symptoms of Parkinsons however, like caffeine, alcohol can be a bladder irritant to some. If this is the case for you, avoiding alcohol may help alleviate urinary discomfort. Similarly, alcohol late at night may interfere with your sleep and if that is a problem for you, avoiding it may help you sleep better through the night.

Management Of Weight Loss

Patients who have Parkinsons disease will have to look towards a balanced diet that will help in giving the right quantity of proteins, calories, and other nutrients to the body to ensure that there is no weight loss. As the menu changes from one individual to another, the doctor refers to a dietician who will look into the preparation of the chart. Apart from the addition of the mentioned components, the dietician will also include vitamins, fluids, and dietary fiber that further help in preventing the occurrence of weight loss.

People diagnosed with Parkinsons disease may find losing weight in the initial stage or the final stage. In such cases, opting for high-calorie foods is preferable. The best examples are deserts, biscuits, and peanut butter, as they are rich in calories, and helps in filling the gap between the demand and supply. Furthermore, avoiding three large meals in a day is necessary and is crucial to replace the same with smaller meals at regular interval. It will ensure that the body is receiving the needed quantity of calories, proteins, nutrients, and fluids. It will also help in easy digestion. Apart from this, it is also necessary to time the intake of food in such a way that there will be no interference of protein with the absorption of levodopa. Addition of fluids will prevent dehydration and avoids the occurrence of urinary tract infections or development of kidney stones.

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/6which Exercise Should You Pick

All kinds of exercises are healthy for your body, so you should choose the ones based on your interests and capacity. With time, you can work on your stamina and training to try other exercises of interest. The main goal is to do any exercises or activities that increase your breathing and heart rate in a healthy way.

Some popular and easy exercises to include in your daily life are cycling, doing pilates, swimming, jumping rope, or simply walking and jogging.

Dramatic Weight Loss In A Patient With Parkinson Disease

Heidi Moawad, MD

Editor’s Note:The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please .

Background

A 67-year-old man who was diagnosed with Parkinson disease 8 years ago has experienced recent, unintentional weight loss. He lost 30 lb over the course of 12 months. He is 6’1″ tall and his weight is now 136 lb , giving him a body mass index of 18 kg/m2, which is slightly underweight.

The patient has never been overweight. His cholesterol and blood glucose levels were previously in the upper limits of the reference range. However, he has not recently been dieting or trying to lose weight. He states that he has not paid much attention to how much he has been eating lately.

Other than Parkinson disease, the patient does not have a significant or relevant medical history. He has been taking a combination of amantadine and carbidopa/levodopa, with good control of his motor symptoms. His Parkinson disease is mainly characterized by a resting tremor in his left arm muscle rigidity in all four extremities a flat affect and a slow, shuffling gait.

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Managing Your Parkinson’s And Weight

If you are concerned about the amount of weight you’ve lost, speak to a healthcare provider. Beyond evaluating your Parkinson’s progression, here are some tips that may help you manage your weight:

• Make mealtime an enjoyable experience. Add spices and seasonings to foods to compensate for a decreased sense of taste. Take a look at the aesthetics of eating. Improving the mood with a tasteful table, music, even candles can sometimes be as important as improving the taste of foods. Make sure you have an adequate amount of time to eat. Feeling rushed can be a hindrance, especially for those whose digestive tract smooth muscles are working more slowly than normal.
• Work with professionals. Seek treatment for depression and other mood disorders you may have. You should also ask a healthcare provider if your medications need to be adjusted as some of these may contribute to weight loss. You can also work with a nutritionist or try nutritional supplements. You can also work with a trainer or physical therapist to boost your activity. Adding a little exerciseeven a small amount of physical activitymay stimulate your appetite.
• Optimize your meals. Choose high-calorie foods whenever possible and don’t be afraid to eat the foods you most enjoy. You should also eat at the times of day when you have the most energy as well as skip liquids and drink them after a meal instead of before or during the meal, if possible.

Cognitive Impairment And Depression

The dementia is more common and severe in the late stages, the prevalence of which is about 20% of PD cases in cross-sectional studies and 80% in longitudinal studies . Furthermore, mild cognitive impairment may be present early in the course of PD. The characteristics of cognitive impairments in PD are attention, executive dysfunction and visuospatial processing deficits , which may be implicated in eating behavior. Several studies have indicated that PD patients with impaired cognitive function tend to be at increased risk of weight loss , while another study has not observed this correlation . It is important to note that some studies excluded patients with dementia or cognitive dysfunctions from their sample and this exclusion criterion might sweep the relation between cognitive decline and weight loss under the carpet. Intriguingly, although patients treated with DBS may experience weight gain during a follow-up period, subtle cognitive declines has been announced after the surgery by some studies . This cognitive side-effect questions the effect of cognition on weight loss in PD. Thus, further studies are needed to corroborate the relation between cognition and weight loss in PD. Since cognitive deficits progress with the disease, a long observation time would be needed and patients with different severities of cognitive decline should be included.

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Is There Anything I Can Do With My Diet To Manage The Side Effects I Experience From All Of The Medications I Take

Depending on the side effects you experience, there may be ways to help minimize them with your diet. For example, if you experience nausea, eating bland foods like saltines and cold liquids may help, as can eating slowly and in smaller portions. Again, if your side effects are unbearable, talk to your doctor as soon as possible to see if they can adjust your medications or suggest other alternatives. Unfortunately, theres been no evidence to suggest that the food you eat can eliminate side effects altogether however, experimenting with various nutrition plans may certainly help you manage them better.

Aspect : Weight/malnutrition Status In Pd

Weight loss and malnutrition are not benign phenomena during the course of PD. PD patients in low BMI group showed lower scores of the K-MMSE and 3MS compared to stable BMI group, implying the potential relation between weight loss and cognitive decline in PD patients . Low BMI and malnutrition is one such risk factor for osteoporosis in PD patients, which deserves more attention for the concomitant risk of fractures . In addition, a growing body of evidence suggested weight loss and malnutrition in PD was associated with worsening life qualities . With respect to survival, only one study explored the association between changes in BMI and survival among persons with PD . According to this study, changes in BMI was not associated with survival after adjusting for covariates although there was inverse correlation between BMI changes and UPDRS score variations. One thing to note is the low number of death in the study limits the results. Moreover, low body weight patients tend to receive significantly higher daily dose of levodopa per kilogram body weight, which may contribute to developing dyskinesias .

Table 1. Summary of literature on weight change in PD patients.

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Why People With Parkinson’s Tend To Lose Weight

There are many theories about the origin of weight loss for people with Parkinson’s disease. Some believe a loss of smell, which can affect appetite, leads to weight loss as well as increased energy expenditure and fat burning due to tremors and dyskinesias. Other theories point to mood disorders related to Parkinson’s disease such as depression. Yet, none of these factors have been definitely confirmed as the sole cause of weight loss.

If you have Parkinson’s disease, you may also have gastrointestinal dysfunction, which is believed to be the most likely cause of weight loss. Comorbid conditions like gastroparesis and decreased bowel peristaltic keep food from moving through the digestive at a normal pace. This decreased motion of smooth muscles in the digestive tract and elsewhere with the disease is often referred to as “autonomic dysfunction,” and may lead to weight loss.

How Hard Should I Exercise If I Have Parkinson’s Disease

A rating of perceived exertion is a good way to measure intensity. On a scale from 0 to 10, 0 would be how you feel while sitting or lying down, while 10 would be the maximum effort you can give. Building up to an effort between 5 to 8 means you are exercising at a high intensity. A good gauge is, if you can have a conversation with someone while exercising, you should probably increase your intensity.

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Common Causes Of Weight Loss

There are many factors that may cause or contribute to weight loss:

• Some PD medications can cause nausea, which may suppresses appetite.
• The motor symptoms associated with PD, including tremors, rigidity and muscle cramps, can make it more difficult to eat.
• Its extremely common for people with PD to lose their sense of taste and smell.This can make eating less enjoyable and lead to decreased caloric intake.
• Swallowing often gets increasingly difficult as PD progresses and can interfere with eating and contribute to weight loss.
• Dietary protein may interfere with PD medications like levodopa . This can make it tricky to intake protein and get adequate nutrition. For more information regarding your diet and PD see our earlier article. More information can be foundhere.
• Non-motor symptoms such as depression and apathy may cause people with PD to lose their appetite.
• Some people with PD may feel uneasy in their slow eating habits and stop eating prematurely.

While weight loss is common for those living with PD, prolonged, unexplained weight loss is not. Its important to talk to your doctor if you experience this symptom, as it may be a sign of other medical issues.

Ive Heard A Lot About The Benefits Of Drinking Coffee Lately Is It Really Beneficial For People With Parkinsons

It is not clear whether there are any benefits to drinking coffee for people with Parkinsons. The consensus from the Parkinsons Foundation is that drinking coffee has no measurable benefits on the symptoms of Parkinsons, but neither should it worsen symptoms in most cases. The majority of the recent research that has come out about coffee has to do with its ability to reduce the risk of developing diseases such as Parkinsons and Alzheimers. Once you have already developed Parkinsons, its benefits are debatable.

So, provided it doesnt irritate your stomach, coffee is okay to drink, but you should talk to your doctor about any symptoms associated with drinking caffeine . Coffee can help if you suffer from daytime sleepiness, but consider having your last cup before the afternoon as caffeine late in the day can interfere with your sleep cycle if youre especially sensitive to it.

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Theres A Lot Of Information Out There About The Link Between The Gut And Brain And Inflammation In Diseases Such As Parkinsons And Alzheimers Whats Important For Me To Know About It And What Are Some Of The Healthiest Anti

The bottom line is that despite increasing evidence that theres an association between Parkinsons and gut health, our understanding is incomplete.

Studies have found that there are lower levels of Prevotella, a good gut bacteria in people with Parkinsons and higher levels of inflammatory bacteria, but more research is needed to understand the connection to Parkinsons. Still, eating a diet rich in anti-inflammatory foods is generally found to be beneficial for your overall health and theres no harm in including anti-inflammatory foods in your diet if you can tolerate them.