My wife broke her hip and ever since she has been underweight.

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My wife fell and broke her hip 2 years ago. Ever since then she has been underweight. She only weighs around 94 pounds. When I try to sneak in larger portions, she notices it and leaves some. I can’t get her to eat more. Do you have any suggestions? She can’t walk very far either.

You didn’t say how tall your wife is, but if she is over 5 feet tall, she is underweight. Her muscle mass is probably smaller because of her low weight and low activity level. Inactivity can cause a poor appetite, which in turn affects a person’s strength.

When trying to get a person to gain weight, some usual dietary advice may be thrown out the window unless she has some other health problems like high blood pressure or diabetes. If she is on a nutrition therapy due to other health problems, you should see a Registered Dietitian who can read your wife’s medical chart and help you combine all her dietary needs, including weight gain.

Since she won’t eat larger portions, I would suggest four approaches for weight gain. Try one or all of the following approaches to help your wife gain weight.

First, increase the calorie concentration of the food amounts she does eat. For instance, put margarine on everything you offer her, including toast, cooked cereal, pancakes, French Toast, potatoes, rice, noodles, and vegetables. Cream or cheese sauces poured over potatoes, noodles, or vegetables add calories. Put peanut butter or jelly on top of the butter on her toast, but vary what you put on the toast each day. Offer your wife whole milk only. You might want to try offering double strength milk. It has 50% more calories and doubles the protein of regular milk. (Double-strength milk is 1 cup of whole milk with 1/3 cup of nonfat dry milk powder added.) You could also make eggnog occasionally as eggs are an excellent source of protein. Use whole milk instead of water for cooking some foods such as cooked cereal and mashed potatoes.

Second, if the volume is a problem, offer your wife smaller amounts more often. Instead of the usual 3 meals per day, offer 6 or 8 smaller meals. Some people’s appetites get turned off when a large plate of food is placed in front of them. The large amounts seem overwhelming.

Also, she may get too full on an 8-ounce glass of milk at mealtimes. Try a 4-ounce glass of milk with meals and 4-ounces in between meals. You might want to flavor the milk with chocolate, strawberry, banana or another flavor. Remember, you would get bored with the same food and so will your wife. Another suggestion is, if the volume is a problem, don’t offer soups or lots of liquids with her meals. They will fill a person up fast and may be low in calories.

Third, you may want to consider using a nutritional supplement. Since there are several hundred on the market, you should consult a Registered Dietitian for their advice on the best one for your wife. You did not mention if she has diabetes or high blood pressure. Some nutritional supplements are not recommended for these people. If she doesn’t have any medical problems other than her hip, I would recommend a formula that has 355 calories per 8 ounces. There are several on the market that would probably be available in your local pharmacy. As a supplement, choose one that is high in calories, average in protein, lactose-free and good tasting. They come in many flavors as well.

Fourth, you mentioned that your wife couldn’t walk very far. Minimal exercise does help to stimulate an appetite. Encourage your wife to walk the same distance, only more frequently each day. It will build up her tolerance and endurance. I would suggest she see a physical therapist for exercises that would benefit her walking. She can also do exercises while lying down or seated in a chair. You can learn how to passively exercise her arms and legs from a physical therapist.

One last suggestion, remember, it is more enjoyable to eat with someone else than alone. Your mealtime with your wife should provide companionship and conversation for you both.