Weight Management

Maintaining a healthy weight is key to living well with PD. It is common for people with PD to experience weight changes: some lose weight, yet others may gain. Changes in weight can affect overall health. By being underweight you may have reduced muscle mass and strength, causing you to be prone to osteoporosis and infection. Being overweight raises risk of heart disease and high blood pressure and puts stress on your joints.  

Common Causes of Weight Changes

Weight Loss

There are many reasons people with PD lose weight. Some people lose weight even if they are eating exactly the same meals. Others find certain PD symptoms affect appetite or the ability to eat.

• Gradual loss of the sense of smell and taste is a non-motor PD symptom that makes eating less enjoyable.
• People who experience depression or apathy — common non-motor PD symptoms — may lose their appetite.
• Motor symptoms like tremor, slowness, stiffness or dyskinesia may make it physically difficult to prepare and/or consume meals. When this is the case, adjustment in PD treatment can be helpful.
• Some PD medications cause nausea, which suppresses appetite.
• Gastrointestinal symptoms of PD such as constipation, nausea, or bloating may reduce appetite.
• Swallowing difficulties are common in PD and can interfere with eating.
• People taking levodopa may have been advised to avoid taking medications with protein, making it difficult to get adequate nutrition throughout the day.
• Severe involuntary movements associated with PD, such as dyskinesia or tremor, may result in increased physical exertion and calorie burn.

Please note that weight loss is a non-specific symptom and may be due to a medical problem other than PD such as cancer, thyroid disease, diabetes, or bowel disease. Ensuring that cancer screenings are kept up to date and following with a primary care physician is critical.

Weight Gain

Weight gain is sometimes a side effect of PD therapies.

• Dopamine agonists are medications occasionally given alone or in combination with formulations of levodopa to manage PD motor symptoms. They have been linked with compulsive behaviors, including binge eating, which leads to weight gain. Commonly prescribed dopamine agonists are Pramipexole (Mirapex®), Ropinirole (Requip®) and rotigotine transdermal system (Neupro® patch). Under the supervision of a doctor, adjusting medications can stop a person’s compulsive eating. Without medication adjustment, this is unlikely to improve despite the best intentions of the person with PD.
• Other medications, especially those used to treat psychiatric complications of PD, can contribute to weight gain.
• Deep brain stimulation (DBS) is a surgical therapy that helps relieve movement symptoms in many people. Weight gain is a common outcome.

Tips for Achieving a Healthy Weight

Whether you wish to gain weight or lose it, diet and exercise are key.

• Eat a balanced diet, with a variety of foods from all the food groups: whole grains, vegetables, fruits, dairy products and sources of protein like meat, fish and beans.
• Exercise helps keep people mobile and strong and can improve mood. Being active stimulates appetite and burns calories.

Talk to Your Doctor

It is important that PD motor symptoms be optimally controlled. See your neurologist or movement disorders specialist to see whether they recommend a medication adjustment. Also, visit your primary care provider to exclude other medical reasons for weight change.

Do you need to gain or lose weight?

• Get a referral for nutritional counseling — learning about nutrition and PD can help you maintain a healthy weight.
• Get advice on starting an exercise routine from a physical therapist who is experienced in PD.

Tell your doctor if you eat compulsively or binge eat — this may be a side effect of PD medications.

Page reviewed by Dr. Addie Patterson, Movement Disorders Neurologist at the Norman Fixel Institute for Neurological Diseases at the University of Florida, a Parkinson’s Foundation Center of Excellence.