Not eating enough

[TheKatGamer]

So I am already too light.. But recently I have been loosing weight again.. I just haven't been very hungry at all so I just don't eat enough.. Any tips or advice?

[Fabkiwi06]

When I get that feeling, I try to eat more smaller meals through the day.

I don't know how your fluid restriction is, but sometimes I find it easier to drink something than eat. I make a smoothie with some protein powder just to get a little bit of something in me. Soup if I'm having a good day fluid wise.

[hatedialysis2]

have you checked with you nephrologist on this?  Your loss of appetite could be related to inflammation or the dialysis prescription, or other medical condition.  So I would recommend checking with your primary care if you do not find an answer from your nephrologist as he/she can rule out other causes.   In the mean time Fabkiwi06 gives good advise.   You have to get the nourishment  since dialysis removes about 15 - 20 gm of protein per treatment plus it removes important water soluble vitamins and minerals.  Eventually the body will start to into a catabolic  state. 

[Michael Murphy]

One thing I have noticed is with all the restrictions on diet that ESRD imposes it is tough to find food that you enjoy.  If you are concerned talk to your dietician about foods that help you maintain a healthy weight.  I find that snacking with good ESRD friendly fruit helps me get through the day.  It takes time to adjust your eating habits to your new diet reality. 

[hatedialysis2]

Forgot to mention to also check side effects of any medication you are taking to see if decreased appetite is mentioned.  Their are several sites online that's will give you that info. 

[Charlie B53]

I am on PD and 'wet' all the time as using the Cycler at night and carry Ico all day.   The abdominal pressure  has curbed my appetite to an extent.  The greater effects is limiting how much I can eat.  I feel so 'full' only eating maybe a third of what I used to eat.  But for me this is a good thing.  Now medically retired as my physical condition, strength and endurance would never allow me to work as physically as I used to.  I now do not burn near the calories I used to so I had been gaining a LOT.  Until I started PD.   In two years I lost slightly over 100 pounds.  Prednisone has put 20 of that back on.

Your solution may be learning how to change some of what you eat to ?? foods that have higher carb and fat per serving.  An easy example may be adding more salad dressing to a salad.   A second slice of cheese to a sandwich with a heavier coating of mayo.   Not trimming much if any fat from meats.  Having a Julius or a Smoothie instead of a diet drink or water.

Not necessarily eating more volume, just not so calorie conscious.

[iolaire]

Desire to eat is something they ask me about maybe once per quarter, leading me to believe its a common issue that your center should be ready to discuss with you.  Various people in my center are provided an ensure like product to load on protein likely due to diet challenges.

[Fabkiwi06]

My center asks me about my appetite every single time I go... so it's certainly been an issue with other patience there.

I find I go through cycles of being SO HUNGRY and not wanting to eat at all. When it's the latter, I tend to relax my restrictions so I can find SOMETHING that I want to eat and up my binders accordingly. My clinic also gave me some protein gel to supplement.

It's a constant struggle - especially since most of the foods I love are now not recommended.

[Charlie B53]

...............
It's a constant struggle - especially since most of the foods I love are now not recommended.

I'm almost certain this applies to most everyone.   Even long before my kidneys became a noticeable problem my Dr's have been talling me to stop eating this, that, and the other thing.   All the foods I grew up eating, and liking.   It pretty quickly seemed to be that if I liked it, I shouldn't have it.

Got to laugh as it won't do a bit of good to cry about it.   I can still bitch, moan, groan, and whimper though!   Wife just tells me to 'Shut up!'    Says I'm getting to be a cranky old man.    I don't think so.  I still laugh!

[Simon Dog]

My cardiologist tells me to eat only whole wheat bread and avoid the white stuff.

My renal dietitian tells me to eat only white bread and avoid while wheat.

[hatedialysis2]

My cardiologist tells me to eat only whole wheat bread and avoid the white stuff.

My renal dietitian tells me to eat only white bread and avoid while wheat.

 Slice of white bread has 1.9 G protein, 25g potassium, 25 g phosphorus, 0.6g fiber.  1 slice of whole wheat bread 3.6 G protein, 65g potassium, 65 g phosphorus,  2g fiber.   

White bread is void of nutrients, raise you insulin levels and do you much harm. 

[Charlie B53]

Wife and I both eat that 35 or 40 cal whole wheat bread.   I was very surprised at the taste and consistency.  It is bread.  Far better than that Bunny White she used to buy.   I always prefer that heavy wide loaf of wheat that has all the different grains and nuts, but that really drives up my sugar now.

The 35/40 I like.  Don't care so much for their other, sour dough maybe?  Not sure, only got it the one time and won't make that mistake again.

[Michael Murphy]

The basic problem is that when you are a dialysis patient most of the old rules you lived by for most of your life have changed.  The old 3 oz of meat per meal is a good example.  Dialysis removes protein from your blood during treatment, patients who urinate generally pass protein in the urine.because of this Hemo Dialysis patients need more protein.  The other things is the rules need to be tailored to your blood work.  Perfect results allow room for some rule breaking.  Less than perfect more rule following.  Your best friend in doing this is the center dietician.  They should help you figure your own set of rules.  The penalty for getting labs way out of whack could be death.  So minor changes and wait for your next labs would  be prudent.    The Rock and hard place is too much phospherous or potassium wifi kill you, while too little will kill you too.  Like I say find the dietician make friends, work with the dietician  good labs you get a little play in your diet bad results tighten up.  This sounds easy but not reading content listings on food is a other problem, recently after three years of perfect labs all of a sudden my results were not good.  It turned out I had tried Eggo waffles, they were good, and without reading the content of them I began eating them for breakfast and sometimes lunch.  I began to retain fluid, and my lab results were just bad.  After getting the results I read the box four the Eggo waffles has400 mg of salt.  I began to retain fluid because of the huge increase of salt, the fact I was retaining fluid meant I was going less that raised my potassium and phosphorous levels.  Dropped the waffles, next month perfect lab results.  Work with the dietician, read packages, if needed keep a food diary.  One last example my next door neighbor in dialysis got back bad phosphorous results, the tech mentioned that his Duncan Donut Koolatta may have chocolate and maybe he should not drink them.  I used my iPad and looked up the ingredients in a Koolata it turned out it was loaded with a phosphorous compound as a preservative.  After stopping the Koolattas his results returned to normal.

[Charlie B53]

It is pretty well proven that even small simple changes in diet, of only one item, can make a large difference in our Labs.

We don't read labels near enough.  Learn to look at the ingredients, this habit alone will make a huge difference in our Labs.

[kitkatz]

My dietitian gave me a grocery list of foods good for a dialysis patient.  I could add it into the diet area of the site if anyone wants it.

[Charlie B53]

So I am already too light.. But recently I have been loosing weight again.. I just haven't been very hungry at all so I just don't eat enough.. Any tips or advice?

I just had a thought and had to laugh.

Are you bragging or complaining?

In my case I would be bragging as I could easily stand to lose another 50.   And that isn't near so easy to do.

But if you are a lightweight already, I can see how this can be cause for concern.   

Added butter to many foods can be tasty and increases fat content.   Same with cheese and cheese sauces, but this one you have to be more selective as the types of cheese vary.   Not all are renal friendly.    Your Dietician should be a good source of information.

I do not use butter substitutes.   Many are barely a molecule short of being plastic.  I don't think plastic belongs in our digestive system.

[cassandra]

I do not use butter substitutes.   Many are barely a molecule short of being plastic.  I don't think plastic belongs in our digestive system.

Completely agree with you there CharlieB53.

KatGamer, maybe try snacking on digestive biscuits with full fat cream cheese?

Love and luck, Cas

[PrimeTimer]

Seems that once my husband hit Stage 5 ESRD he's had a poor appetite. He doesn't eat enough and they've been on him about it. When he was doing home-hemo, he did it in the evenings and would be very hungry afterwards and would eat but, during the day he hardly had much of an appetite. Now that he does early morning dialysis at the center and is hungry afterwards, he is finally eating a late breakfast/early lunch. He still eats dinner as usual. Obviously dialysis affects appetite. I am glad he chose the early morning shift because in a way, the hunger he feels after a treatment forces him to eat.

[Charlie B53]

LOL   Prednisone will add weight to you!

Surprisingly it also helps with many afflictions, like pain.  Every gout flare up the first thing they tell me to do is start taking large doses.  As soon as symptoms begin to recede to start tapering off, taking at least a week before stopping.

If you are not hungry, it WILL make you hungry.  You will eat most anything you can fit in your mouth, not all good either.

[cattlekid]

Yeah, Prednisone is the Devils Tic Tacs for sure.  I could eat a horse if I had enough BBQ sauce and a large enough grill.

LOL   Prednisone will add weight to you!

Surprisingly it also helps with many afflictions, like pain.  Every gout flare up the first thing they tell me to do is start taking large doses.  As soon as symptoms begin to recede to start tapering off, taking at least a week before stopping.

If you are not hungry, it WILL make you hungry.  You will eat most anything you can fit in your mouth, not all good either.

[Charlie B53]

When we still lived in Everett, WA I would borrow a friends roaster for the one phone Co picnic each summer at a private park next to a river, and cage up TWO medium pigs, hit the switch and let them turn over the fire all night.  Dinner somewhere about 1 pm.  Nothing left but bones.    Good times.

[Riki]

My cardiologist tells me to eat only whole wheat bread and avoid the white stuff.

My renal dietitian tells me to eat only white bread and avoid while wheat.

 Slice of white bread has 1.9 G protein, 25g potassium, 25 g phosphorus, 0.6g fiber.  1 slice of whole wheat bread 3.6 G protein, 65g potassium, 65 g phosphorus,  2g fiber.   

White bread is void of nutrients, raise you insulin levels and do you much harm.

The higher potassium and phosphorus amounts in whole wheat bread can also do harm because damaged kidneys and/or dialysis can't filter it out..

I've also been told that I need to eat more.... when I look at my 5ft1, 220lb body, I have to wonder about that.. Really?  More?? *LOL*  I'm lucky to eat 2 meals a day, and the dietician is probably right... she told me that my protein and albumin levels were on the low side.. she suggested Special K protein bars as a snack for after dialysis.. I have a box of them next to my bed, because there's where I tend to go after dialysis... She gave me a list of the different kinds that she approved of, and all but one of them had chocolate.. so, when I get home from dialysis at night, while I'm watching tv and getting myself ready for bed, not only am I getting my protein, but I'm also getting my chocolate fix..

[jmintuck]

My center asks me about my appetite every single time I go... so it's certainly been an issue with other patience there.

I find I go through cycles of being SO HUNGRY and not wanting to eat at all. When it's the latter, I tend to relax my restrictions so I can find SOMETHING that I want to eat and up my binders accordingly. My clinic also gave me some protein gel to supplement.

It's a constant struggle - especially since most of the foods I love are now not recommended.

Not a heckuva LOT of struggle to me is the new diet, and hey, I was on it since Spring 2016. I really need to ask the center about the protein gel supplement tomorrow morning as I am worried sick about no appetite and the possibility of catalabizing. I just know that soon I am gonna be in some ^$#t.

[jmintuck]

The basic problem is that when you are a dialysis patient most of the old rules you lived by for most of your life have changed.  The old 3 oz of meat per meal is a good example.  Dialysis removes protein from your blood during treatment, patients who urinate generally pass protein in the urine.because of this Hemo Dialysis patients need more protein.  The other things is the rules need to be tailored to your blood work.  Perfect results allow room for some rule breaking.  Less than perfect more rule following.  Your best friend in doing this is the center dietician.  They should help you figure your own set of rules.  The penalty for getting labs way out of whack could be death.  So minor changes and wait for your next labs would  be prudent.    The Rock and hard place is too much phospherous or potassium wifi kill you, while too little will kill you too.  Like I say find the dietician make friends, work with the dietician  good labs you get a little play in your diet bad results tighten up.  This sounds easy but not reading content listings on food is a other problem, recently after three years of perfect labs all of a sudden my results were not good.  It turned out I had tried Eggo waffles, they were good, and without reading the content of them I began eating them for breakfast and sometimes lunch.  I began to retain fluid, and my lab results were just bad.  After getting the results I read the box four the Eggo waffles has400 mg of salt.  I began to retain fluid because of the huge increase of salt, the fact I was retaining fluid meant I was going less that raised my potassium and phosphorous levels.  Dropped the waffles, next month perfect lab results.  Work with the dietician, read packages, if needed keep a food diary.  One last example my next door neighbor in dialysis got back bad phosphorous results, the tech mentioned that his Duncan Donut Koolatta may have chocolate and maybe he should not drink them.  I used my iPad and looked up the ingredients in a Koolata it turned out it was loaded with a phosphorous compound as a preservative.  After stopping the Koolattas his results returned to normal.

More outta me. Often, rather more often than never, I MAKE myself read those contents of foods whereever possible. I try to sort out whether or not it is "good enough" so to speak for me, or to just reject it on sight. I found that a small square, about 1 and 1/2 inch squared is fine. I was told a small amount like this was OK in the UK dialysis diet charts. I thought I would try this kind of thing for a while, then adjust accordingly. I rarely get potato crisps, really. Well the occasional Halloween crisp "tiny bag". I had a few vomiting episodes, blamed on potassium. For that, I even had to crunch right down for a while until the labs come back any better. I am now actively keeping an eye on labs and finding out pros and cons if a food in question "occurs".

Additionally, I love cream cheese, and have alwys loved full fat cream cheese anyhow. Would do well to get a couple ones, one plain and another with some flavor, such as strawberry. I KNOW to verify whether potassium is low or high before I ever sink money into it, so I can be sure. I learned one hell of a lesson regarding Marmite I bought on Amazon.ca. I won't eat much of that until the day BEFORE if not closer to dialysis. Yes, I know, NOT MUCH btw. Just a 1/2 slice of toast for this spread. Thankfully I found a slightly better Peanut butter brand I can order for other days, other than specific days. A bagel and cream cheese would do wonders for me, I think, with such a sad appetite. More quick-smack together ideas would be appreciated, especially the no refrigeration needed ones if possible. Other refrigeration ones would be for the brands with serving size to smaller containers of said products.

IF you ARE questioning potassium, that is my hugest Achille's Heel, Google can be your friend. I have NO idea why Potassium is my BIGGEST Achille's Heel, whereas, in other people phosphorus is the ringer. IDK if I am more or less lucky in any tiny way. I have yet to hear anything bad about Phosphorus. Potassium is the real Kryptonite for me, somehow.