Preventing Weight Loss during Cancer Treatment
by Colleen Gill, MS, RD, CSO
Three common problems lead to the rapid weight loss associated with many cancers and cancer treatments. Without hunger, it’s easy to forget to eat. When food no longer tastes right, there’s little incentive to finish. Filling up on half the food you could previously eat thwarts anyone’s best intentions.
Regardless of your starting weight, rapid weight loss isn’t healthy. Losing two pounds per week is the result of a shortage of approximately 1,000 calories a day. Such famines change the way food is used. Protein is no longer saved but is burned to provide the calories required to keep your body running. Muscle is broken down to provide needed protein, and you lose strength. To limit the amount of muscle lost, your body cuts back on the proteins it builds, leading to slower healing and poorer immune function. Your oncologist may delay treatment cycles to allow you to recover, interrupting the schedule that research shows is most effective.
Add in only the extras you need to avoid rapid weight loss, and check your weight weekly
The following strategies can help you maintain your weight during treatment:
♦ Schedule small, frequent meals and snacks. Eat or drink something every two and a half to three hours. Think of it as taking a scheduled “dose” of food like you would take a dose of medication. Cell phone alarms serve as great reminders.
♦ Create a list of options and ideas for meals and snacks. Post the list on your refrigerator and continually update it. Editing a list is easier than creating one from scratch, and caregivers can help you shop for and prepare the foods on your list. Your list should include foods that add calories, such as avocado or guacamole, nut butters, olive oil, and dressings, in order to maximize your efforts to maintain your weight. Rotate different foods to keep variety in your diet and avoid burnout. If they agree with you, include stronger flavors to improve taste.
♦ Make it easy for yourself. Ask yourself, “What do I think I can tolerate today?” Keep snacks nearby, and if it’s difficult for you to get up and move around, pack a cooler to put next to your chair. Divert yourself from the work of eating and drinking by pacing bites with TV commercial breaks. After a program ends, get up and walk around the house for five minutes. Exercise improves appetite and aids in digestion.
♦ Try high-calorie drinks as snacks or meal replacements. Regular or chocolate milk, milkshakes, smoothies, eggnog, and commercial drinks, such as Ensure, Boost, or their generic versions, are good choices. Orgain is a popular organic option. Scandishakes, Substimeal, Carnation Instant Breakfast, and Ovaltine offer powders that can be added to milk. Juice-like options with protein, such as Resource Breeze, Ensure Clear, Odwalla, Naked Juice, or Bolthouse Farms juices provide a change of pace.
♦ Make every bite count. Limit lowcalorie foods and drinks, such as diet sodas, tea, coffee, and lean or light versions of foods. Some junk food, like ice cream, tacos, pizza, and hamburgers, can provide needed nutrients. When you can’t eat as much as you used to, choose foods with calories packed into small volumes.
Still Losing Weight?
Continued weight loss means something is still in your way. If you’re too tired to cook, simplify food preparation. Frozen or microwavable meals are quick and easy to cook and create fewer dirty dishes. Enlist friends and family to help with cooking, and give them recipes for dishes you like. Freeze any leftovers to reheat for later. Drink enough fluids to avoid dehydration. If you’re experiencing diarrhea, constipation, nausea, or pain, talk with your doctor about how you can manage these side effects.
Eat enough to avoid losing weight rapidly, but avoid excess. Add in only the extras you need to avoid rapid weight loss, and check your weight weekly. Not all cancers or treatments lead to weight loss, and weight gain is rarely a goal.
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Colleen Gill is a nutritionist, registered dietitian, speaker, author, and board certified specialist in oncology nutrition. She has worked with cancer survivors at the University of Colorado and in private practice in Denver for over 20 years, and she is active in the Oncology Practice Group of the Academy of Nutrition and Dietetics.
Dietitians who specialize in oncology can help you establish your weight management goals. Locate one near you at EatRight.org by clicking the “Find a Registered Dietitian” button on the homepage.
This article was originally published in Coping® with Cancer magazine, March/April 2013.