Why Your Weight May Change With Multiple Sclerosis

Weight changes are common with multiple sclerosis (MS). The number on your scale might go up or down, depending on things like fatigue, depression, or medicine you take. But there are tips to try that can help keep your weight on an even keel.

Causes of Weight Gain

Lack of physical activity. Some MS symptoms make it hard to move around or put you less in the mood for exercise. You might find yourself adding extra pounds because of things like:

Unhealthy eating. You might be too tired to make healthy meals. Or you might overeat when you feel depressed or stressed out.

Medication. Newer treatments like disease-modifying therapies shouldn't affect your weight. But you might add some extra pounds if your doctor treats your MS flare with long-term oral steroids. Certain antidepressants can also cause weight gain.

Not enough shut-eye. A lack of sleep raises the chances of weight gain in anyone. But there are certain things about MS can that can make it even harder to get enough rest, such as:

How to Lose Weight

You might want to shed those extra pounds really fast, but you're more likely to keep weight off if you lose it slowly. Aim for a loss of 1-2 pounds a week. Here are some ways to do that:

Create healthy food habits. It's a key part of a weight loss strategy. Choose snacks and meals that are high in fiber, vitamins, and minerals and low in added sugar, salt, and saturated fats.

It might be easier to eat healthy if you:

  • Plan a weekly menu
  • Get groceries delivered
  • Cook extra food and freeze it for later

In general, you should eat more of these:

Limit or avoid:

  • Ultra-processed food, like white bread, chips, or cookies
  • Sugary drinks, like soda or juice
  • Red meat
  • Processed meat, like bacon and sausage
  • Fried foods

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Talk to a nutritionist. A registered dietitian nutritionist (RDN) can tailor a food plan just for you. Ask your doctor to suggest someone who works with other people who have MS, or search for an RDN near you on the website of the Academy of Nutrition and Dietetics.

Get enough sleep. Here are some tips that might help at night:

  • Stretch before bed to prevent muscle spasms
  • Treat the MS symptoms that wake you up
  • Don't nap during the day
  • Avoid caffeine and alcohol close to bedtime
  • Don't drink a lot of liquid before bed

Find the right exercise for you. Physical activity can help you drop weight. It's OK to start out slow. Any movement is better than none.

Talk to your doctor before you start a new routine. They'll let you know what's safe. If you have trouble moving, a physical therapist can design an exercise plan that works for you.

Here are some exercise tips to get you started:

  • Wear cooling gear, like a vest, neck wrap, or hat
  • Drink plenty of water to cool your body down
  • Swim or do water aerobics in a cool pool (less than 84F).
  • Bike indoors
  • If it's hot outside, exercise in the morning or evening
  • Garden or do yard work
  • Walk around your block
  • Build muscle with strength-training

Exercise is good for your body and mind, even if you don't lose a lot of weight. And remember that physical activity won't make your MS worse, even if your symptoms flare up a little after you push yourself.

If none of this helps, ask your doctor to refer you to a sleep specialist.

Ask about your medicine. Your doctor might be able to switch you to a drug that's less likely to affect your weight.

Causes of Weight Loss

Poor appetite. You might not feel like eating if you're depressed or really tired.

Swallowing problems. MS can affect the muscles that help you chew and swallow. The medical term for this is dysphagia.

Medication. You might lose weight if you take certain drugs, such as:

  • Stimulants for fatigue
  • Antidepressants like bupropion

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How to Gain Weight

Eat small meals more often. You might get full really fast if you don't have much of an appetite. Instead of three big meals, try five to six smaller ones throughout the day.

Add a nutrition drink. You can pack a lot of healthy calories into a shake or smoothie. If you have dysphagia, thicker liquids might be easier to swallow.

See a specialist. A registered dietitian nutritionist can help you come up with a dietary plan to get all of your nutrients. If you have problems swallowing, you might need to see a speech pathologist. They can teach you exercises that make eating and drinking easier.

Do strength training. You can add pounds by building up your muscles. If you have weakness, talk with a physical therapist to find out which resistance exercises are best. An occupational therapist can help if you have problems with your arms and hands.

When to Talk to Your Doctor

It's good to get a checkup anytime you gain or lose weight and you don't know why. Your doctor might want to rule out another medical condition, like a thyroid disorder.

WebMD Medical Reference Reviewed by Michael W. Smith, MD on August 12, 2020

Sources

SOURCES:

Sharon Stoll, DO, assistant professor, department of neurology, Yale Medicine. 

National Multiple Sclerosis Society: "Taking Control of Your Weight," "Weakness," "MS Symptoms," "Sleep," "Exercise," "Fatigue," "Swallowing Problems."

Multiple Sclerosis Society (UK): "Managing your weight."

BMJ Open Sport & Medicine: "Sleep deprivation and obesity in adults: a brief narrative review."

CDC: "Healthy Weight: Losing Weight," "Healthy Weight: Getting Started."

Hippokratia: "Body composition in multiple sclerosis."

American Heart Association: "How to Eat Healthy without "Dieting."

Eatright.org: "Find an Expert."

University of Pittsburgh: "Sleep Disturbances," "Stomach and Intestinal Issues."

Journal of Clinical Medicine: "Long-term Weight Change after Initiating Second-Generation Antidepressants."

Familydoctor.org: "Healthy Ways to Gain Weight If You're Underweight."

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