How can my 75-year-old mom gain weight?
July 26, 2014 7:04 AM   Subscribe

My 75-year old mom has always been naturally thin, but for the last couple of years she's been underweight to an unhealthy level. She seems worse now. I'm not sure how much weight doctors want her to gain, but probably at least 10 pounds if not more. She's been trying to eat things to help (avocadoes, peanut butter, some protein shakes sometimes) but she says she has trouble digesting anything with a lot of fat. She's also vegetarian and often also vegan, though she eats dairy and eggs occasionally. What should she be eating?
posted by three_red_balloons to Health & Fitness (15 answers total)
If she's avoiding fats, she should eat more carbs. Bread, spaghetti, fruits.
posted by cacao at 7:16 AM on July 26, 2014 [1 favorite]

If she isn't diabetic, she might need to eat more carbohydrates. The things you list would all appear to be relatively low-carb foods and a low-carb diet is often used to lose weight, for overweight people at least.
posted by XMLicious at 7:16 AM on July 26, 2014 [1 favorite]

Yes, another vote for carbs! The Standard American Diet is basically designed for weight gain and munching-enhancement, and always outperforms other diets at causing weight gain in lab mouse models. Straight-up sugar might not be optimum (blood-sugar issues) so complex carbs in the form of crap foods might be the better option -- things like Doritos, cake, cookies, crackers, toast, crumpets with jam, popcorn, etc, etc. And, bonus, many of these things are vegan or vegetarian.

For most people it's difficult to overeat on straight fat or straight protein, but it's very easy to overeat on carbs or carbs plus fat.

Also, long shot, but -- have her doctors run her thyroid numbers? I have a family member who had issues with hyperthyroid (which can cause weight loss) when her doctors lost track of her Synthroid dosing (and hyperthyroid can also happen for other reasons, of course). It was super-non-obvious because she was also on beta blockers, which blocked all of the normal side effects (until she started having issues swallowing, at which point they realized what was going on).
posted by pie ninja at 7:28 AM on July 26, 2014 [2 favorites]

Thanks, just to add--she does eat quite a bit of carbs, although she just doesn't seem very hungry anymore, so her portions are never big. She doesn't seem to be able to force herself to eat a lot.
posted by three_red_balloons at 7:28 AM on July 26, 2014

She needs some fat and protein in her diet, but calories make you gain weight. More carbs. Pasta?
posted by J. Wilson at 7:29 AM on July 26, 2014

We went through this with my mother recently. What we did was switch to small but very frequent meals. We would prepare something for her every hour. Even if she only took a few bites, we'd convince her to try again in another hour. The small servings helped with digestion and the total daily amount was larger than she had been taking in.

We also went through her favorite foods and found way to increase their calorie content. For example, she loves malts so we made them from ice cream, Ensure and protein powder. Not vegan obviously, but maybe you can find vegan equivalents.

It was difficult, she didn't feel like eating, and we spent many hours convincing to eat something. But it did pay off and she's physically much better now.
posted by beowulf573 at 7:31 AM on July 26, 2014 [3 favorites]

Is she drinking any kind of high cal supplement shake? Resource, boost plus, ensure plus and the like have around 500 calories per 8 oz serving.
posted by pintapicasso at 7:33 AM on July 26, 2014 [3 favorites]

My father had the same problem at age 81. And if you are really thin, gaining 10 pounds takes a lot of change in your eating pattern. I went with him to the doctor to discuss this. He ended up prescribing Nutricia Protifar. Much to my surprise it worked very quickly. Not sure how much he gained, but somewhere around 8 pounds in a month. It is not the sort of stuff that you consume for fun (my father was in the hospital back then). But apart from the gain in weight, he became a bit more energetic and slept better. So, all in all, I recommend this or a similar product.
posted by ouke at 7:34 AM on July 26, 2014 [4 favorites]

One though that occurs to me is, has she gone on any new medications during the past couple of years? If there's a new one that tends to reduce appetite, perhaps her doctor could try switching to a different medication with different side effects.

And how about diet-wise, everything she eats she wraps in a tortilla for enhanced carb-density.
posted by XMLicious at 7:39 AM on July 26, 2014

Start drinking calories too. Juice and whole milk instead of water.
posted by Jacqueline at 7:42 AM on July 26, 2014 [4 favorites]

When my grandmother was struggling with major underweight issues and wasn't very hungry, by far the most effective and easiest thing for her were the high calorie supplement shakes like Ensure.
posted by Lutoslawski at 7:43 AM on July 26, 2014

My mom had this problem - it wasn't so much that she was eating the wrong things, it's that she wasn't hungry and wasn't eating enough, and it didn't occur to her to eat when she wasn't hungry, so the problem snowballed. She ended up doing two things that really helped; one, she added shakes between meals on the instruction of her doctor (Ensure type), and two, she set an alarm for eating times. When it beeped, she ate something. The advice above to drink whole milk, if she can, is extra important because when older women are too thin, they have less padding when they fall, and if they have osteoporosis, they can easily break bones.
posted by juniperesque at 7:45 AM on July 26, 2014 [3 favorites]

Even if she doesn't use a smartphone--I have appetite issues due to anxiety and medication, and have also been running really dehydrated. This is now my schedule in Sleep As Android, with alarms set with generally not-very-obtrusive tones for both mealtimes and water. If she could get some kind of device that would run such a thing, it's turned out to be a really handy way of managing a whole huge list of things that I need nudging about many times a day. And I don't have to re-set it for the next thing on the list, everything just goes off at the same time every day. She may or may not be comfortable with such a thing, but my stepdad's in his 70s and buys fancier phones than I do, so clearly people in that age bracket can learn!

I can't do calorie tracking personally, but it would probably also be a good idea if she can to actually record, including quantities, everything that she's consuming over the course of, say, three days, and add up what the actual numbers are, and see what her actual patterns are, not just what she thinks they are. Even without calorie numbers, that helped me to realize that my biggest problem was not dinner, which always felt like the biggest fight, but breakfast and lunch, which I was routinely skipping and was making dinner feel a lot harder. It's hard to adjust habits if you don't know what they are.
posted by Sequence at 9:04 AM on July 26, 2014 [1 favorite]

When my elderly relative was underweight, we made him ice cream shakes. It was the only thing he would consume in large quantity. That's probably because he LOVED ice cream shakes. What's your mom's favorite food? Is there anything she loves so much she'll eat it all the time?
posted by Cygnet at 9:04 AM on July 26, 2014

three_red_balloons: "Thanks, just to add--she does eat quite a bit of carbs, although she just doesn't seem very hungry anymore, so her portions are never big. She doesn't seem to be able to force herself to eat a lot."

When I was pregnant, not hungry, and needed to gain weight, and I felt like I would barf and then DIE if I had to drink one more protein shake or milkshake, I drank a lot of Dunkin Donuts Strawberry Coolatas, which is basically icy strawberry sugar water. It's 230 (all-carb) calories in something that drinks like a glass of water, so it didn't make me feel uncomfortably full and I could manage to drink it when I didn't feel hungry or food seemed repulsive.

Dunkin Donuts just happened to be the place closest to my house; every coffee place or fast food restaurant on the planet has some form of sugary slushy on offer. I would drink one in between meals, like I would a glass of water otherwise.
posted by Eyebrows McGee at 9:20 AM on July 26, 2014 [1 favorite]

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