Malnutrition in the setting of weight loss isn’t a made up thing—it’s real and it isn’t something you hear about enough.

When you lose weight rapidly, a stress response occurs that can be the culprit of outward signs like headaches or hair loss. Coupled with an inadequate diet in vitamins and minerals to support hair growth or inadequate hydration, the headaches and hair loss can persist in an endless cycle. But sometimes the signs of malnutrition are more subtle. Diminished bone density, hormonal changes, gut imbalances and gallbladder damage can occur and these have long lasting effects on a person’s quality of life.

Assess your malnutrition risk

Enter the help of a dietitian: for some adults, the allure of a diet plan coupled with other anti-obesity tools like oral medications or injections is  strong. As a dietitian certified in weight management, I know how life changing and effective a good pharmacotherapy routine can be in addressing weight but I also know how important it is to outline a personalized plan to address all of the malnutrition risk associated with rapid weight loss before the medications are started.

What is malnutrition?

Malnutrition is a condition of eating too much of the wrong nutrients or not eating enough of them to support normal body function. What do I mean by “normal body function”? I’m referring to energy, menstrual cycles (in women of childbearing age), digestion & cognitive function. The incidence of malnutrition in adults is 2-15% depending upon age and 40% (according to the CDC) for adults with over nutrition and obesity. As a registered dietitian, I get consulted often to help adults with outward signs of malnutrition, but my hope for all adults seeking lasting weight loss is to prevent it from ever happening.

Steps to reduce malnutrition risk

The first step to preventing a situation of nutrient deficiency in the setting of weight loss is to formally gauge that individual’s starting point in terms of how much key macronutrient and micronutrients they eat on a daily basis. This can be achieved in a multitude of ways but a specialized team of medical providers will have the knowledge of key nutrients to watch for that are often diminished in the setting of medically supervised weight loss. In real life, this may look like meeting with a dietitian who has subspecialty training in weight loss for a clinical assessment in conjunction with a physician who draws lab work. Together the pair work to create a personalized plan for assuring a person is getting enough or will be getting enough nutrients while a calorie deficit is sustained. This may include the use of short term supplementation, specific dietary changes, the use of fortified foods or specialty beverages designed to address common nutrient deficiencies.

Contingency planning is key. Often times unforeseen stressors or outcomes occur. A good example is constipation or nausea experienced by adults adhering to low-carbohydrate diets while on GLP-1 agonists. There are evidenced based dietary approaches to addressing these symptoms and a dietitian can help formulate those plans on an as needed basis.

If an adult is on the fence about starting a formal weight loss routine, becoming informed about one’s personal nutrition status is a healthy and worthy exercise. There are online food tracking tools for free offered by the USDA and available online to assist an adult in tracking their personal nutrition intake against recommended daily intakes for their age and gender.

For those who need a dietitian’s help monitoring their food journals, we offer that service at North Texas Nutrition Associates and it is often paired with customized meal planning.

Malnutrition is the equivalent of the “check engine” light on a car dashboard. It is a sign that a person’s nutritional status needs to be addressed and supported. If you are experiencing fatigue, muscle weakness, irritability, brittle hair or nails and frequent infections while you are losing weight, please reach out to your doctor to discuss what nutrition changes if any need to be made to address your symptoms. We are here to support you!