Around the world and especially in America, we are struggling with obesity. Our diets are high in sugars and our calorie intake exceeds our energy expenditure. Fast food and sweetened drinks such as cola and now a dizzying array of coffee based drinks prove hard to resist for many. On this background it may seem surprising that many patients with advanced IPF struggle to maintain their weight.
Weight Gain – at First
Early in the course of IPF, patients face many of the same challenges as everyone else—weight gain. Patients with mild IPF have preserved appetite and as they slowly become more short of breath with exercise, eating remains a source of pleasure and connection with friends and family.
As IPF progresses, many patients notice reduced appetite. They may start with a good appetite but once they start eating they feel full much faster than normal. This begins to reduce the amount of calories consumed. During this time shortness of breath is increasing and activity levels decrease.
Eating Becomes Challenging
With advanced IPF, patients dramatically reduce their food consumption. Eating becomes challenging and increases shortness of breath. Patients quickly learn to avoid foods that take more work to eat, such as steak or chewy bread. They gravitate towards softer foods that don’t require much chewing and are swallowed easily. Early satiety (onset of fullness) becomes more pronounced. During this period most patients start to lose weight, sometimes quite quickly.
In addition to the reduced calorie intake, patients with advanced IPF also spend a greater deal of energy in breathing. In health breathing is a very energy efficient process. With advancing pulmonary fibrosis, we spend more and more energy just breathing. Combined with reduced food intake this leads to more weight loss.
Tips for Minimizing Weight Loss as IPF Progresses
The most important strategy to combat weight loss that accompanies advancing respiratory disease is to break away from our traditional three meals per day. Eating three meals per day is very impractical for anyone with advanced lung disease. Instead patients should try and eat at least 5 small meals. Focus on soft foods that are easy to swallow but moderately calorie dense. Smoothies or shakes are a great supplement. Yogurt, ice cream and certain pasta dishes are also good choices. Avoid tough meats. Supplements can be very helpful. Try and choose the high protein versions.
With planning and awareness you will be able to minimize weight loss that accompanies pulmonary fibrosis.