Weight worries

JMack88

I'm wondering about what other people experience with their loved ones who worry about their weight.

I'm trying to organize my thoughts on this so they make sense in this message.  I saw someone else's message regarding sugar and it made me want to ask this.

My entire life, mom struggled with her weight.  She tried every diet that came along.  She was in and out of Weight Watchers. She yo-yoed but was never happy with her weight even when she was thin.

Now, she lost a LOT of weight between caring for my dad in his last days and until we realized what was going on, she was forgetting to eat meals.  She'd just snack on a yogurt or granola bar instead of eating a meal.  The doctor says she's ok, but she's just skin and bones and I worry she might have a form of anorexia.

She insists on weighing herself every morning.  She is never happy with the results and claims she's gained 5-10 lbs. every time she weighs herself.  She reads the labels on every food and refuses to eat foods she considers having too many calories.  When served food on a plate she never eats the full serving, she always holds back half - which she puts in the fridge to "eat later" except most of the time later never arrives because she forgets about it.  If she serves herself she'll put at most 3 normal bites of food on her plate and refuse anything more than that.  

Out of fear of malnutrition we luckily have convinced her to drink an Ensure every day.  She will open the bottle and drink half in the morning and half in the afternoon.

As the other person noticed, mom seems more interested in eating sweet things.  She asks after every meal if we have dessert and wants some cookies or candy or something sweet.  Then she wants to go for a long walk to exercise the calories off.  Even though she has bone on bone arthritis in her knee and we are trying to keep her from aggravating it.

She constantly asks us if we can lose weight and if we have been tested for diabetes.  Then she starts asking us if we have wills.  This touches on a sore spot with me because I know I am overweight and am trying to improve but I refuse to do fad diets and yo yo like she did. 

Does anyone else go through this?

Quilting brings calm

My MIL was hyper focused on her ( and everyone else’s ) weight.  She supposedly had dementia, but none of our generation could see it.  She was sharp as a tack.  I asked her once if she would rather sit next to an axe murderer or an overweight person.  Her response- she did not want to sit next to a fat person.  My husband started calling her on it when she began insulting our son, a child at the time.  

I don’t know how you get her to stop- we couldn’t . 

As to the desserts - treat her like we were treated as a child.  You only get dessert if you eat your meal. 

ninalu

Hi JMack88,
Food and weight can be a tricky issue in families. Some of the behaviors you mention sound potentially troublesome (disordered), e.g. 

- Eating only a few bites of food and then being full or done
- Weighing oneself frequently (daily or more)
- Being very thin but seeing oneself as normal or overweight (distorted body image)
- Criticizing others' bodies and eating 

I hear a lot of things going on in your description of your mom; forgetfulness, caregiving, maybe grief (caring for your dad) combining with lifelong habits around slimness, dieting, eating and exercising. Possibly all these things are coming together and combining in scary ways? In people without dementia, troubled eating can happen in response to life stressors - some people stop eating, some people eat too much, some people become perilously concerned with their body image. I don't know about the intersection of dementia and eating disorders. I find myself wondering how your mom's appetite is now and how that compares to other times in her life? 

In my own family, we've had our share of wonky food and body-image stuff. My mom was never bone-thin but she always rigorously (religiously?) managed her weight. As she aged, and especially as her judgement seemed to be affected, her PCP ran labwork to ensure she was sufficiently nourished; things like B12, Folate, Thiamine, Zinc, Magnesium, Iron / Ferritin, + Blood chemistry (electrolytes) + others as needed. How did your mom's doctor determine that she was "fine" - do you know? (Good on you to bring in Ensure.) 

An anecdote from early in my mother's journey with dementia:
She and I were out on an errand; standing in line at the bank. A woman (or man, I can't remember) walked past us and my mother said, loudly, 'It's just horrible when people don't care and let their bodies get so fat."
I was mortified. The other person must have heard my mom but didn't look or respond in any way. I looked at my mom, ready to chide her, but her face showed a look of care and concern, not disgust, not meanness. I don't think she knew that it was hurtful and inappropriate to say what she said. I think the comment reflected her historic, cultural, lifelong training as a woman AND that dementia was affecting her judgement and choice of words. 

I hope you find a good answer to what is going on with your mom. 

Cynbar

My DH went through a stage where he lost his filter and thought nothing of commenting on someone's appearance, always in a negative way. I suppose I should be grateful he wasn't oogling pretty women, but he would zero right in on someone who was overweight or sloppy or poorly groomed. It was especially a problem in restaurants, where the waitresses were captive audiences. Of course, there was no reasoning with him or convincing him how hurtful this could be. Thank goodness, that stage pretty much passed on its own. It was humiliating for awhile, got so I avoided taking him out.

DanM

My wife lost about 10% of her body weight about a year ago. The result was that she was very close to her 'ideal weight'. But, the rapid loss (over about 2 months), and her lack of desire to eat concerned me very much. We've been on a program for the past year, and she has lost no more weight since then. Here's what we did:

1. When I used to ask her what she wanted for her meal, she always says that she's not hungry, and wants nothing. So, I stopped asking her. Instead, I just prepared the meal or snack and we sat down to eat. Once she is sitting at the table with a prepared meal, she always eats at least some of the meal.

2. We have 5 or 6 small meals a day, which gives her a lot of opportunity to get nutrition into her system.

3. She never eats if she's not encouraged to eat. So, if I have to be out for a couple of hours, I make sure that one of my children stop by and either, 1) take her out for a meal, 2) bring her a meal or 3), prepare her a meal at home.

4. She never really cared for sweets when she was younger, but she favors them now. So, I offer her something sweet at every meal, in addition to the main entree. I make sure that she has vitamin supplements to help offset the unbalanced meals.

5. She did not like Ensure type of products, but she does like normal milk shakes. So, on our daily rides, I'll often drive through for a milkshake snack. She may only drink 1/4 of the shake....but everything helps. Also, I got her to change from diet coke to regular coke.

6. We weigh every day. Of course I have to remind her what her previous weigh-in results were, but she knows the importance of maintaining her current weight. So far, she has held her weight for the past three quarters.

Hope this helps...

JMack88

@DanM  I know a lot of people don't care for the Ensure.  My grandmother was a nurse and when my great-grandmother was losing weight toward the end of her life and refusing to eat, my grandmother made her special "Milkshakes."  She would take her blender and put in Ensure, a few scoops of ice cream, a banana, and some heavy cream and blend it up to the consistency of a milkshake.  The added fruit and ice cream got rid of the objectionable flavor from the ensure and the heavy cream provided extra calories.  She gave Great Grandma one of those every day to keep her weight up.

NizhoniGrrl

I think your hardest challenge is going to be to not take her remarks about your weight personally. They can really lose their filter! When my brother was terminally ill in the hospital, if I brought my mother to visit him I had to constantly monitor her because she would say terribly inappropriate and insensitive things about other people she saw as we walked through the halls. "Look at that man!" when some poor guy who clearly had some sort of rectal procedure was wheeled by on his stomach with his rear elevated. It was AWFUL and really enraged me at the time.

JMack88

@ninalu  Yes. I recognize some of the symptoms like the distorted body image and the obsession with weighing herself and losing weight.  That's why I'm concerned.  She used to eat small but normal servings of food, but never exercised which is why she always had to watch her weight.  I think she felt that anything that made her sweat wasn't ladylike, hence the no exercise.

The caregiving for Dad at the end of his life was a major stressor for all of us.  None of us anticipated Dad getting sick and dying before Mom because she's a breast cancer survivor and also 2 years older than Dad.  Even though Dad had some heart problems, he'd always been in reasonably good health.  He got a rare disease called Multiple System Atrophy (MSA) which could be described like Parkinson's on crack.  Initially the symptoms led to a Parkinson's Disease (PD) diagnosis, but it soon diverged from regular PD and it progressed significantly more rapidly.  He passed away about 2 years after the initial MSA diagnosis, after having failing health for about 5 years.  Mom was his primary help during the first 3 years, but my sister and I noticed her struggling with it and brought our parents back to my sister's home where we cared for Dad.  Due to the difficulties we were experiencing with Dad's care it wasn't obvious that Mom had problems although the longer they were with us the more we noticed.  

Mom is definitely in major grief over losing Dad even though that happened in 2018 she hasn't broken out of the cycle of grief yet.  The doctor says that antidepressants are unlikely to help because of the cognitive difficulties she's having.  He indicated that it is probably the cognitive problems that are leading to the ongoing grief because every day she realizes all over again that he's gone.

Thanks.

aannaa

I also think a sign on the door might help. This often worked with my neighbor who has a very bad memory. As about brother, I hope he is all right? When my brother was sick, I often bought him vitamins from https://www.canadadrugsdirect.com/online-pharmacy and they really helped him feel better. Maybe more fresh fruit will also be able to lift his spirits? In any case, I wish you and your family good health!

Lollita

My sister too has weight issue, although her issue is that she forgets to eat, or says she is not hungry.  We grocery shop together and I make sure her choices are healthy ones, although the sweets is also an ongoing item.  Since she has lost too much weight (she is now only 88 lbs), I struggle to get weight on her.  I have talked to a dietician friend and she suggests that she snack throughout the day on healthy foods, like quacamole and chips, deviled eggs, peanut butter and crackers or celery, etc.  I also take her out to lunch twice a week and she eats well when we are out but she does not fix meals for herself.  She is early in her alzheimber dx, so she is living on her own but I go over to her house daily to check on her.  She no longer drives so I don't worry about that.  Getting enough food in her is my main problem.  Her doctor told us that giving her a supplement drink like Ensure will only fill her up and she won't want to eat real food.  So doc discouraged from drinking supplements.

Tfreedz

My mom also lost a ton of weight over the last 2 years before her diagnosis. She wold order a kids meal, then put half of it away for later and forget. I always thought the body or brain would signal hunger pains but I guess not with dementia. She has been living with us for 5 months now and I realize that she no longer knows how to cook, in the past she was a fabulous cook. She also claims she loves food but always wants to put a few bites on her plate and save the rest, then forgets about it. I’ve gotten in the habit now of asking her not to put any food in the fridge for later and to try to eat it now and although this initially bothered her, she is now eating full meals. She also wanted to walk after eating but with the bad weather that has slowed down. I did try the ensures but she would just take a couple sips then say she was full. I’ve also noticed she loves toast and snacking but won’t think to look in the cupboards. I try to leave things like bread and pretzels right on the counter and she’s more apt to help herself. Otherwise, she would never eat or say she is hungry unless I prepare it for her. Her doctor prescribed her remron to help her sleep through the night and increase her appetite, so far it’s helping.

Marta

Remeron (mirtazapine) has a new black box warning for use in elderly patients with dementia, just like the atypical antipsychotics. There is an increased risk of death. Just FYI.