Maintaining a healthy weight

If you are underweight or have difficulty putting weight on, it may be because of the side effects of Parkinson’s medication or difficulties with chewing or swallowing.

Weight loss is caused by your body using more calories than you're consuming. This may be due to increased movement caused by tremors or dyskinesia. It may also be due to practical problems, such as food shopping, preparation or keeping your food hot while you're eating.

You may find the following tips useful:

• Make the most of adding extras to foods, such as extra cream, butter, oil or honey where you can. These will make the food more energy-dense and tasty.
• Try to have 3 meals a day and 2 to 3 snacks between your meals. It’s important to try to eat every 2 to 3 hours during the day.
• Instead of snacks, try having a milkshake, malted drink or smoothie. These may be used to supplement your usual diet. But, if you find you are replacing your meals with these, it is important to seek help from a dietitian.

If you are finding it difficult to maintain your weight or reach a healthy weight, your GP, specialist or Parkinson’s nurse can refer you to a dietitian.

They may recommend tailored changes to your diet and special high-calorie products that are available on prescription.

It's easy to gain weight if you become less active but are eating the same amount of food.

If you are trying to lose weight, here are some tips to start with:

• Don't eat fried food regularly – grill, dry fry, microwave, bake, steam, poach or boil, without adding fat or oils. Instead, use marinades, adding extra herbs, stock and spices for flavour.
• Use skimmed or semi-skimmed milk instead of full fat.
• Try eating healthier snacks like diet yoghurts, nuts, fruit, crumpets or teacakes.
• Have sugar-free, no added sugar or low-calorie drinks and use artificial sweetener instead of sugar.

If you have other health conditions as well as Parkinson’s, such as circulation problems, high cholesterol, heart disease or diabetes, and are concerned about being overweight, speak to your GP, specialist, Parkinson’s nurse or ask to see a registered dietitian.

Parkinson’s and weight gain

Parkinson’s medication does not tend to make people gain weight, but a small number of people may experience impulsive and compulsive behaviour. This is a side effect of some Parkinson’s medication, particularly dopamine agonists and, in some cases, levodopa.

Impulsive behaviour is when a person can’t resist the temptation to carry out certain activities. These are often activities that give an immediate reward or pleasure, such as gambling, hypersexuality and overeating.

So, someone may eat large amounts of food in a short period of time because they can’t control their appetite, and as a result, they gain weight.

If you think you’re experiencing this behaviour, speak to your GP, specialist or Parkinson’s nurse.

We don’t advise anyone to stop taking or to change their Parkinson’s medication without the advice of their specialist or Parkinson’s nurse.

Any changes have to be made slowly and gradually, and should always be carried out and reviewed by a specialist, because of the risk of side effects and withdrawal symptoms.

Someone experiencing impulsive or compulsive behaviour may not realise they have a problem. So it's important that their carer (if they have one) is aware of these side effects.

Deep brain stimulation and weight gain

Some people with Parkinson’s may put on weight quickly after having deep brain stimulation, a surgery sometimes used to treat the condition.

If you are considering surgery, talk to your healthcare professional about being referred to a dietitian, ideally before you have surgery.

Some people with Parkinson’s may experience constipation. This can be helped by:

• drinking more fluid
• physical activity and exercise
• eating more fibre-rich foods

How does fibre help?

Fibre absorbs fluid as it moves through your bowel, forming a soft stool that can be passed more easily.

It is very important to increase your fluid intake if you increase the fibre in your diet, because too much fibre without enough fluid can increase constipation.

A dietitian can give you more information and advice.

How can I increase my fibre intake?

Fibre is found in cereals, seeds, nuts, fruit, vegetables and pulses, such as peas, beans and lentils. To increase your fibre intake you can try:

• eating high-fibre varieties of foods, such as wholemeal bread, pasta or brown rice
• altering recipes to use some wholemeal flour instead of all white flour
• choosing a breakfast cereal containing wheat, wheatbran or oats, such as Weetabix, porridge or bran flakes
• eating more vegetables. They can be raw or cooked, fresh or frozen. Try using more peas, beans or lentils
• eating more fruit. It can be fresh, stewed, tinned or dried. Try bananas, oranges or prunes
• gradually introducing ground linseeds. You can add 1 teaspoon to cereals, salads or yoghurts to start with and increase this over time to 1 tablespoon. If you do this, make sure you drink an extra glass of fluid a day, otherwise it won’t work and may make constipation worse

When increasing your intake of fibre, it's important to do so gradually to avoid bloating or flatulence (wind). Aim to introduce 1 new high-fibre food every 3 days.

Some people may need to take laxatives for regular bowel movements and minimal straining. You can discuss this further with your GP, specialist or Parkinson’s nurse.