Tips to Avoid Weight Loss During Chemo or After Surgery

by Jane Ashley

Loss of appetite (due to nausea, fatigue, mouth sores, difficulty in swallowing or taste changes) leads to unintentional weight loss during chemo. Unless your oncology team has recommended that you lose weight, it’s best to maintain your weight and muscle mass during treatment.

Losing Weight During Chemo Or After Surgery

Be sure to tell your oncologist about these symptoms and their impact on your appetite.

• Nausea/vomiting . Your oncologist team wants to help you avoid nausea, but they can’t help you if you don’t tell them. Something as simple as a change in the nausea medicine before chemo can make a big difference in the way you feel. They may also prescribe an oral disintegrating tablet so that you don’t become more nauseated swallowing a tablet. Anti-nausea medicine can be delivered in a suppository (inserted in the rectum) or via a patch attached to the skin if you are vomiting and can’t keep a pill down.
• Mouth sores and/or difficulty swallowing. Mouth sores are a consequence of some chemotherapy drugs (including Depocyt, Doxil, Etopophos, Trexall, Xeloda, and 5FU). Patients might experience mouth sores following radiation for head and neck cancers. Bone marrow transplants may cause mouth sores too. There are a number of effective treatments which include eating ice chips for the first 30 minutes of infusion, careful brushing and flossing, topical agents and special mouthwashes. 

Loss of appetite is the cumulative effects of treatment – fatigue, malaise, depression, anxiety, and change in tastes. We can overcome our loss of appetite with tricks and strategies. Here are some ideas to help.

You need protein to fight cancer. Now is not the time to dramatically alter your diet. Our bodies need protein to maintain and repair muscles, help build new red blood cells and strengthen our immune systems. We need more protein than we realize. How much? Divide your body weight by 2, and that’s a rough estimation of your protein needs in grams. For example, if you weigh 150 pounds, you need about 75 grams of protein. That might be substantially more protein that you’re currently eating.

Foods For Protein

• 3 ounces of meat (beef, pork, chicken, turkey, lamb and fish) = 21 grams
• Milk = 8 grams
• Yogurt = 10 grams
• Egg = 6 grams
• ½ cup of cottage or ricotta cheese = 12 grams
• ½ cup of tofu = 14 grams
• 2 tbs. peanut butter = 7 grams
• 1 cup bone broth = 7 – 9 grams, depending on the brand

Try to think outside the box and add protein to every meal. Slice a hard-boiled egg over your salad. Add some cottage or ricotta cheese to a casserole. Use milk instead of water to make hot cocoa (from a package). Swirl peanut butter into a milkshake. Use bone broth to make homemade soups. These simple additions won’t add bulk so that you feel too full, but you’re adding protein.

Change of taste and smell. Most people don’t realize how much their sense of taste and smell influence their appetite. Patients receiving chemotherapy often complain of a metallic or bitter taste. Other patients think that everything tastes sweet. Others patients experience bland tastes from previously favorite foods.

I can vouch for this. I love mashed potatoes made from scratch and chicken and dumplings. But neither of these foods tasted like I remembered them. Instead, I craved Mexican food. I wasn’t craving hot jalapeno flavors, but I was craving homemade chili, fajitas and chicken enchiladas. 

Try these suggestions to counteract your taste buds being off. 

• Metallic. Citrus juice like lemon or lime juice helps eliminate that taste. Use balsamic vinegar to help counteract the bitter or metallic taste of red meat (works for beef or pork).  Related Post - 15 Ways to Battle Metalic Taste From Chemo
• Sweet. Add a little more salt or cook with acidic foods like tomatoes, lemon or lime juice or vinegar.
• Too salty. Check the labels on canned goods. Many canned vegetables contained lots of added sodium. Rinse canned beans. Buy low-sodium versions.
• Strong tastes and/or smells. Eat bland foods for a few days after chemo. Rely on comfort foods like mashed potatoes, pudding, saltines, white toast and cream soups.
• Bland or no taste. Use herbs and spices to kick up the taste. Add Greek, Italian and Mexican seasonings to meat dishes, roasted potatoes and pasta dishes. Sour pickles may help reactivate your taste buds.

Tricks to Maintain or Gain Weight during Treatment

Cancer treatment requires stamina, endurance, and strength. Don’t accept weight loss as an inevitable consequence of chemo. Patients need to consider the “long haul” and strive to maintain their weight. Part of this is a mental commitment to eat.

When I began treatment, my oncologist told me that I would have 12 cycles of chemo. After the end of the first cycle, I had lost just over 3 pounds. At 5’3” tall, I weighed 128 pounds and was within the normal range for BMI. I was shocked as I did the math – after 12 cycles of chemo at that rate of weight loss, I would weigh just 92 pounds. It was a wake-up call for me that I had to “force” myself to eat in order to maintain my weight.

Use a calorie calculator to learn how many calories you need to maintain your weight. Then divide the total calories required by 4 or 5, and eat small meals throughout the day. You’re less likely to experience nausea or a full feeling by eating less at each meal. Here are some tricks to add calories. 

My personal eating plan added these little tricks. My oncologist was concerned about my weight and told me to eat anything that I could tolerate. (Always consult with your oncologist about dietary changes.)

• Use one slice of bread with the same amount of meat and cheese as a full sandwich, and make half a sandwich.
• Eat a good quality premium ice cream or frozen yogurt – it’s nutrition-dense without being filling.
• Beans and rice (with optional ham) = comfort food, protein and calories.
• Baked potato with real butter and sour cream.

Unintentional weight loss is associated with a poorer prognosis. Be proactive for yourself. Commit yourself to eating with these tips and strategies.

Related Articles You May Find Useful

24 Tips to Better Handle Chemo and Radiation

What to Expect From Cancer Treatments

Cancer and Nausea-Seven Tips For Relief

Losing Weight After Chemotherapy

Good Nutrition and Cancer  A Guide to eating well and staying well during cancer treatments from the American Cancer Society

Weight Loss While on Cancer Treatments  Staying Healthy With Nutrition

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