Weight problems with multiple sclerosis

Factors influencing weight gain in multiple sclerosis

Weight gain can have various causes. According to studies, 25-33% of MS patients are overweight. Factors influencing weight gain in Multiple Sclerosis are described below.

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Exercise and diet

MS patients often suffer from sensory disturbances, pain, muscle cramps or fatigue, which makes physical activity difficult. A lack of exercise reduces the body's energy requirements. A constant diet therefore results in an excess calorie intake, which leads to weight gain in the medium term.

Due to the severely restrictive side effects of multiple sclerosis, such as pain and/or fatigue, many sufferers do not have the energy to prepare healthy meals themselves. If they resort to highly processed foods or fast food, for example, this can also be reflected in their weight.If you are overweight, losing weight can have a positive effect on the progression of multiple sclerosis. To achieve a normal weight, regular exercise and a healthy, balanced diet are recommended.

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Exercise

Light, regular physical activity normally helps to reduce weight. This also includes activities in the garden or a simple walk.

As this can be difficult at times due to the accompanying symptoms of multiple sclerosis, it is important to avoid overexertion. The right amount of exercise depends on the normal activity level: For patients who are very inactive in everyday life, short walks can be a start, which can be extended over time. As some of the accompanying symptoms of multiple sclerosis (e.g. fatigue) can be influenced by the level of activity, it is advisable to discuss weight reduction with the doctor treating you in advance. They know you holistically and can best assess a weight loss strategy that is right for you.

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Nutrition

In order to reduce weight sustainably and healthily, it is recommended to develop new eating habits. Fast, sharp weight loss (e.g. crash diets) are rarely sustainable. Which diet is most suitable for the individual is also influenced by taste and preferences. For this reason, we only provide a few guidelines below that you can take into account.

Foods that should be avoided are

• Highly processed foods
• Foods with added sugar
• saturated fats
• Excessive salt
• fried foods
• sweets
• sweetened drinks

Foods that should be consumed more often are

• Fruit and vegetables
• Wholemeal products, oatmeal and unhulled rice
• Nuts, beans and seeds
• Vegetable proteins, legumes
• Fish for omega-3 fatty acids
• Water/unsweetened teas

Healthy alternatives should also be considered for snacks and in-between meals: Sliced fruit and vegetables instead of sugary baked goods, nuts, yogurt or wholemeal crackers can satisfy small hunger pangs in between meals. Changing your diet often sounds like a big task. It's important to make a start and build up new habits step by step - and even a piece of dark chocolate is sometimes okay.

Adjusting diet may also have positive effects on the course of the disease, as research indicated positive effects of anti-inflammatory diet for patients with multiple sclerosis.

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Medication

Multiple sclerosis, especially in relapses, is often treated with steroid therapy using glucocorticoids. However, glucocorticoid therapies, often cortisone therapy in MS, also affect the metabolism.
Weight changes are a known side effect, particularly with longer-term therapies.

Some antidepressants such as mirtazapine or amitriptyline can also lead to weight gain.If you notice any changes or side effects of a therapy, you should discuss these with your doctor. There may be alternatives that you tolerate better.

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Factors influencing weight loss in multiple sclerosis

Unintentional weight loss in multiple sclerosis can be caused by accompanying symptoms and/or medication.Multiple sclerosis can affect the muscles that are active during swallowing. As a result, swallowing disorders (dysphagia) can occur, making it difficult to swallow solid and liquid food. As a result, those affected reduce their food intake.

In addition, accompanying symptoms such as fatigue and depression can be accompanied by a loss of appetite. Those affected eat less and their calorie intake is reduced. While energy requirements remain the same, there is a calorie deficit, which leads to weight loss.Some medications can also cause weight loss. Antidepressants such as bupropion can have a stimulating effect. They increase energy consumption, which can lead to weight loss if the diet and activity level remain the same.

Depending on the origin and severity of the weight loss, it can help to eat smaller meals throughout the day. Mindful eating can also be helpful in establishing a healthy relationship with food. You pay attention to all the sensory impressions that affect you when you eat: What does the food look like? What does it smell like? How does it feel? And how does it taste? Also try to slow down your eating speed so that you can concentrate fully on the sensory impressions.

Food supplements such as shakes can help you to consume calories and nutrients without having to eat a lot. This can be helpful if, for example, you lack appetite or have difficulty swallowing. If you still have problems with your weight even after changing your diet, you should discuss the symptoms with your doctor.