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Strategies to Increase Body Weight
September 2001
Because of the increased morbidity and mortality among elderly people who have a chronically low BMI or who have experienced involuntary weight loss, strategies to increase appetite, food intake, and body weight are critically important. While the use of nutritional supplements may result in small (if any) improvements in weight, these supplements may not be effective in patients who are chronically underweight or cachectic. Megestrol acetate (MA), a synthetic progestin, has been reported to increase appetite and body weight in anorexic patients with cancer and HIV infection. Yeh and colleagues examined the effects of MA in elderly nursing home patients who had lost 5% or more of their body weight in the previous 3 months or who were at least 20% under their ideal BMI. They reported that 800 mg of MA per day resulted in increased appetite, increased food intake as measured by dietary recall, and a delayed (13 weeks after the cessation of MA) increase in body weight. The Nutrition, Exercise, and Metabolism Laboratory at the Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, has also demonstrated that MA resulted in a substantial increase in appetite, total daily energy intake, and body weight in a group of underweight older men.[25] This effect may be important to clinicians and registered dietitians who attempt to stimulate weight gain in elderly people. Other potential appetite stimulants that have been used in elderly people include oxandrolone, an anabolic steroid that may increase appetite and stimulate muscle growth; and dronabinol, which is tetrahydrocannabinol, a derivative of cannabis. Dronabinol has been approved by the US Food and Drug Administration to stimulate appetite in wasted patients with AIDS, and it prevents nausea due to chemotherapy in patients with cancer. Its use in treating underweight elderly men and women has not yet been adequately tested, but has shown some potential benefits. From Medscape's Nursing Clinical Management Volume 3 Aging and Malnutrition: Treatment Guidelines CME Author: William J. Evans, PhD
Disclosures =============================== MEGACE ® (megestrol acetate) http://www.nursespdr.com/members/database/ndrhtml/megestrolacetate.html for the PDF formated sheet that comes with this drug, ho to Bristol Meyers http://www.bms.com/medicines/data/ and on the upper right hand side, go to Megace. Dronabinol (Delta-9-tetrahydro-cannabinol) http://www.nursespdr.com/members/database/ndrhtml/dronabinol.html oxandrolone/anabolic steroid nothing located. |
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