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Parkinson’s Disease And Weight Loss

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Weight Loss in Parkinson’s

For many individuals with PD, there comes a point where additional care and support are needed to complete their daily activities. Our communities offering Parkinsons care are equipped with everything a person needs to live their life as they manage a PD diagnosis.

Are you curious if Walker Methodist is the right next step for you or your loved one? Schedule a tour and see for yourself.

No Matter What I Do I Keep Gaining Weight Whats Happening And What Can I Do About It

Weight gain is another common side effect that can occur from a decreased ability to exercise or as a result of gastric emptying, in which you may feel like youre uncontrollably gaining weight despite not eating much. The discrepancy may have to do with your body going into starvation mode as it tries to recalibrate your energy input and output. Again, the best course of action is to speak with your doctor about a weight loss plan that aligns with your specific issues and goals. Also, you might consider an anti-inflammatory diet if youre suffering from weight gain associated with gastric emptying.

Why Weight Loss Is Concerning

Researchers have found that weight loss, defined as the loss of an average of one pound per month, is linked with a significantly lower quality of life. Though weight loss was not found to lower survival, the small sample size of some of these studies makes a true judgment of the effect of weight loss on survival difficult to assess.

One concern is that people with Parkinson’s disease appear to be at a higher risk of osteoporosis, and osteoporosis is a significant cause of both illness and death in older adults. Weight loss has been found to increase the risk of osteoporosis in people with PDpeople who already have an elevated risk of developing osteoporosis. Weight loss also increases the risk of pressure ulcers , another condition which is already increased in people with PD due to a redistribution of body fat and restriction of movement. More than just weight loss, Cachexia is another concern and is considered a significant cause of premature death.

One study found that those with PD who lost weight had faster disease progression. However, researchers aren’t sure if weight loss causes Parkinson’s to worsen or if weight loss is the result of the more severe disease.

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Preventing Parkinsons Disease Weight Loss

Walker Methodist | Apr 5, 2022

If youve ever known someone with Parkinsons disease , you may have noticed meal times can be difficult. Between a loss of appetite and the presence of tremors, its common for someone with PD to begin losing weight.

At Walker Methodist, we work closely with our residents with PD to make sure they can gain or maintain their weight while keeping as much independence as possible.

These simple steps can help someone with PD live more comfortably.

Predictors Of Weight Loss In Pd

Parkinsonism causes, symptoms, diagnosis, treatment &  life expectancy

Increased energy expenditure

Despite eventual weight loss, PD patients increase their energy intake by about 350kcal/day, mainly due to increased carbohydrate intake .2). This suggests that weight loss is induced by increased energy expenditure . Indeed, metabolic studies had shown that resting EE is increased in PD in ON and OFF-medication state. The main factors for this increase seem to be dyskinesia and rigidity . Consequently, when patients with severe dyskinesia were excluded, resting EE was not increased . Dyskinesia and rigidity as well as tremor may be considered as spontaneous physical activity, like standing or fidgeting. In healthy volunteers, it was shown that spontaneous physical activity may account for EE up to 700kcal/day . If this is not compensated by energy intake, weight loss is inevitable.

Mechanisms of body weight loss in PD. Mechanisms of body weight loss in Parkinsons disease according to the stage of the disease. Factors with important contribution to weight loss are dark grey.

Impaired homeostatic regulation of energy metabolism

Ghrelin, the gastric «hunger hormone» is reduced in PD and has even been considered as a potential biomarker of the disease . This could be due to impaired gastric mobility and contribute to weight loss in all stages of the disease . Furthermore, evidence from studies with rodents indicate that hypothalamic leptin signaling might be enhanced in PD .

Impact of dopaminergic treatment

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Why People With Parkinsons Tend To Lose Weight

There are many theories about the origin of weight loss for people with Parkinsons 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 Parkinsons disease such as depression. Yet, none of these factors have been definitely confirmed as the sole cause of weight loss.

If you have Parkinsons 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.

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Increased Resting Energy Expenditure

Using indirect calorimetric methods, Levi et al. and Markus et al. consistently observed increased REE, which was significantly associated with muscle rigidity, both in the untreated state and treated state . In consistency with the results, Marianna et al also found that REE was higher in the off state, and could be decreased by 8% after dopaminergic therapy . In contrast, Delikanaki-Skaribas et al. and Toth et al. reported that there was no difference in REE between neither PD patients and healthy controls nor weight loss and weight stable PD patients. Moreover, according to recent data, normalization of REE may contribute to the weight gain after DBS surgery . However, other authors reported that REE remains unchanged in PD patients treated with STN-DBS .

I Was Telling Someone At My Parkinsons Support Group About The Pains I Have In My Stomach And He Mentioned Something Called Gastric Emptying What Is It And If Thats My Issue What Can I Do About It

Parkinson’s & Weight Loss Success Story

Gastric emptying or gastroparesis relates to a delayed movement of food from the stomach to the intestines that can cause stomach pains, bloating, nausea and feelings of uncomfortable fullness after only a bite or two of food. Its not known whether this condition is associated with Parkinsons itself or levodopa treatment, but whether it is or isnt, there are a few things you can do to address your symptoms such as trying smaller but more frequent meals of easy-to-eat anti-inflammatory foods and limiting caffeine, alcohol, grains and dairy. Currently, there is no medication for gastric emptying that is compatible with people with Parkinsons, but you can talk to your doctor and your nutritionist about other possible strategies and treatments.

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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.

Other Symptoms That May Contribute To Weight Loss In Pd:

  • People with difficulty swallowing associated with PD will typically slow down their eating and reduce their consumption in an attempt to eat without coughing or choking.
  • PD often causes slowed transit of food through the gut which can impact absorption and cause weight loss
  • Mobility issues and tremors may impede the ability to buy groceries, prepare meals, and eat, all contributing to reduced food intake.

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Dietitians Speech Pathologists And Mental Health Experts Can Help Too

Talking to a registered dietitian can help you make changes to your diet for example, by learning how to use thickening liquids or soften solid foods.

If swallowing continues to be a problem, a speech-language pathologist may be able to help you find ways to make swallowing easier.

A speech pathologist who is also a swallow therapist can do a swallow study, a test during which you try different foods and they monitor how you swallow using an X-ray machine, Subramanian explains. Food aspiration, or when food gets into your lungs, can be a problem with Parkinsons disease, so the swallow study can identify problem foods and your doctors can recommend changes and diet modifications to make eating safer.

Finally, as anxiety or depression are common in people with Parkinsons and can suppress appetite, its important to recognize symptoms associated with these behavioral health conditions and seek out treatment if needed.

Determinants Of Weight Loss In Parkinsonism

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The multivariable Cox regression model examining the determinants of weight loss was constructed for all 275 parkinsonian patients. Variables included and excluded from the models of outcomes of weight loss are listed in . At diagnosis, parkinsonian patients who went on to develop sustained weight loss at any time after diagnosis were on average 4.5 years older and had a 1-point-higher median part I Unified Parkinsons Disease Rating Scale score than those without sustained weight loss .

Multivariable Cox regression models for time to weight loss and time to selected outcomes in parkinsonian patients

After multivariable adjustment, only age was independently associated with developing sustained clinically significant weight loss at any time after parkinsonism diagnosis . There was an indication that atypical parkinsonism may be associated with greater weight loss than PD . The association between lower dependency measured by the Barthel Index and weight loss after adjustment for age and diagnostic group was probably spurious because of collinearity.

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Body Mass Index And Weight Variability

Weight and height have been measured at baseline and annually. BMI was calculated as weight in kilograms divided by height in square metres. Weight variability was calculated by the average successive variability method. In detail, weight variability was determined by calculating the averaged absolute values of the differences in weight between visits. PD patients were then stratified according to the median value of ASV into patients with Stable Weight or Unstable Weight . Unstable Weight patients were further divided according to the directionality of AVS into the weight loss group and weight gain group .

Concluding Remarks And Future Perspectives

Increasing evidence has suggested weight loss is commonly observed in patients with PD. Notably, with the global epidemic of obesity and increased application of modern therapeutic measures such as dopamine agonists and DBS, normal weight even overweight may be also frequently reported in PD patients nowadays. An early identification of patients at risk of weight loss might be of some help to develop measures to prevent weight loss. Recently, only two groups of researchers have assessed profile of weight changes in PD patients among PD subtypes . According to the studies, the anosmic group and non-tremor dominant subtypes are associated with weight loss in PD among the different phenotypes respectively. Hence, early detection of olfaction impairment may be predictions for weight loss in the early phase of PD although further corroboration is needed in the future.

Weight loss is not an independent pathogenesis but seems to be coupled with PD pathogenesis as demonstrated in AD . In AD, weight loss is one of the criteria for the clinical diagnosis of dementia. Likewise, in the context of PD, weight loss may precede the motor symptoms and be considered as an index for disease progress. To address the crosstalk between weight loss and PD is quite necessary and metabolic manipulation may provide a therapeutic alternative in the treatment of PD in the future.

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How Weight Loss Can Impact Your Life

Weight loss can have a significant impact on the quality of life of people living with PD and can lead to additional health complications further down the road. Inadequate food intake can result in vitamin deficiencies that may increase the risk of fatigue, frailty and infection. Fatigue and lethargy may cause a decrease in physical activity, which is crucial for alleviating many of the physical and mental symptoms associated with PD.

There is evidence to suggest that early weight loss can increase the severity of PD symptoms . This is possibly due to the involvement of the neuroendocrine system or the gastrointestinal nervous system. Further research is needed to understand the relationship between weight loss and PD progression.

How To Boost Appetite

Weight Loss in Parkinsonism

If a person has a low appetite due to an underlying medical condition, treating the condition may improve it.

For longer-term causes of low appetites, such as cancer, the Pancreatic Cancer Action Network suggest that people adjust their eating habits to increase their desire for food by:

  • eating foods that look and smell good using aromatic spices and herbs to enhance flavour making meals enjoyable
  • planning meals the day before
  • drinking plenty of liquids

As other lifestyle factors, such as sleep, exercise, and stress, also influence appetite, PanCAN recommends:

  • getting enough rest
  • taking medications to reduce nausea, if appropriate

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How Can Parkinsons Patients Gain Weight

According to a review of the scientific journal on Parkinsons disease, published by the SISSA research scientists states that the weight of patients suffering from Parkinson disease can be affected by the non motor symptoms associated with the disease. Along with influencing the food habits and changing body weight, the disease also impairs the persons ability to derive pleasure from food and discourages any motivation. These studies are helpful in understanding the ways to reduce the adverse effects of the Parkinson disease which aggravates an already harmful medical problem.

There are a series of changes in body that a patient of Parkinsons go through they may lose or gain a large amount of weight depending on the stage of the disease or they may also end up putting ten kilos after deep brain simulation . These only add to the plight of the patients and negatively affect the quality of life which is already in distress by the non responsive motor disorders. Hence, it is vital to understand the issues causing it. The body weight and eating habits of Parkinsons patients change as the disease progresses. Studies reviewed on the Parkinsons that provided data on the association between non-motor symptoms and dietary habits and body weight evaluated some factors which, beyond the motor symptoms and drug treatments, might play a role in this problem.

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Weight Changes In Pre

In prospective American cohort or casecontrol and Chinese epidemiological studies, a decrease of body weight was reported several years prior to diagnosis .1). On the other hand, large Finnish and Japanese cohort studies reported a weight gain in pre-diagnostic PD . The same result was found in the Honolulu Heart Program which included Americans of Japanese origin . No association between PD and BMI before or at disease onset was reported for the Greece EPIC population , the UK-based general Practice Research Database , and in Italian casecontrol studies . As degeneration of the dopaminergic system begins years before diagnosis , BMI variation may reflect a dysregulation of dopaminergic control of eating behavior rather than modification of energy metabolism in pre-motor stages of the disease. Apathy, depression, and anxiety are frequent in de novo PD and eating disorders may also appear in response to these negative emotional state. In the general population, a strong association between depression and overweight has been described which may be due to sub-threshold eating disorders described as emotional eating , increased snacking , or increased sweet preference . Alterations of eating behavior have been described in de novo PD, prior to treatment .

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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.


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