How Can I Get Someone to Eat When She Says She's Not Hungry?

A fellow caregiver asked...

How can I get someone to eat when she says she's not hungry?

Expert Answer

Beth Reardon, M.S., R.D., L.D.N., is Caring.com senior food and nutrition editor and the director of integrative nutrition at Duke Integrative Medicine. As a practitioner of integrative nutrition, Reardon takes a holistic approach to wellness, recognizing that the foundation for optimal health and healing begins with a health-promoting diet. As a practitioner of integrative nutrition, Reardon takes a holistic approach to wellness, recognizing that the foundation for optimal health and healing begins with a health-promoting diet.

The most important thing you can do is to make meals as pleasant an experience as possible. Too often, worry over someone's lack of appetite can make every meal a battle. It often plays out like this: You're insistent, she's defensive, it gets ugly -- and, in the end, she still doesn't eat.

Many health conditions can contribute to poor appetite. Here are some solutions that apply to many people:

Try offering the person smaller but more frequent meals, and serve smaller portions. Also let the person serve herself, if possible. Being served up large portions (or portions she sees as too large) can be an immediate turn-off. If you serve a very small portion and she finishes it, she can always have another.

Focus on providing nutrient density, rather than volume. A big bowl of spaghetti, for example, can overwhelm her. Besides, spaghetti contains few nutrients; it's mostly carbs. Consider instead serving much less pasta along with roasted chicken and vegetables cut up in small pieces. It's easier to eat and provides more nutrition in smaller amounts.

Appeal to a loss of taste caused by aging or disease with the use of stronger seasonings in cooking. Try adding garlic, onion, scallions, turmeric, cumin, curry, ginger, cinnamon, red or green pepper.

Serve beverages between meals rather than with meals. Many older people fill up on fluids at the table and don't have room for real food. If dehydration is a risk, liquids not served at mealtime should be offered throughout the day. Offer beverages that are higher in calories, such as fruit nectars, cocoa, yogurt drinks, and juices.

Serve the biggest meal at the time of day the person is most alert. That's when people tend to have the best appetite. For older people, this is often breakfast or late morning.

Make sure a stash of healthy snacks is readily available. This way, the person can grab something that requires no preparation and is easy to reach. For example, in the pantry or even in the room where she spends the most time, you might have meal bars, nut butter, trail mix and crackers, or whole-wheat fig bars. In the refrigerator, keep front-and-center options like yogurt, hummus and carrots or whole-wheat pita bread, or peeled hard-boiled eggs.

Rely on reminders. People with dementia, in particular, often forget to eat. So you can post a note on the refrigerator about what's inside. Pictures are especially good, as they also can stimulate appetite.

Serve nutritional supplement drinks. Options such as Boost, Ensure, or Sustacal help provide nutrients. Add ice cream to make it more like a shake, which can be drunk through a straw. Supplements also come in pudding form, which most people like.

Make sure the person gets some exercise during the day. Exercise is shown to improve appetite.