Changes in weight are among the more common side effects of multiple sclerosis. Depending on the symptoms of those affected, both weight gains and weight losses can occur. Factors that can influence weight include fatigue, depression, muscle weakness, physical inactivity or medication. This article highlights weight gain and loss in multiple sclerosis and discusses influencing factors and approaches to action.

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Factors influencing weight gain in multiple sclerosis

Weight gain can be caused by a variety of reasons. According to studies, 25-33% of MS patients are overweight. Factors influencing weight gain in MS are described below.

Exercise and diet

MS patients often suffer from sensory disorders, pain, muscle cramps or fatigue, which makes physical activities difficult. A lack of exercise reduces the body's energy requirements. If the diet remains the same, there is therefore an excess of calories, which leads to weight gain in the medium term.
Due to severely restrictive side effects of multiple sclerosis, such as pain and/or fatigue, many people affected do not have the energy to prepare healthy meals themselves. If, for example, heavily processed foods or fast food are used in this case, this can also be reflected in the weight.

If you are overweight, weight loss can have a positive effect on the course of multiple sclerosis. Regular exercise and a healthy, balanced diet are recommended to achieve a normal weight.

movement

To reduce weight, even light, regular physical activity usually helps. This also includes activities in the garden or a simple walk. Since this can be temporarily difficult due to side effects 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 are extended over time. Since some side effects of multiple sclerosis (e.g. fatigue) can be influenced by activity level, it is advisable to discuss weight loss with the attending physician in advance. He knows you holistically and can best holistically evaluate a weight loss strategy that is right for you.

sustenance

In order to reduce weight sustainably and healthily, it is recommended to establish new eating habits. Rapid, severe weight losses (e.g. crash diets) are only rarely sustainable. Which diet is the most suitable for each individual is also influenced by tastes and preferences. For this reason, we only provide a few clues 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
• whole grains, oats and unpeeled rice
• nuts, beans and seeds
• vegetable proteins, legumes
• Fish for omega-3 fatty acids
• water/tea

In addition, healthy alternatives should also be considered for snacks and snacks: Sliced fruit and vegetables instead of sugary baked goods, nuts, yoghurt or whole grain crackers can satisfy a small snack in between meals. Changing your diet often sounds like a big task. It is important to make a start here and build new habits step by step - and even a piece of dark chocolate is sometimes okay.

medicines

Multiple sclerosis, particularly relapses, is often treated with steroid therapy with glucocorticoids. However, glucocorticoid therapies, often cortisone therapy in MS, also influence metabolism. Weight changes are a known side effect, particularly in the case of longer-term therapies.
Some antidepressants, such as mirtazapine or amitriptyline, can also cause weight gain.

If you notice any changes or side effects of a therapy, you should discuss them with your treating doctor. There may be alternatives that you are more comfortable with.

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Factors influencing weight loss in multiple sclerosis

Accidental weight loss in multiple sclerosis may be due to side effects and/or medication.

Multiple sclerosis can affect the muscles that are active when swallowing. As a result, swallowing disorders (dysphagia) can occur, which make it difficult to absorb solid and liquid food. As a result, those affected reduce their food intake.
In addition, side effects such as fatigue and depression may be associated with loss of appetite. Affected people eat less and calorie intake is reduced. If energy requirements remain the same, a calorie deficit is created, which leads to weight loss.

Some medications can also cause weight loss. Antidepressants such as bupropion can have a drive-boosting effect. They increase energy consumption, which can lead to weight loss while maintaining the same diet and activity level.

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

Dietary supplements such as shakes can help you consume calories and nutrients without having to eat a lot. This can be helpful if, for example, there is a lack of appetite or swallowing problems. If you still have problems with your weight even after a change, the symptoms should be discussed with the treating doctor.

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synopsis

Multiple sclerosis can result in both weight gain and loss. Depending on your symptoms, dietary changes, physical activity, changes in medication, or even dietary supplements can help to normalize your weight. Your plan should always be discussed with your doctor so that you don't stress yourself too hard and worsen your symptoms in the worst case. Weight change should also be a long-term goal. Small changes that are retained are more effective than large ones that are discarded after a short period of time.