#467 Unintentional Weight Loss with Dr. Eva Szymanski
Jan 20, 2025
auto_awesome
Dr. Eva Szymanski, a geriatrician at Penn Medicine, shares invaluable insights on unintentional weight loss in older adults. She delves into the 5Ms framework, discussing medical, mental, and social factors contributing to weight loss. The conversation highlights the significance of medication review and deprescribing to enhance patient care. Dr. Szymanski also emphasizes the need for comprehensive evaluations to address weight loss and its links to serious health issues. Listeners will appreciate her practical strategies and compassionate approach to geriatric care.
Unintentional weight loss exceeding 5% in older adults often indicates significant underlying health issues requiring comprehensive assessment and intervention.
The Geriatric 5Ms framework—multi-complexity, mind, mobility, medications, and what matters most—provides a holistic approach to addressing weight loss in older adults.
Engaging family members and caregivers in care decisions and dietary management is essential to support older adults experiencing unintentional weight loss.
Deep dives
Understanding Unintentional Weight Loss in Older Adults
Unintentional weight loss in older adults can signify serious underlying issues, warranting further investigation. A weight loss of more than 5% of a person's usual body weight over six to twelve months is generally considered concerning, and can often be linked to factors like depression, cognitive impairments, or medical conditions. It is critical to distinguish this from more benign age-related weight loss, which typically does not exceed about 0.4 pounds per year. Understanding these differences helps healthcare providers engage patients in meaningful discussions about these symptoms and their implications.
The Geriatric 5Ms Framework
The Geriatric 5Ms framework—multi-complexity, mind, mobility, medications, and what matters most—offers a structured approach to addressing geriatric syndromes, including unintentional weight loss. This framework encourages healthcare providers to consider a broad range of contributing factors, from physical health issues to mental health and social support systems. By applying this model, clinicians can develop a comprehensive understanding of a patient's situation and tailor interventions more effectively. It's a reminder that treatment often requires a multifaceted approach rather than merely addressing immediate presenting symptoms.
Assessing Contributing Factors
When addressing unintentional weight loss, it's important to conduct a thorough assessment of various potential contributing factors. This may include exploring medical history to identify untreated conditions, screening for depression and cognitive impairment, and evaluating mobility issues that might impact a patient's ability to obtain and prepare food. For instance, changes in cognitive function might affect a patient's ability to shop for groceries or prepare meals, significantly impacting their nutritional intake. Identifying these interconnected issues through a comprehensive assessment can be vital for developing effective management strategies.
Interventions Beyond Medication
Management of weight loss in older adults often requires a multifaceted approach that extends beyond pharmacological solutions. Encouragement of higher-calorie diets through dietary choices, with suggestions to liberalize food intake and add caloric density, is essential. This could mean adding oils or creams to meals, encouraging nutrient-rich foods, and fostering a socially stimulating dining environment. Furthermore, exploring non-pharmacological strategies, like ensuring good dental care for edentulous patients, can also improve food intake and appetite.
The Importance of Family and Caregiver Involvement
Family members and caregivers play a critical role in the management of unintentional weight loss among older adults. It is crucial to engage them in discussions about potential dietary changes and the overall health plan to ensure they understand and can assist in the patient’s care. Providing education about the signs of dehydration, malnutrition, or other complications allows caregivers to participate in the care journey actively. By addressing their concerns and involving them in decision-making, healthcare providers can foster a supportive environment that benefits both the patient and their family.
Become a mini geriatrician in our new Geriatrics series!
Geriatricize your knowledge of caring for older adults with unintentional weight loss! You’ll round out your history taking and weight gain plan by harnessing the age-friendly “5Ms”. We’re joined by Dr. Eva Szymanski (@eva_szy), expert geriatrician at Penn Medicine.
Upgrade your closet this year without the upgraded price tag. Go to Quince.com/curb for 365-day returns, plus free shipping on your order!
Sponsor: Freed
Visit Freed.ai and use code CURB50 to get $50 off your first month.
Switch to Mint and new customers can get half off an Unlimited plan until February 2. To get your new wireless plan for just $15 a month, and get the plan shipped to your door for FREE, go to MINTMOBILE.com/curb
Get the Snipd podcast app
Unlock the knowledge in podcasts with the podcast player of the future.
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode
Save any moment
Hear something you like? Tap your headphones to save it with AI-generated key takeaways
Share & Export
Send highlights to Twitter, WhatsApp or export them to Notion, Readwise & more
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode