Weight gain

Putting on too much weight can be an issue when we are ill. It’s a problem not just for health reasons but because it can make us feel so out of control of our body and negative about how we look and feel. Cancer treatment can be a problem, particularly with hormone-related tumours such as prostate or breast cancer. With dementia, a new drug may interfere with hunger messages in the brain, so that the person doesn’t register feeling full and so stop eating. They may also forget that they have eaten and say they want more food when they don’t physically need it. We can also overeat when we’re feeling anxious or depressed, turning to food for comfort or as a side-effect of medication prescribed to help stabilise our moods. Or we may give too many sweets, chocolates and snacks as a treat to those we love when they are poorly.

Check with your doctor to see if weight gain is linked to your treatment. If it’s impossible to change or tweak your drugs, it may be that the weight gain has a ceiling as your body adjusts to the medication.

I wouldn’t recommend eating what’s commonly known as a cleanse or detox or a very low-calorie diet when you’re recovering from treatment, as depriving yourself can leave you feeling depleted in every sense. It can also change the way your body metabolises medication, which could unsettle your regime. But there are positive ways to take charge of what you eat, reduce your calorie intake and lose weight healthily, and achieve the personal goal of feeling better in your body.

• Keep a food diary recording what and why you are eating for a few weeks. It will help you assess how much you are really eating and to see ways you can improve. This can be particularly beneficial if you or someone you care for is struggling with Alzheimer’s disease or dementia, as the simple record keeping can provide clues about where changes can be made. Some medication, particularly antidepressants and steroids used in cancer treatments, can interfere with how quickly the brain acknowledges when you’re full, which can lead to too much weight gain. Again, keeping a food diary will help you assess your intake, and even the act of writing down everything you eat before you put it in your mouth may prompt you to eat less. You may find, for example, a cup of tea, a glass of water, or a mug of delicious broth, can satiate you enough.
• Cut back on very sugary foods, eating delicious, naturally sweet fruit such as Medjool dates, figs, unsulphured dried apricots and dried strawberries instead. Enjoy some stewed fruits, such as the Stewed Apples in my recipe section, in place of chocolate (unless it’s a square of the high 70% plus cocoa chocolate, which can hit the chocolate spot without too much sugar). And junk refined sugar cakes and sweets and have an occasional homemade treat, such as my Carrot Cake or Orange Bread Pudding, both of which are high in protein and made with wholemeal flour to help control blood sugar levels. We have so many delicious puddings, snacks and treats in our recipe section for those moments when you crave something indulgent; the trick is that they’re also rich in other nourishing ingredients so they provide more than a simple sugar rush.
• For a savoury crunch, try a few unsalted nuts or a crispbread to replace the classic savoury crisps. You could make your own vegetable crisps with shavings of parsnip, carrot, beetroot or kale.
• Balance blood sugar levels – and sweet cravings – by swapping from the refined white starches (white bread, pasta, etc) to eating more of wholegrains (such as a slice of dark wholemeal rye bread) that release energy more slowly. Swapping to the nuttier tasting brown rice or to the wholegrain pastas can make a big difference and also help you to feel more satiated.
• Cut down on the calorie-intense fattier foods such as butter, cream, cheese, olive oil. With cheese, remove the rind from soft cheeses and use a cheese slicer for thin shavings of delicious intensely flavoured hard cheeses instead of a large chunk. Use a drizzle, rather than a lashing, of olive or another vegetable based oil. It’s amazing how you can still achieve great flavours without having too much oil.
• Reduce fattier meats, such as pâtés, thick-rinded bacon, sausages, unless they have a high meat content, and instead choose leaner cuts. When making casseroles, allow them to cool, then remove the fat which floats to the top before reheating.
• Don’t cut back too much as a little good fat can help us feel satiated. So, for instance, if you have a salad, don’t be afraid to use a drizzle of good olive oil on it, as this brings great flavours and helps stimulate the part of the brain which acknowledges when you’re full. The trick is to have a small amount of a good fat. Don’t be tempted to use low-fat products as they often contain a lot of sugar and sometimes even more calories than the full fat version and seldom taste good. I much prefer eating a smaller amount of a full-fat cheese than a larger amount of a low-calorie cheese which tastes lousy.
• Increase vegetables and salads as there are so many great ways to eat them, alongside moderate amounts of lean protein, such as a delicious roast chicken, a simple omelette and fish, be this the oilier fish such as tuna or salmon, or the white fish like sea bass, cod or haddock. You can make a delicious salad Niçoise with simple tinned tuna. Or take a piece of cod, which you’ve had in the freezer, and bake it with some fresh dill, a squirt of lemon and a drizzle of olive oil on top, to make a simple nourishing protein hit. See the Proteins section in my Nutrition Basics for more ideas.
• Identify emotional eating. Ask yourself before you eat anything, or give someone you’re caring for the question: ‘Is this food going to nourish me/them, or is it an emotional crutch? If you are using food for comfort, then have a think about ways to distract or relax other than food, like taking a walk or looking at a photo album together. If you do want oral comfort, make a gorgeous soup or broth, or a big mug of tea, as so often some warming liquid will hit the feel-good spot.
• Eat more slowly, as this can make a difference to how soon you feel full and satiated. Concentrate on savouring the tastes and ideally juggle tastes and textures with each mouthful. For instance, if you have a plate with a buffalo mozzarella, roasted tomatoes and avocado, have one mouthful of mozzarella, appreciate the flavours, then move on to a mouthful of tomato, then a mouthful of avocado, etc. This way you stimulate the part of the brain which acknowledges when you’re eating and getting full, so the more juggling and savouring, the quicker you’ll feel full and more satiated you’ll stay, meaning you’re less likely to overindulge.

For more information on a nourishing healthy diet, see Nutrition Basics.