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Health & Wellness
Mayo Clinic Q and A: Weight loss in older adults can signal underlying health issue
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DEAR MAYO CLINIC: My father is 84 and lives on his own. He is in very good health but seems to have lost some weight in the last few months. He says he just doesn’t have much of an appetite. Would having him try meal replacement drinks be a good idea, or should he see his doctor first?
ANSWER: Before he starts using meal replacement drinks or other diet supplements, encourage your father to see his doctor. 
Weight loss in older adults can sometimes signal an underlying health issue. It’s important to have unexplained weight loss evaluated to investigate the cause and make sure there isn’t a bigger problem that needs attention.
When you go to see your doctor, one of the first things you do is step on a scale. The focus often is on the positive benefits of weight loss, and losing a few pounds typically is seen as a healthy step. Although that may be the case for some older adults, too, for many people in their 70s, 80s and beyond, weight loss may be the first sign of a health problem. That’s particularly true if an individual is losing weight without intentionally trying to do so.
Unexplained weight loss can be the result of a lingering infection or illness that could get worse if it’s not treated. Certain medications can also cause weight loss. If that’s the case, an alternative medication may be necessary to help maintain a healthy weight. Although less common, undiagnosed cancer, heart disease or a neurologic illness like Parkinson’s disease also can lead to unintended weight loss.
Memory loss and a decline in thinking skills, or cognitive function, are also possibilities that should be assessed in a situation like your father’s. In their early stages, conditions that affect memory, such as Alzheimer’s disease and other types of dementia, can often interfere with routine daily tasks, such as grocery shopping, making meals and eating.
Depression is an underlying concern for some older adults, as well, and it can frequently lead to weight loss. Those who have recently lost a spouse or other close friends, or individuals who are otherwise socially isolated, may be particularly vulnerable to depression.
Finally, the problem could stem from a change in taste buds or a loss of the sense of smell, which makes eating less pleasant. This happens in some people as a result of aging, but it often results in very slow weight loss.
If there is an underlying medical problem, treatment for it may be able to help stabilize a person’s weight. In some cases, meal replacement drinks or other diet supplements can also help. They typically provide about 300 calories per serving and can be useful for people who have a hard time getting all the calories they need each day.
These products also may be helpful for those with mild memory loss or other conditions that make it hard to prepare meals on a regular basis. In general, though, it is best for most people to get the bulk of their nutrition from a diet that contains a variety of healthy foods, such as whole grains, plenty of fruits and vegetables, and lean meat, fish and poultry. People who have unintended weight loss should avoid restrictive diets, such as those that focus on low-fat foods.
Even though your father doesn’t appear to have any other health issues at this time, it’s still important for him to visit his doctor to have his weight loss evaluated. If left unchecked, even when it is not associated with an underlying medical problem, weight loss in older adults can eventually lead to other concerns, such as weakness and loss of balance. The sooner his weight can be stabilized, the better it will be for your father’s health overall. — Paul Takahashi, M.D., Primary Care Internal Medicine, Mayo Clinic, Rochester, Minn.
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