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Maintaining weight after a lung cancer diagnosis

By Nicole Erickson M.Sc, Registered Dietitian

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How do I maintain my weight?

Maintaining body weight can be really challenging for somebody who is losing weight without trying. Once you have accepted the fact that diet and energy intake is a part of your treatment, it may become easier for you to maintain your weight. Here are the steps you need to follow:

1. Weigh yourself regularly

Knowing your true weight, is the first step. Weigh yourself at the same time of day on a regular basis. It is usually enough to weigh yourself once a week as soon as you wake up in the morning if the doctor has not asked you to do otherwise. Keep track of your weight and inform your care team if your weight has increased or decreased by 1-2 kilos or more in a week, or if you are observing a steady pattern of unintentional weight loss over time. There are lots of different mobile apps that you can use to help track your weight – they can show you any trends in your weight, and help your healthcare team understand more about your health and wellbeing too.
Please note: Keep in mind that body weight can also be affected when your body retains water. If you are retaining water, this can mask your true weight and any unintentional weight loss. In this case it important to maintain close contact with your care team and to keep your food intake stable.

2. Eat on a schedule

Even if you have no appetite, if you stick to a schedule you ensure that you do not miss meals without realising it. Therefore, even if you are not hungry, you ensure that you still fuel your body with the energy needed to fight the disease.

3. Eat small meals frequently

Eating smaller meals more frequently has many advantages for lung cancer patients. For example, chewing and digesting food utilizes oxygen. If you wear an oxygen mask, you need to remove it to eat. That means you need to work harder to breathe enough while you eat. Furthermore, as your stomach fills, the lungs and diaphragm have less room to expand. You might also be struggling with breathlessness, which could cause similar issues. Therefore, eating small frequent meals enables you to minimise these problems while ensuring an adequate energy intake.
Tip: Eat sitting up. This helps make space for your lungs and diaphragm to expand. Also don’t be afraid to use your oxygen during meals. If you use a cannula, wear it while you eat; if you have an oxygen mask, take the time to inhale between bites.

4. Where you can, be flexible

Some medicines need to be taken with food, or at certain times – you can find details of this in the ‘Patient Information Leaflet’ that is always supplied with your medicine – ask a doctor or nurse if you need a copy, or if you have questions. It may also be worth clarifying what ‘take with food means’ – should you take medicine before, after, or during your meal? Again, your doctor or nurse can guide you here.

If your treatment allows a bit more flexibility, the match your meals to your treatment demand, and your appetite and energy level. If you get more tired later in the day, eat your favourite foods, or high calorie foods, earlier in the day. If you have plans that you know will leave you tired, eat beforehand. If your favourite meal of the day is breakfast, consider eating breakfast foods for dinner.

5. Think before you drink

Beverages, or liquid meals like soups fill your stomach but don’t always deliver high amounts of energy. If you are struggling to get enough calories from foods, don’t forget to use your fluid intake as an opportunity to sneak in extra calories. Instead of water, a low calorie beverage, or tea or coffee, consider drinking juice, shakes, smoothies, or even high calorie nutritional supplements.

Tip: High calorie drinks make the perfect snack.
Tip: If you do not have much appetite save your beverage until the end of the meal so that you don’t fill up on liquids.

6. Take your time

Eat and chew slowly. Take your time with your meal to take deep breaths to fill your body with the oxygen it needs. Take smaller bites and rest in between. If you feel out of breath, slow down and take a break.

7. Choose foods that are good for helping to keep weight up

  • Melt butter or add cream or oil to potatoes, rice, pasta, and cooked vegetables. Stir butter, oil or cream into soups and casseroles and spread on bread before adding other ingredients
  • Add seeds or nuts to cereals, porridge, fruit, ice cream, pudding, and custard. Nuts also taste good with on vegetables, salads, rice or pasta. Spread nut butters like almond butter or peanut butter on your toast, or add it to sauces or smoothies
  • Add grated cheese to beans, potatoes, omelettes, vegetables, soups, pasta, meat, and salads. Cream cheese can be mixed into stews, soups, pasta, rice and vegetable dishes
  • Starchy vegetables such as potatoes, peas, corn, carrots, winter squash, and beets have more calories than watery vegetables. Eat your vegetables with butter, oil, cream, or gravies and sauces to increase the energy value
  • Bring dried fruit along as a snack. Combine fresh fruit with dried fruit, nut butters, cream, ice-cream or sherbet
  • Drink high-calorie, high-protein beverages like smoothies or milk shakes and or try a high calorie liquid supplement

What should somebody eat if they are not losing weight, but have lost their appetite (and so are at risk of losing weight)?

  • If you are not losing weight already, but have lost your appetite, make sure you still are getting enough calories by following the advice above
  • Don’t be afraid to try new foods. Some things you never have liked before might taste good during treatment
  • If side effects from a treatment are making it difficult for you to eat, try avoiding foods that seem to trigger them. Try keeping a diary to see if there’s any link between what you eat, when you eat, anything you did after eating (e.g. walking, resting, lying down, etc.), and how you feel afterwards

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