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I am really glad that you have asked this question and that you are reaching out for help. OCD can be exhausting. And sometimes we need to sort things out with someone else.I would like to share some of my insights with you as I may have a unique prospective. I am a Counselor in private practice and a devout woman of Faith . I also have been diagnosed with Obcessive Compulsive Disorder. So if you will allow me to I am going to answer your question in story form. And then I will offer you some suggestions that may help you in your situation.If you were sitting across from me in my Counseling office right now , you would hear some relaxing back ground music playing. I would be pouring you a cup of herbal tea and there would be a plate of homemade biscotti with ginger bits in it for us to share. I have a large assortment of teas and hot chocolate for you to choose from. Today I'm drinking Chammoile tea. Which type will you Choose? There are tissues if you need to cry as you tell me what is troubling you. My office is a safe cozy place with a heavy door that shuts the outside world out. And what you tell me stays safely inside the room.We would fill out an intake form together and I would ask you some questions about your Self. I would tell you that I would only see you as a client if you would agree to see a medical doctor. I would give you a referral card for a doctor I work with and trust and encourage you to set up an appointment with them before our next meeting. I may refer you to a specialist also and ask you to continue to see them on a monthly basis.I would tell you that I am a Woman of Faith and that I am open to talking about any questions or concerns you may have about God or Religion. I would encourage you to consult your clergy or the sacred texts of your Religion. But that if you would perfer not to talk about God or Religion with me that would be okay too. That I feel comfortable either way. I would tell you that I use a combination of modern psychology, Ancient Wisdom and scientific evidence based research in my work. And you would see books from many disciplines on my shelves. And Art from around the world on my office walls.Then we would talk about some of the boundaries I have with clients and if you and I both agreeded you would sign the intake form promising to respect these boundaries and so would I.We would spend some time getting to know one another. You would be a little nervous at first and that is normal. But as you drank your tea and nibbled on the cookie you would sink into your chair and begin to relax a bit.Then you would begin to tell me about your life and what you are currently struggling with. I would listen patiently and nod or ask questions so that you knew that I was paying attention and understood.At some point you would say to me “ If someone has made a rushed promise to God about not doing an OCD compulsion but can’t remember if he made one , is that promise valid? “And I would say “ Tell me more about that…” and I would be supportive and listen. And sooner or later your whole story would come tumbling out.And maybe, just maybe you would be feeling a lot of shame and worry. And maybe you would admit that the “ someone" who has been “making rushed promises to God about not doing compulsions" is you.At this point you may not be willing to tell me what exactly the compulsions you are struggling with are.. Because …well you have any one of a million reasons for not wanting to share the specifics of your unique compulsions with me yet. And I would tell you that it is okay. That you and I are in the beginning of the bonding and trust building stage. And I would write an affirmation on a 3x5 card for you and hand it to you. I’d reach over and chose a marker from my art supplies sitting on the bookshelf next to me. I'd say “ What is your favorite color Dear One?” and then I would take a marker in your favorite colour and write out ..*For me Trust grows slowly and appropriately.Then I would hand the affirmation to you. And I would tell you that when you were ready to share what your compulsions were I would be there for you. And that you were very Brave to come in and ask for help. And that together with God's help we would get to the bottom of this. That we would work together to get you some relief from your compulsions.You would most likely be very nervous and uncomfortable inside when you talked about the compulsions. And I would tell you that it is normal to feel discomfort when first discussing things we worry about. But that in time you would become more relaxed as we worked together to overcome these compulsions.On the intake sheet you filled out there is a place to list any Obcessions or Compulsions that trouble you. I would have that sitting on the table between us so that we could both see it. I would write on my tablet [ 11x 12 pale lavender paper in case you are wondering Dear One ]Obcessions. * Compulsions * Worries* TriggersAnd as you talked to me I may make notes. I stop and answer questions along the way.Now at this point you have something that you feel very embarrassed and deeply ashamed about. And you want to tell me what it is but you can't. You say “ I really want to explain this thing that happens to me. But it is VERY EMBARASSING and I don't think you will understand. And I am really worried that you won't like me if I tell you.” And you start obsessing about it in your mind.And I give you a tablet and put some art supplies within reach and I tell you sometimes I doodle when I am nervous and you are welcome to colour or draw or doodle while we are together.And I pour us both another cup of herbal tea and I say to you “ Would you allow me to share my story with you about my own personal struggle with OCD? “ And you say you “ Yes" and now here we are together in the cozy room with the music softly playing and you begin to draw on your tablet and I share my story…I have struggled with OCD my entire life. All of my life I have known that I was different from other people. I have been very detail oriented since I was a little girl.1) I like to arrange objects in certain ways. I am not comfortable if my objects are moved. [ At this point I get up from my chair and move a 5x7 black graffic art canvas that says “ Love sees no Colour" on it in white type. I move it over on the wall a couple of centimeters. Now it is not in balance with the other near by art canvas that says “ Love is All you need" Then I tell you.” Okay, let's wait and see what happens…. ..“ I can only stand for the pictures to be crooked for like 56 seconds. We watch the clock. You time me. Then I start to twitch my fingers. “This is the Tension building phase.“ I say. “This absolutely drives me crazy.” I am being real with you and you nod and keep coloring. Then I cannot bare it any more and I straighten all three pictures very quickly in succession. And we both laugh knowingly. You get it immediately. You understand. I tell you this is what we will do together in therapy. We will identify Compulsions, Obcessions, Worries and Triggers and our feelings around them. And search for meaning in this extreme order or chaos.So I have my own tablet and I write : JeanneObcessions. * Compulsions * Worries* TriggersStraighten frames.* HAVE TO *crooked frame Feelings: out of control/ AnxiousAnd then you nod knowingly. And I explain how in my own space, I can control the frames and make them straight now as an adult.[ Because I use a combination of picture hangers, velcro and push pins I developed especially for this very purpose. Ha!]But I grew up in a Southern California earthquake zone and it drove me crazy to HAVE to constantly readjust and straighten the frames in my childhood home multiple times a day. My family did not understand. And we had one of those walls with all of the family portraits on it of all different sizes and shapes. And we lived on the San Andres fault. And I crave Symmetry and Beauty and Order. And trust me , there was absolutely no Symmetry or Order in a home with 6 kids spaced one year apart. No matter how many times I straightened all of those picture frames I could not keep them straight and aligned. I may as well have been rearranging the deck chairs on the Titanic. Because it was an impossible task I had assigned my child Self. But I had a Fear that if I didn't do it something terrible would happen. [ add Feeling of impending doom to my list] And I had to walk past that family portrait wall coming in and out of our home. And every time I'd go use the bathroom. And every time I went past that family portrait wall I would ABSOLUTELY HAVE TO adjust each and every picture. And I'd get them all just right and someone would slam the door, the wall rattle, the house would shake and I would HAVE TO start all over. Over and over until it’s done. It's NEVER DONE. And I would get caught in THE LOOP of IT HAS TO BE PERFECT. And feel afraid something terrible would happen if I didn't DO IT PERFECTLY. And OVER AND OVER UNTIL ITS DONE ITS NEVER DONE became my motto.And soon I was sowing stones that would bare no fruit. Doing an impossible task. Caught in a Trap. Doomed to repeat the cycle over and over again and again. Knowing that something was not right. But completely unable to stop my Self from straightening those frames.And the tragic thing was I would be convinced if I straightened those picture frames everything would be okay. I had a magical thinking fixation that straightening those picture frames would somehow fix and straighten my Life. I wanted desperately to set the Twisted things Straight. But no matter how hard I tried I could not stop those pictures from becoming crooked. It just was not humanly possible for a third grader to do. I had unknowingly assigned my Self an impossible task.2) And there was a whole cycle around my compulsion.FEELING NEED TO DO IT/ URGERESISTING THE URGE*TENSION BUILDING PHASE*GIVING IN TO COMPULSION/ ritual*CAUGHT IN THE TRAP/*FEELING COMPLETIONELATION MOMOMENTARY cycle*DISPAIR at failure to stopPOWERLESSNESSBACK TO THE START3) I had a whole List of childhood symptoms that people overlooked. I counted things. I had Obcessive thoughts. I could remember long lists of names and details. I had a near photographic memory. All of these things were like a dual edge sword. I got a lot of positive attention for being smart and having a good memory. But inside I was being tortured by compulsions, rituals and Obcessive thoughts. I kept these thoughts secret from others for years. I created my own internal belief systems to deal with them. My family moved a lot so my rituals would get interrupted and this caused a lot of stress for me.4) I was dealing with the Challenges of compulsions and obcessive thoughts pretty much alone as a child as I was too ashamed to ask for help. As a young child I started to pray and ask God for help. And I started reading the Bible at a very young age. I have read it over and over many times all the way through each year since childhood. I started memorizing large sections of scripture each year. I found that prayer and memorizing scripture verses helped soothe me. Because of this I have regularly memorized and meditated upon Bible verses since I was 8 years old. I also know the lyrics to many, many songs by heart. I also memorized Psalms and Proverbs and sayings in other cultures. I did this from a pure heart of sincerely wanting to be closer to God and please Him.5) As a teenager I asked a Trusted Therapist and a Psychiatrist about my compulsions and rituals. I felt deeply ashamed when they both said “ Well it's not like you wash your hands a million times a day…..RIGHT?” And ‘Well it's not a compulsion because you can control it.” They were well meaning but they had limited views and not much experience treating Obcessive Compulsive Disorders. So I did not get the help I needed.6) The positive side of this is I know the Bible inside and out. And I feel very close to God. Because of my Obcessions about obscure details in scripture I can answer Biblical questions off the top of my head. Not many people today can do that.7. ) As an Adult , I was working as a mental health professional and I did not realise I had OCD. it took years for me to be formally diagnosed with OCD. I got diagnosed at 33 old after my third child was born. My symptoms get worse with stress.8.) Very few people know this about me. Most people just think I am Detail Oriented. Because I did not get diagnosed until later in life I had developed coping strategies for dealing with my OCD.9) Because of my personal experience I understand exactly how frustrating, shameful and depressing the OCD cycle of Compulsions, Rituals and Obcessive thoughts can be. I know what it is like to feel hopelessness and despair of ever being free of the cycle. I totally get it.So after sharing this with you , you would most likely be nodding and maybe even crying and sharing more of your own personal story with me. And at some point you would ask your original question about rushed promises to God and whether or not they are valid. And this is what I would tell you:Dear One, God knows your heart better that you know your Self. He loves you with an everlasting love that is not dependent on your behavior. You are His child and He loves you unconditionally. The Bible says that God understands that we are but dust. That means He knows what we are made of. He knows all of the stressors each one of us is under. He knows how we get caught up in obcessions and compulsions and rituals and get stuck in that endless loop. He knows all about our shame spirals. He knows EVERYTHING there is to know about us and still He loves us. While we were yet sinners Christ died for us. God wants you to be free. He came to set you free from sin and death. You shall know the TRUTH and the TRUTH shall set you FREE. There is now therefore no condemnation for those who are in Christ Jesus. For the law of the Spirit of Life in Christ Jesus has set you FREE from the law of sin and death.If we were together in my office I would give you the business card of a doctor and strongly encourage you to go get evaluated and explore the possibly of taking medication for your OCD. I would give you some Affirmations to memorize. And maybe some verses if you asked for them. And if you asked me to I would pray with you aloud. Let's do that now.Dear Lord God, Thank You so very much for Your great love for me. Thank You that You created me and You know EVERYTHING I struggle with. Lord God please help me. Sometimes I make promises to You that I cannot fulfill. Sometimes I promise you I will stop doing this certain thing but then I go right back and do it again and again .I make promises to You then I break my promises. Then I worry a lot about this God. And I have a lot of fears around this. God I need Your help I can't do this on my own. Please help me to find a Counselor and a Doctor who understand OCD. Thank you for Quora. Thank You for leading and guiding me here. Thank You for Your Love for me that will Lead me to Health and healing. Thank you that Your Word, the Bible says that there is now no condemnation for those who are in Christ Jesus. Thank You God that You gave men the ability to make medications for OCD. Thank You that You are making a way for me out of this frustrating cycle I have been stuck in. Thank You for helping me. I say this in Jesus's name, Amen. [ or Yahshua's name, whichever you feel more comfortable with Dear One.]I would suggest to you that perhaps you would find comfort in reading the book of Psalms in the Bible. Many people have found it to be soothing.I would give you these Affirmations to say to your Self first thing in morning and last thing before bed for 5 minutes:It is just a thought and a thought can be changed.There is now therefore no condemnation for those who are in Christ Jesus. Romans 8:1God loves me.Jesus [ Yahshua] understandsI can ask for help when I need it.Then we would set up our next appointment to get together. And now that you know what a Counseling session is like, it is time for you to set one up with a Therapist on line. Asking for help from Quora was a big first step. The next step is seeing a Doctor and working with a Therapist doing your inner work. I will be thinking of you and praying for you. I am sending love and hugs from Washington State, USA, Jeanne of In Loving Hands Counseling and ASMR

Q&A: What to Do About Unintentional Weight LossQ: My 88-year-old father lives in his own home about 100 miles from us. He’s been living alone since my mother died five years ago. I thought he looked rather thin last time we saw him. I’m starting to feel worried about his nutrition. Should I be concerned? Would you recommend he start drinking a supplement such as Boost or Ensure?A: This question comes up a lot for families. It is indeed very common for older adults to experience unintentional weight loss at some point in late-life.The brief answer is that yes, you should be concerned. But I wouldn’t recommend you jump to purchasing Boost or Ensure.Now, in most cases, some nutritional supplementation is in order. But before focusing on this, you should first get help figuring out why your father is losing weight.For doctors, unintendedweight loss is a major red flag when it comes to the health of an older person.So in geriatrics, we usually recommend that an older person — or their caregivers — monitor weight regularly. This enables us to spot weight loss sooner rather than later.Once we’ve spotted unintentional weight loss, the next step is to figure out what might be causing it. And then we’re in a better position to recommend a treatment plan, which might well include a nutritional supplement.Why you should monitor for unintentional weight lossThis often goes hand-in-hand with malnutrition in aging. Now, they aren’t quite the same thing: it’s possible to be malnourished without obviously losing weight. But they tend to go together.Both problems are common in older adults. One study found that 39% of hospitalized older adults were malnourished.It’s important to detect and evaluate weight loss and malnutrition for several key reasons: They are often caused by underlying health problems which need to be diagnosed and managed.They leave older adults weakened and more vulnerable to additional illnesses and injuries.They may be a sign that an older person is impaired, or otherwise needs more support with daily life.Fortunately, there’s an easy way to screen for these problems: tracking an older person’s weight.How to track weight and nutrition in an older personTracking Weight: This is a terrific quick-and-easy way to monitor overall health and nutrition in an older adult.To track the weight of an older person who lives at home or in assisted-living, I usually recommend checking and recording the weight at least once a month.(Note that nursing homes are usually required to weigh residents monthly; some assisted-living facilities may do so as well.)You should keep records of the weight checks, preferably in a way that makes it easy to bring the information to the doctor’s office. Some families keep the information in a paper chart, but it’s potentially better to keep it in a shared computer file; see this article on keeping and organizing information for more details.You can also consider one of the newer “connected” scales. These are devices that can wirelessly connect to a mobile device or even the home’s wifi. The weight record can then be accessed through an app or website.A general rule of thumb is that unintentionally losing 5% of one’s original body weight over 3-6 months is cause for concern. But it’s also reasonable to be worried if you notice a steady downward trend.Once you’ve become concerned and documented a change in weight, you’ll want to bring it up with a doctor or other health professional.Tracking Nutrition: Monitoring for unintended weight loss, as detailed above, is probably the easiest way to screen for nutrition problems.Other red flags to take note of are: Loss of appetite.Decreased strength and/or ability to get around.Note: The term “nutrition” can be used differently in different contexts. In geriatrics, the focus is often first on ensuring that an older person is getting enough calories and protein to maintain energy needs and muscle mass. Obviously, there is more to nutrition than just this; it’s also important that people meet their body’s needs for vitamins and minerals, and that they eat a “healthy diet.” Exact definitions of a “healthy diet” differ, but it’s generally one that promotes health and well-being, and doesn’t cause or aggravate health problems. A Mediterranean-style diet can work well for many people.Common causes of weight loss and malnutritionIt’s important for an older person to get a clinical evaluation, once you’ve noticed weight loss or other signs of possible malnutrition. A simple initial assessment tool that many clinics will use is the Mini Nutritional Assessment.Some additional issues that particularly come up in older adults include: Difficulty leaving the house to purchase food. This can be due to limited mobility (e.g. due to pain, fear of falling, etc), lack of transportation, or cognitive problems.Difficulty affording food. Some older adults live on a very limited income.Difficulty or pain with chewing and swallowing. Many seniors fall behind on dental care for various reasons. This can lead to painful mouth conditions, or a lack of suitable dentures.Constipation. This is quite common in older adults and can interfere with appetite and eating enough.Paranoia about food, due to dementia or a psychiatric condition. A fair number of older adults become suspicious of others during early dementia. Occasionally this leads them to not eat enough.Forgetting to eat or having difficulty organizing meal preparation. This is especially common for those with Alzheimer’s and other dementias, but can also be due to problems like depression or even mobility limitations.Unappetizing food. Sometimes the food is not to an older person’s taste, especially if it is a low-salt, low-fat, low-carb, low-sugar, or other medically “recommended” diet.Generally, to sort through all these possibilities, doctors will need to interview the older patient and the family. For instance, they will want to know: How is the older person’s appetite? Do they like to eat or seem uninterested? How has this changed over the past year?Any pain or difficulty with chewing or swallowing?Any problems with diarrhea or constipation?Who does the shopping for food? Who cooks the meal and organizes the time to eat? Does the older person do this alone or usually with someone else involved?It’s also very helpful for the doctors to have as much information on what food — and how much food — the person is actually eating.Last but not least, during the clinical evaluation, the doctor will physically examine the older person and then probably order some bloodwork as well.How you can help doctors evaluate weight lossThe main way to help doctors is two-fold. One is to bring in a weight record, showing how the older person’s weight has changed over the past several months.The other is to bring in information related to symptoms and ability to obtain food. You can do this by asking your older relative — and anyone else who is familiar with the person’s daily life — the interview questions listed above.Of course, the doctor will still need to ask these questions, but it’s extremely helpful for patients and families to have thought through the questions ahead of time.The best treatment plans are based on a careful evaluation and correct diagnosis of what health problems — and social factors — are causing the weight loss.Unfortunately, it’s common for many doctors to quickly turn to prescribing high-calorie supplements like Ensure, or even prescription appetite stimulants.In fact, this is such a common problem that the American Geriatrics Society chose to address it in their Choosing Wisely recommendations: Avoid using prescription appetite stimulants or high-calorie supplements for treatment of anorexia (loss of appetite) or cachexia (loss of muscle mass) in older adults.Instead, optimize social supports, discontinue medications that may interfere with eating, provide appealing food and feeding assistance, and clarify patient goals and expectations.(Learn more here: Choosing Wisely: 5 More Treatments For Older Adults You Should Question)Now, even when social issues and medical problems are addressed, it’s often necessary to provide some extra nutritional support to those older adults who have been losing weight.This usually means providing extra protein and extra calories. Fat is dense in calories, so this can be a good way to increase energy intake. Technically it’s better to provide “good fat” like olive oil, but in the short-term, I encourage people to consider whatever fatty foods the older person really likes to eat, which might mean ice-cream or peanut butter.Research also suggests that many older adults may benefit from supplemental protein, especially if they’ve been showing signs of lean muscle loss. Many studies have used milk or whey protein.So should you consider Ensure or Boost? You should discuss more with your father’s doctor, but my take is that such commercial supplements should be used only as a last resort. They are expensive, usually contain a lot of sugar, and contain various additives. So it’s better to make your own smoothies or otherwise provide nutrient-dense snacks and protein to your father, if at all possible.I’ve provided a lot of information while answering your question, so let me summarize the most important take-aways.Tracking monthly weights is a good way to keep an eye on the health of an older adult. Put it on the calendar. A “connected” scale can make it easier to log and share the weight record.Unintended weight loss is a major red flag. Take action and consult a doctor if an older person loses 5% of more of their body weight, or if you’re otherwise concerned.Be sure to check for problems related to purchasing, preparing, and eating food. These are easily overlooked in older adults. They may be related to mobility difficulties, cognitive impairments, dental problems, depression, or unappetizing diets.Commercial supplements and/or appetite stimulants should be used only after careful consideration with the doctor, and after considering alternatives. They often feel like the “easiest” solution (assuming one can afford them) but they’re usually not the best way to maintain an older person’s nutrition and well-being.If you want a more scholarly take on nutrition in aging, here are a few good articles: Flu Shots for Older Adults During COVID Times: What to Know & Do for 2020 »I’m concerned because when I mention it to the doctor he just brushes it off. Having to get these sweet protein drinks because she really likes them, but even with that and eating more sweets, she is still losing weight. Over the course of ten months she has lost over thirty five pounds. She eats about 60 percent of the amount on the plate. Wondering if we need to find a doctor who will take it more seriously? Would a digestive enzyme help?A 35 pound weight loss sounds worrisome. The doctor should not leave you feeling brushed off. If he has evaluated it, he should explain what he did, what he found, and what his conclusions are regarding why your relative has lost weight. I would try asking him to explain what he thinks is going on.If you are not satisfied that he has looked into it enough, or if it’s hard to communicate with him, then a second opinion certainly might help.I wouldn’t expect digestive enzymes to help in most cases, but you never know. For now I say you need to find out more about why she isn’t eating much and why she is losing weight. Then you’ll be better positioned to counter the problem.I am almost 91 years of age and I am losing weight slowly. I have always weighed between 120 and 130 in my later years. I slowly lost down to 110, now in the last month I have lost down to 108. I eat well balanced meals, lots of fruits and vegetables.This amount of weight loss does sound concerning. I would definitely recommend that you see a health provider and ask for an evaluation. An initial evaluation for this type of weight loss can be done during a primary care visit. Good luck!Losing 60 pounds in 3 years is quite a lot, so I’m glad the doctor is evaluating him. If your father is eating 2000 calories per day and still losing weight, I would recommend you keep asking the doctor questions about what they have checked for and how they plan to evaluate further. Good luck!Hello Leslie, Greetings from me! My mother age 70, weight 35 kilos. She feels weakness, nausea every day. It’s been 3 years she has diabetes and arthritis rheum. Please advise.Hello and thanks for your kind greeting! That sounds like your mom has a low body weight, but you don’t mention her height or how much weight she has lost, and over what time frame. Diabetes and rheumatoid arthritis, and the medications used to treat those conditions, can interfere with appetite and have side effects that include nausea. If I were giving advice to someone in your situation, I would start by looking at the medications and other health issues, probably also ordering some screening bloodwork.My mother weight is dramatically declining, she is in a nursing home and her weight is around 67 pounds. She has always been thin but around 110 pounds. Is there anything that can be done in helping her gain more weight?That sounds like a dramatic change in weight, but it’s also vital to consider the rate of loss, other health issues and medications that a person is taking. I would strongly advise tracking the weight of someone with that much of a change and consulting with the health care team at the nursing home, including a dietician if possible.This is a very well thought out article about the complexities of unexplained, sudden weight loss in older adults. You are good to point out that it is first of all important to discover the cause(s) and not jump to conclusions, or a solution, before really delving in. Especially if an older adult is living on his/her own, far away from adult children who can help and monitor. Make sure the social supports are in place, including hiring help if necessary or enlisting neighbors and friends, if possible. This is really, really complex.But just dumping in the calories is probably not the best idea. I realize that providing cases of Ensure seems really simple especially if you live far away from your aging parent, but it does not help increase health. It detracts from health. It would be better to thoroughly examine the person’s diet, enlist the help of a nutritionist, keep a detailed food log, and go for nutrient dense foods rather than “protein” or “fat” to put on weight.Maybe spend some extended time with your father who lives 100 miles away, not just a short visit, but enough time to get a grasp on the problem from up close.There are few simple answers, when it comes to the health of older adults. If you are concerned about unintentional weight loss, you should consult a health professional. The article aims to help older adults and families prepare, so that they can get better help.So very true. I applaud your, as always, calm and methodical approach, bringing to light avenues which could easily have been overlooked. In this case, especial thanks for moving the easy fix supplements way down the list of things to consider! THank you.My mom was about 180lbs at 5’3 and over the course of the past two years, lost 40lbs by dieting. She’s been complaining lately (she’s 83 now) that she has no appetite, so isn’t eating enough and has lost another 5-10lbs. She feels a little sick after she eats, but it passes. She is also depressed because my brother and I are trying to move her cross country with us and she has to sell the house we grew up in. I’m making her go to the Dr on Monday, but I’m sooooooo worried she has something seriously wrong with her. Could she be in ketosis and burning the small amounts she’s eating quickly? Any advice is greatly appreciated! She would be living with me already but is so stubborn!Loss of appetite, weight loss, and feeling unwell after eating does sound worrisome, so a visit to the doctor is a good next step.I don’t know much about ketosis in older adults, it doesn’t strike me as something that most geriatricians would think about as part of evaluating someone like your mom. But I suppose you could see what the doctor thinks of this possibility, and perhaps it will be possible to check your mom’s urine for ketones.Normally, what we would do is a careful history and physical exam, and then some blood tests.You can help your mom get a thorough evaluation by asking the doctor to clarify, at the end of the visit, what he/she thinks might be the cause of the weight loss, and what are the next steps in exploring this. Basically, the doctor should have a plan for checking for the common causes of weight loss that are in the article; if he/she isn’t checking for one of them, ask for more information on why they’ve concluded it’s unlikely.Your mother may well be experiencing some depression and this can cause lack of appetite and weight loss. But it’s important to not conclude this is the main cause of weight loss until other causes are checked for and ruled out. good luck!My grandpa is losing weigh about 10 kg in one year Also has macrocytic anemia.He doesn’t lose appetite but has issues with dental problems. underlying diseases are polycystic kidney disease and hypertension.I would strongly recommend that he see his doctors. Your family can ask about evaluation for all the common causes of weight loss and malnutrition that I list in the article.I also cover the evaluation of anemia here: Anemia in the Older Adult: 10 Common Causes & What to Ask Macrocytic anemia can be caused by deficiencies in vitamin B12 or folate, but he may well have other causes for his weight loss (or anemia). Good luck!I have moved fromNJ,to be close to my father,and mother permanently. Prior to such,dad was at a healthy 170 or so pds, eating well,and still is… Last few weigh-ins, (also was diagnosed as still competent and gets around but healing from light to mild stroke, (Dec.2017) active 82 years, He,since then dropped a few pounds,but is eating quite normal. Three to four or so meals a day adding in snacks,(he love his ginger snap cookies, and other snacks his grapes,and he is again having NO LOSS OF APPETITE.)Dad, again in January last weighed in on or about the last week of January 2018 (At his shoulder/arm dr., after his fall) was at 162 pds. – Dad, with late onset(diagnose late)Dementia/ALZ has been eating so well. He also gets out at least 1x to 2x a day.He really enjoy going out and i ensure/making sure i do just that to get him out the house each day, with the exception of bad weather, snow and or rain storms http://etc.al., and he is always happy, laughing, and enjoying his days regularly, and has ZERO issue with bowels Development Mode.,but again he is now as of tonight, (i did a weigh-in) and am going to keep doing so at least once or twice a week,he is down to 159.2 pounds.” I shall schedule a dr.’s check-up,regular primary physician appt., tomorrow for this week.I would like your feedback please as to the feasible underlying issue involving weight loss with the elderly, as i am researching thoroughly, insofar as such relevance. I even learned some with such illness,diagnosis that this does not happen to him/her and i hoping you’re able to help til’ i reach his doctor, thank you very much. Dad is early eighties. Always was/is healthy such a long time. Thank you so much in advance for your courtesies and care when responding.Good day now. God bless us all.Hello, I had to edit down your comment as it was too long to be posted in its entirety.It sounds like your father has been diagnosed with dementia and has lost 10 pounds recently. Also sounds like his appetite is good and he has no particular complaints.Although it’s great if he’s feeling well, I think you are right to be concerned and to ask the doctor to look into things. Based on your father’s past medical history, and current findings on physical exam and when your family is interviewed for symptoms, his health providers should be able to determine whether any of the common causes for weight loss appear likely in his case.Regardless of what the health provider finds, it would probably be a good idea to continue to track your father’s weight, as you are doing.My girlfriend’s almost 26th four months ago she took 96 sleeping pills when I found her they said she her body was shutting down they saved her every since then she has lost so much weight almost 3 to 4 lb a week what should I do I’m trying to look for something to read up on it so I can call the doctorMy wife age 68 yrs. We are from India and living in a joint family. She is a patient of High blood pressure but we’ll controlled. She is having type II Diabetes also under controlled. She lost 07 kilogram for last 03 years. Lot of Medical tests have already been conducted and found suffering from Gastritis. She is being treated by Gastroenterologist and other concerned doctors. But her health is not at all improving and she is gradually moving towards depression. Request your advise for her weight gain.Impossible to say over the internet what might be causing her weight loss and what should be done. If she is not improving under the care of her current health providers, I would recommend considering a second opinion.You could also ask her doctors to clarify what conditions they feel they have ruled out, and what do they think is the likely cause of her weight issue. Good luck!Yes, there are many items to investigate with elder weight loss. I smiled as I read your list and wondered why you had left out poor dentition.Medicare does not pay dental bills and dentistry is expensive plus may not be accessible near the patient. If the person can’t chew properly or has gum or other related oral disease, then not doing so causes less pain and subsequently weight loss.Actually, in the article, I list “Difficulty or pain with chewing and swallowing” as an important issue to consider when it comes to weight loss in older adults, and I mention that inadequate dental care is common.I agree that it’s unfortunate that Medicare does not help older adults with dental care, as it’s certainly important to overall health and wellbeing.Hi Leslie, this is such great info. Just wondered if you would mind me posting on a local Facebook group I have set up Bayside community Aged Care and Disability group. Or you are welcome to join. Only 50 members do far but hoping to grow as only just set up.My husband and I have an increasing concern regarding his 90 year old mother’s nutritional intake (she presently looks like a war refugee). For over 5 months now, she’s been at a Christian Science care facility. In our view, the facility’s approach to kitchen-management is resulting in a form of anorexia.The mom has long been a “picky eater”, always outspoken about not being able to tolerate any food that’s even slightly spicy. Unfortunately, at this facility, the “head cook” is Latina, and by the mom’s account, ALL the prepared dishes are seasoned with hot spices. (She also says the desserts are all “disgustingly sweet”.) The cook also seems to have a large repertoire of “unfamiliar” dishes; due to the apparent onset of dementia, the mom won’t even taste anything she can’t identify. According to her detailed descriptions of recent meals, she often eats nothing, or only one item, from any lunch or dinner. (Example: “So I thought, ‘at least I can eat the roll’ – and then the roll was disgusting.”) Yet, it appears to us, that nobody at the facility is noticing or caring that her plates are going back virtually untouched.We have asked her why she isn’t making a general complaint, or even demanding a separate, unspiced, simple meal be made for her, that she CAN find palatable, so that she can eat a normal amount. She only gives us vague answers, that “people have tried asking”. We are wondering if the overall decrease in nutrition, combined with this scant energy supply being largely diverted to healing 2 broken bones over the past months, is actually diverting energy from the brain, and and accelerating her dementia, which seems to be worsening week by week.Now, this menu/nutrition/anorexia situation seems to me, to be a serious red flag for whether the place is providing a truly acceptable level of “care”. And I’m wondering if any facility which takes money from Medicare, and which therefore must have to meet certain standards, is entitled to an overriding religion-based “right” to turn a blind eye to some residents’ wellbeing. (Particularly those who are not fully competent to assert or articulate their needs.) It seems to us, that the mom, at least, is slowly starving herself to death (due to a resistance to the food being offered her). How much “freedom of religion” should be allowed, in this kind of situation? Should it extend to a “right” to employ someone who cannot or will not agree to modify the menu to suit the residents’ needs? Should it extend to a “that’s what we’re serving, take it or leave it”, Oliver-Twist-like institutional insensitivity?I’d like to find out if there is an “official” way to get government authorities involved, to at least compel the place to address the situation, by (a) assigning someone to record my mother-in-law’s evident food consumption, meal by meal – and her weight on a weekly basis – and make that record available to us, and (b) ordering the cook – who seems to be wilfully ignorant of geriatric residents’ basic nutritional needs – to make a reasonable effort to prepare food that the elderly can all eat and enjoy. Must we go through a long process of formally complaining and demanding corrections to the system (by phone, writing, etc.), or should I try to just “blow the whistle”?Your mother in law’s situation does sound concerning. Especially if you are worried about her mental function, you will likely need to step in and help get the situation resolved…it may not be realistic to expect her to make complaints or otherwise negotiate with the care facility.I am not sure just how the rules may be different for Christian Science facilities, but in general, nursing homes are required to weigh residents monthly and to make various accommodations to ensure that residents get adequate care.California Advocates for Nursing Home Reform has a good page summarizing standards of care here: Nursing Home Care Standards. This page also provides resources on how to lodge a complaint.Generally, every state should have a long-term care ombudsman; the office is required to investigate complaints. Many states also have local advocacy groups. You can find your local LTC ombudsman and LTC advocacy groups here: How to Find a Long-Term Care Ombudsman Program.It is usually advisable to try to first resolve the issue with the facility…if your parent is going to be staying there, it’s good to try to keep relations as positive as possible, and facility staff may understandably feel frustrated if families report them to the state without first giving them a chance to address a concern. You can start by asking to talk to the head of nursing or of operations; also a good idea to send a letter or email, so that your concerns are in writing.I have to say that it sounds unusual for a nursing facility to be serving highly spiced food; at such a facility, I would expect the menu and food to be determined by some kind of dietary professional, it should not be up to the whim of the cook. Have you actually sampled the food being served to your mother? It may be a good idea to discreetly do your own research; if her mental state isn’t quite right, she may not be accurately reporting what is happening.That’s not to say that the facility doesn’t have room to improve or perhaps isn’t living up to required standards. They may well need a reminder and a little persistence in order for your mother to get better care. Good luck!Hello. My father is 65 years old and he is loosing weight constantly. In last 1.5 years he has lost around 20 kgs. He was 92 and is now 70 kgs. The weight loss is drastic. Being concerned he got various medical check ups and got to know about diabetes and some stomach problem. Can the weight loss be because of that ? And is it something we should worry about? If yes then what can be done to improve his health? Your reply will be highly acknowledged Regards JaveriaSorry to hear of your father’s weight loss. I really can’t say whether diabetes or stomach problems are the likely cause, it depends on a lot of things. I would recommend you ask his doctors whether they think this explains all the weight loss you’ve noticed. You can also ask if/how they checked for the other common causes that I listed in the article. good luck!My mother (74) is unable to eat due to a dental infection. Her dentist has put her on antibiotics, but he won’t be able to work on the affected tooth until the infection and swelling are under control. It may be up to 10 days before she is back to normal, best case scenario. She’s gone without eating for five days so far, and feels tired and weak, spending her days mostly in bed.Other than making sure she’s getting plenty of water, juice, broth, etc., should I be concerned about her going this long without being able to eat? Or is a 10-day fast considered safe? Thank you again.I don’t know that 10 day fasts have been studied in women your mother’s age, and presumably the “safety” would depend in part on a person’s underlying health state.If she can’t chew food, I would recommend talking to her doctor or dentist about other ways for her to get adequate nutrition during this time. Couldn’t she drink bean soups or hearty shakes with fat and protein?It is definitely not ideal for a person her age to remain mostly in bed, because at this age the muscles get deconditioned very quickly when older adults are in bed due to illness. So I would encourage you to ask her doctors about ways to maintain her energy and nutrition while she’s unable to chew. Good luck and thank you for visiting the site, I’m glad you like it.Hi dr. Leslie I have been having a very slow process of weight loss of about 10 kg in last 5 years .I am middl aged 45 male suffering from anxiety disorders since age of 30 . However this weight loss in the recent 4 years is new . Doesn’t seem to stop. Have seen many doctors but none of them have been able to help. There is no significant finding in the tests. Not sure what kind of doctor to see and which test to perform further . Now at o 47 kg at 169cm .any advise will be Helpfull.Sorry to hear of your weight loss. Unfortunately, the only advice I can give is to keep asking the doctors questions. You may want to ask them what they have done specifically to check for the common causes I list in the articles. You may also want to try seeing a different type of doctor or a specialist. There are some people who have digestive issues that prevent them from absorbing their food as well as they could. Good luck!My mother is 77-years old. She had an angioplasty in December and had two stents put in. She is also diabetic. She takes Metformin for blood sugar and ticagrelor for anti-coagulation, along with other medications. Almost immediately, she began having stomach cramps and diarrhea. Since December, however, she has lost her appetite, can eat only a little, ended up with a hemoglobin of 80 that resulted in a blood transfusion and – perhaps most alarming – has lost between 20 and 25 pounds. She still gets occasional lower abdomen cramps and her bowel situation alternates between constipation / normal / diarrhea. Her blood tests are “normal” – except for the anemia – and her fecal occult blood test also showed no blood in the stool. Doctors are quick to place the blame for her anemia and loss of appetite on her ticagrelor, saying that causes angiodysplasia, resulting in microscopic bleeding. They say her 25 – pound weight loss could be ascribed to her medication-induced loss of appetite and, consequently, the fact she’s not eating much. My concern is, doesn’t 20 – 25 pounds of weight loss over 5-6 months seem excessive to just be attributed to loss of appetite / subsequent eating less? Is it just coincidence that her symptoms started immediately post angioplasty? Is a malignancy in the stomach, for example, a more likely reason for such significant weight loss? My Mom weighed around 172 pounds in December and is now down around 149 pounds…Needless to say, I’m quite worried.It does sound like a significant weight loss, so I think it’s reasonable to keep asking the doctors lots of questions.Regarding her anemia, you could ask them to explain whether she shows signs of iron deficiency on her testing, I explain that more here: Anemia in the Older Adult: 10 Common Causes & What to Ask.If you are very concerned about malignancy, I would ask them to discuss the possibility of further evaluation to look into that. What tests to do and whether they are appropriate will really depend on your mother’s particular health circumstances and past medical history, but also on what her preferences are as a patient.You may also want to consult a gastroenterologist, if you haven’t already done so, to make sure it’s not some type of digestive issue that the usual doctors haven’t considered. Good luck!My mother has dementia and lately she will eat very little food. She spits it out in her napkin ,she gags on it and almost http://vomits.It as if she is eating Rancid food. Anything that was sure bet is no longer.. She does not even like her sweets . Just me making sure she drinks some ensure plus, yougurt with effort, pudding ,tapioca, Homemade soups she rejects. Once in a blue moon she will eat shrimp cocktail. She has gone from 133 to 117. At this rate I see her going much lower. Food tastes horrid to her. Why is that? And is there any way to restore her tastebuds? No new medication has been added.Hm, I can’t say just what is going on with her, but developing eating issues certainly is common in people with dementia and can happen for a variety of reasons. Are you quite sure that it’s the taste of the food that she’s rejecting, or could there be something else? Sometimes people are reacting to pain or discomfort in the mouth or otherwise related to eating. People with dementia can also start to forget how to eat, or have difficulty coordinating the mouth and swallowing movements due to the ongoing degeneration of their brain cells.I would recommend talking to her doctor and getting her evaluated. Be sure they take a look in her mouth. You could also consider asking about a swallowing evaluation; these are done by speech therapists who have experience identifying difficulties people have with eating and swallowing.You also don’t say how far along she is in her dementia, but if it’s quite advanced, then it’s important to consider her comfort and whether it’s worth pushing for her to eat more than she feels like. I have more on planning for decline in dementia here: How to Plan for Decline in Alzheimer’s Dementia:A 5-Step Approach to Navigating Difficult Decisions & Crises with Less StressOlder adults do experience changes in their sense of smell and taste as they get older, and this might be worsened by dementia. If it’s not due to medication or to another health problem that can be identified and treated, I’m not sure it’s likely to be reversible.There is more on the physiologic causes of anorexia in aging in this scholarly article: Mechanisms of the anorexia of aging-a reviewHi Leslie, My 76 year old father is down to 81 pounds now, and my brothers and I are very very concerned. He had a throat issue which they were finally able to fix through surgery. He wasn’t able to swallow due to a flap of skin in his throat. Now he should be able to eat and swallow, but his stomach bothers him when he tries to eat. He continues to lose weight. His doctor authorized a feeding tube, which will Hopefully help him gain weight, but we are still concerned and wonder if there is anything else we can try. Any advice you can offer would be much appreciated!!Sorry to hear of your father’s weight loss. My main advice would be for you to keep asking lots of detailed questions and keep carefully following how well the doctors’ suggestions are working. You may want to ask his doctors to explain to you why his stomach is bothering him when he eats. Also, you could try to clarify whether it’s his actual stomach that is bothering him, versus some other aspect of his digestive system. And has he been checked for other common causes of weight loss (what have they done to check, what did they find)?Lastly, you could ask the doctor whether it’s possible to get a consultation with a dietician. Good luck!My mom is 95 living in a nursing home she has dementia and I was told today that she has lost 13 pounds in the last month … they putting her on a supplement to hopefully hold her weight from going any lower … is this part of the dementia ?Sorry to hear of your mother’s weight loss. Well it might be due to her dementia but it could also be due to something else, so they should be checking for the common causes listed in the article.Re dementia and weight loss: some people with dementia do lose weight because they forget to eat or otherwise have trouble organizing themselves to get food, prepare it, etc. This usually happens to people with mild or moderate dementia who are still living at home; it should not be happening in a facility.Otherwise, quite advanced dementia (when people are totally bedbound) can indeed be associated with weight loss. This can happen if the person starts to have difficulty swallowing, or if the body otherwise starts to shut down due to quite advanced dementia.I have more on the stages of dementia here: How to Understand the Stages of Alzheimer’s & Related Dementias.You may want to ask your mother’s doctors to talk about how she’s doing otherwise, and how they expect her dementia and other health issues to progress over the next few months. Good luck!My Dad has been a heart patient (valve regurgitation) for almost 7 years. At first his weight didn’t effect much and staid the same but for the last couple of years he lost weight significantly (25 pounds) and his muscle mass seems to be reducing by the time. I’ve read this article that says it could be because of less nutrients absorption due to decreased intestinal blood flow and weak overall blood circulation.I was wondering what should we do or how do we modify his diet to control this unintentional weight loss.If your father has been losing weight these past few years, then it’s important that he get a careful evaluation, as explained in the article. Effective treatment of his weight loss needs to target the underlying cause of his weight loss.Otherwise, general dietary approaches that tend to help is to make sure the food is appealing to him, easily accessible, calorie-dense, and includes a lot of protein. Good luck!As a 70 year old woman who has lost 35 pounds in the last 4 months I became concerned and found your site. Thank you so much for your insight and encouragement. As I am eating less and less and not enjoying food at al. Your no nonsense approach was what I needed. Off to the Doctor for a frank discussion. Thanks to this article I know how to approach the issue and what questions to ask. Thank you again.I am sorry to hear of your weight loss but delighted to know that the article was useful. I hope your conversations with your providers bring you the information and advice that you need.I do recommend going with a family member or other trusted companion if possible, as there is a lot to cover and it’s always good to have an extra person there to take notes and otherwise support you. Good luck!My mother in law, keeps dropping weight. She has moderate dementia. She will sometimes eat if something is put front of her. She keeps rejecting meals on wheels saying she is fine. We think she forgets to eat. She refuses home healthcare or assisted living. She is down to 112 lbs. How can we get her to eat? She has rejected all doctors suggestionsFirst of all, I hope she has had a thorough medical evaluation to look for medical problems that might be affecting her eating or her weight. If she’s had such an evaluation and nothing turned up, then it’s possible that it’s because of her dementia that she is forgetting to eat, or otherwise is too disorganized. If she lives alone and cannot feed herself reliably, then she is potentially experiencing self-neglect, and if she really endangers her health, she may eventually have to be forced to move. Below is a good site explaining self-neglect: Self Neglect | DSHSSelf-neglect is challenging, especially when people have dementia. The usual recommended approach is to ask the doctor for help and also report to Adult Protective Services. If she cannot be persuaded to accept whatever help is necessary to eat and maintain her weight, this might be grounds for moving her, even if it’s against her wishes. These are difficult situations. Good luck!My father is 71 years old. He is about 5 feet 9 inches tall and he used to weigh around 65kg back in 2006. He had lost around 16kg over 7 years. Since then he has maintained at 49kg. He only has hypertension. Blood test two years ago was normal including thyroid levels. He saw the doctor in 2013 but the doctor mentioned it wasn’t a drastic weight loss and concluded it was due to aging as he had no concern given my father’s appetite. He can eat a lot (breakfast, lunch, dinner, snack and supper) and he eats very healthy (lots of fruits, vegetables, oats, bread). He also has a good bowel movement everyday and stools are normal. Is there any value in doing a colonoscopy? Also, he has tried Appeton 60+ and Ensure powder but still not seeing any weight gain. I read about whey protein isolate for sports people and was wondering if it would be a better option than the ones he has tried? Thank you.It sounds like he lost weight but for some time now has been stable at a lower weight? If this is the case, and he doesn’t have any other particular symptoms, then colonoscopy should only be done in the context of regular colon cancer screening. (See here for the options.)If you are concerned about him, you could consider getting a second opinion, to confirm that he’s had a reasonably thorough and appropriate evaluation so far.To gain weight, it’s important to counter whatever is causing weight loss (if it can be identified). Otherwise, we generally recommend calorie-dense foods and extra protein. Whey protein has been studied and can be helpful. You can also try eggs, tofu, yogurt. Some research suggests older adults benefit from 1.0 to 1.3 g/kg/day of protein. You can also increase calorie content with olive oil, avocado, and other healthy fats. Good luck!I am a 91 year old female was very fit playing golf body surfing no medicationuntil 5 years ago I had Giant cell arthritis Started on 40 Prednisolone reduced to 6 but had further symptoms so have remained on this medication. Normally weighed about 9stone which had reduced from 10stone before illness In last 6 months no longer play golf – stopped body surfing 2 years ago. Now find I am regularly losing weight – down to about 8lbs 4 ozs gone from size 16 to 12. Eat Weetabix or porridge breakfast. Midday Main Meal meat or pasta or fish with veg evening sandwich & yoghurt Do not feel hungry but always eat very reasonably for my age compared with others. People comment on my loss of weight – lots of loose skin. Do not feel ill – but tire. Live with 91 year old husband -large family close by. Try to eat things to increase weight but no luck. No difference in bowel action – regular once each morning. Have regular 2 monthly blood test because of being on Prednisolone so far no negative result from doctor Advice please how to put on weight – my clothes are all getting too big !!Sorry to hear of this recent weight loss. If you are still continuing to lose weight, I would recommend bringing it up to your usual health provider and asking them to help you figure out WHY you are losing the weight. How to stabilize or increase your weight will really depend on why it’s going down now. In the article, I cover the more common causes, so ask your health provider about those.Otherwise, to stabilize weight, we generally recommend calorie-dense foods with extra protein. It’s also a good idea to eat plenty of vegetables and fruit, but that’s for overall health and bowel health, and won’t necessarily help increase weight. Good luck!My husband has Parkinson and diabetes he has lost a lot if weight he was about 180 4 years ago drop to 171 since then he has progressively losed know 149 been to many dr. Two complete cat scans and mri of brain. He has Parkinson trouble sawallowing medication seem to help he does eat three meals a day not like he did but he does eat. Also dieabets so doesn’t try to eat to many sweets. No one seems to no why he is losing so much weight. It is becoming more loss in the pass weeks. Takes supplements.Sorry to hear of his weight loss, I can see why you are worried. It can sometimes be difficult to figure out why a person is losing weight. I would recommend continuing to bring this to your husband’s health providers. It might also help to see if they can assist with some kind of calorie counting and evaluation of how much he is actually taking in. Good luck!70 years old Lossing weight in the last 7 months.. I used to weight 140 down to 133 I did have endescopy done last month I was having burning sensation on upper stomach. Biopsy came back positive for H. Pylori & some inflametion. Feeling good now but every 3 months I may get same burning goes away by itself… Why taking a strong course of antibiotics I really feel this is not the real problem.. colonoscopy was normal I don’t have any issues with stool, except I noticed the smell is very different than 7 months ago..why the strong smell? I eat healthy don’t eat red meat. Never smoke don’t drink thanksWell, in some cases it can take some investigation to figure out why an older person might be losing weight. I would recommend continuing to monitor your weight and your symptoms, so that your providers can continue to monitor to you and see if more clarity emerges regarding what might be going on. You may also want to consider getting a second opinion.Hey my father suffered from heart attack about 1 years ago due to blockage in the arteries causeof increased level of cholesterol, 2 stent were placed. He was very healthy before the operation but after it he is being losing weight and by my observation leam muscles too , he also have diabetes and for few months his appetite is also not that good , as he got diabetes most of food is limited cause of fats and sugar . Can you suggest what can be the problem.Sorry to hear about your Dad’s health issues. It is difficult to say precisely what the cause of his challenges is however a good place to start might be documenting exactly how his weight is changing. Sometimes when we weigh someone regularly (every week or 2 should be sufficient) we find that things are actually stable or improving slowly. After a heart attack many people start medications which can affect appetite and energy levels and subsequently weight. Other things that are common after heart attack are dietary changes that can take off a few pounds and depression. Is also possible that because of the heart attack your Dad suffered some damage to his heart muscle which has affected his energy and activity level and subsequently his appetite. Here’s another answer from Dr Kernisan to someone in a similar situation. I hope this is helpful and best of luck.Dr Kernisan, just “found” you and subscribed. Your conscientious response to queries and down-to-earth, common-sensical advice are . . . well . . . really impressive! I’m 82. A workout regular. Good appetite. Healthy diet. Great zest for life. But I’ve unintentionally lost 30 pounds over the last two years, and still losing. Chronic digestive problems. Six or more BMs daily (including middle of the night), very loose, gassy, very OILY! Malabsorption? Doc recommends colonoscopy but I had one just 3 years ago. Aren’t there other tests, short of invasive procedures, to check out possible pancreatitis, gall bladder, liver and other factors that might cause malabsorption and weight loss? Thank you!Thank you for joining our reader community. Sorry to hear of your digestive issues though. Yes there are blood tests that can help check for pancreatitis, liver issues, and gall bladder conditions, but I imagine you’ve already had them done. Ultrasounds are also sometimes used, as are CT scans. That said, an internal procedure would allow the doctors to visualize the lining of your gut and also take some biopsies.I’m not a gastroenterologist so I really can’t advise on whether this is strictly necessary or a reasonable next step. If you have doubts, I would recommend considering a second opinion, preferably at an academic medical center. And of course, ask the doctors what they hope to learn from the colonoscopy and is there any other way to get this diagnostic information?Since you mention oily stools, this sounds like “steatorrhea” and you can learn more here: Steatorrhea - StatPearls - NCBI BookshelfI do think you keep getting it looked into as you are relatively young and fit, and likely to benefit from getting this diagnosed and treated. Good luck!My Dad is 74 years old. He has gone from 309 lbs in March 2019 to 210 lbs currently. He’s had every test ran thinkable. A colonoscopy which was normal. He recently had an EGD and that came back normal. They thought that he might have pylori bacteria. That tested negative. At this point he is frustrated because his appetite is steadily decreasing. He basically has to force himself to eat. Any advice would be helpful.Hi Kydra and sorry to her about your dad. You mention some imaging studies, which thankfully you report have been unremarkable, and remember that there are blood tests that can reveal causes of weight loss as well. Here is an answer to a similar question that I provided recently. Loss of appetite can be due to a variety of causes, ranging from depression to a medication side effect. I would suggest that you keep being inquisitive and working with your dad’s health care team.My uncle is 69 years old and has told me he has lost a significant amount of weight without changing his diet. He went to the VA hospital and the doctors have no answer either. He smokes and drinks regularly but no cancer was present. Any suggestions would be welcome.Hi Destiny. Here is an answer to a similar question from a few weeks ago that may be helpful. You mention smoking which can affect one’s sense of taste and smell, and can contribute to a reduced appetite. Good luck!My Husband is 85, was a healthy man until he had a heart attack, and had no problems since a triple bypass 10 years ago, however in 2016 diagnosed Aortic aneurysm 5.6cm in abdominal, and as 6 monthly scans. Since 2019 he has blood tests and had borderline anemia twice, first time took iron tablets for 3 months, and returned to normal, then test showed anemia again.For last 6 months he passed blood in urine, he has CT and Bladder test, determined cyst on kidneys and had gynecomastia, scan result no cancer in breasts.Checked with blood test his SHGB levels and has has actinic keratosis on his face, its slowly improving over last 4 months, of using prescription cream. He eats kealthy nutritious food and walks daily for exercise. the problem is over the last 2 years he remains the same weight 12 stone 11 pounds, height 5 feet, 9.5 inches but his body shape is changing, but looks about 3 stone thinner, his clothes are too big, he looks skin on bone, but weight on scales remains the same. He takes daily medication: 40 mg rosuvastatin, 2.5mg bisoprolol, 7.5mg clopidogrel, 400 microgram tamsulosin, modified release capsules for enlarged prostrate for last 3 years he was also took lanzoprazole for 7 years, stopped as had no problem with acid However, he still passes blood in urine and they don’t understand why. He always feels very cold no matter how warm it is. I have been the Dr’s many times and told its his age, I am having sleepless nights with worrying as the weight drops very thin, and his body shape changes. I think he should be checked by a Gastroenterologist and his esophagus. Please can you advise, many thanks.Thanks for your detailed comment. I can imagine it;s very frustrating to be told that a symptom that’s worrying you is due to “old age”. There are many changes that are a normal part of aging but to my knowledge unexplained blood in the urine and unexplained weight loss are not normal.Sometimes, the weight on the scale stays the same, but a person’s body composition can change. For example, the weight change could reflect a loss of muscle but a gain of fluid. This would show up as swelling, usually in the legs and feet.In terms of blood in the urine, medications that affect platelet function can make a person more likely to have bleeding but usually only if there is some other vulnerability in the system.I would advise someone with a story like yours to continue to advocate for answers and seek second opinions if needed.I’m 55 and 5’3″ the past year that I’m losing weight I went from 107 to like 99 I’m not trying to lose weight I have been trying to grain weight. I have very bad night sweats I wake up 2 to 3 times a night like I have work out for an hour or more. It’s really starting to concern me because I eat more than anyone in the house. I waiting to hear from the doctor he gave me some meds for the night sweats and checking my blood. I’m working on trying to find out the problem. I really getting concern I don’t feel sick and I really don’t do anything just go to work. I know a couple people that lost a lot of weight too, hoping I don’t loss weight like them and I am. feeling worriedHi Sue and sorry to hear about your weight loss, and I can understand feeling worried. Being a Geriatrician, I usually care for older adults, and the causes of weight loss in a younger person may be quite different, so I don’t want to speculate about what might be going on. I’m glad you’re working with your doctor to sort it out.My dad is 55years .. he has lost around 20 pounds in the last 4 months.. he has good appetite and no fatigue .. he has changed his diet a bit for past few months with low carbs nd low fat.. but the weight loss seems to be way too much.. all this blood workup came back normal what shld i do nxtIt sounds like your dad has made some lifestyle changes that could account for the weight loss. In most situations, that is normal, and can even be a positive step towards better health. Weight loss is worrisome when it is unintnetional.Loss of muscle mass can lower a person’s overall weight, and this could happen slowly, over a period of a few years. When weight loss is related to cancer, we usually hear about other symptoms, such as blood loss, sweating (particularly at night), or pain. Your doctor would best know your health history and risk factors for weight loss, so I would continue the dialogue with them if you’re concerned.My neighbor has always been very thin but in the last couple of years has been steadily going down in weight. She tells me she now weighs 75 pounds (she is about 5’6″). I am extremely concerned but neither she nor her family seem to be. How dangerous is this?It’s hard to get a handle on how dangerous it is for an older adult to have a low body weight, because it really depends on the person. Someone who is frail, for example living in a nursing home, who loses significant weight and/or has a very low body mass, is probably at increased risk of dying compared to a frail person who is heavier and has a stable weight. But that may not be so for a healthy, community-dwelling older adult who has always been thin.The other thing to remember is that people report incorrect weights all the time, so interpret anything you hear with caution.Thank you for your reply. She is not healthy – constant back problems and lately also problems with her gallbladder and recurring lung infections. I’m just wondering what happens to a person when they continue to lose weight – it seems like there must be a weight ‘limit’ when even worse things are going to happen. I’m not sure exactly about the 75 pounds but is stick thin and looks scarily skin-and-bones. Thanks again!What do you think…My Mom,88yrs for a good 10yrs was 116-118 . 2yrs ago started losing 2-3 lbs..but in the last 6 months has lost 6 pounds. She has 3 meals a day and a snack at night. She has 1 can of boost plus daily too. She does get full feeling quickly. She does have muscle atrophy and fatigues easily. Is this normal aging process?Anything more to add to diet. Thanks for your helpAs Dr Kernisan points out in the article, unintentional weight loss sometimes point to a concerning underlying problem, and it can take a comprehensive approach to sort it all out. The numbers you share, seem to add up to about a 5% weight loss over a 6 month period, which is less than the 10% amount in 6 months that is classically considered to be a rate of loss that should set off alarm bells.Feeling full early can be sign of a problem with digestion or swallowing, and fatigue and muscle atrophy can be a cause or an effect of poor nutritional intake, or there could be something else that is causing all of the symptoms. Normal aging shouldn’t be associated with weight loss.In a case similar to the one you describe, I would want to rule out another cause of the weakness, fatigue, and weight loss, before just adding another supplement. Keeping close track of weight, activity and intake is a good place to start before talking to a healthcare provider.My father is 5′ 10″, 82 yo and has parkinsons, heart disease and prostate cancer. In the past 8 months he has gone from mid 140’s to mid 130’s … Two years ago he was at 152, which is a good weight for him. Every time I go to his cardiologist, neurologist and most recently GP, I mention my concern about the weight loss, as I am guessing it could mean a cancer recurrence or could be due to heart failure. Last time I went to cardiologist he said it was likely due to Parkinsons. Neurologist doesn’t say anything when I ask. GP recently said that it was likely due to lower calorie intake but did not do ANY TYPE of evaluation, not even asking if his eating habits had changed. I know they haven’t because I’ve been feeding him for the past 4 months.Any idea why doctors would not be interested in doing a thorough evaluation to diagnose possible causes of unintentional weight loss? Is there some question I can ask that will inspire them to at least be interested in the situation? Or is a second opinion and a change of doctors the best approach at this point?I’m sorry that you’re getting the impression that your concerns about your dad’s weight loss are being dismissed. That must be frustrating. In the article, Dr Kernisan mentions the MNA (Mini Nutritional Assessment) which is a validated tool for looking at nutritional risk in older adults. There’s a form of it that your dad could complete on his own, or that you could do together. Sometimes it’s helpful to bring these types of tools to a doctor visit to share some objective information and show that you’ve done some research and thinking about the issue.There are many ways that Parkinson’s disease and heart failure can affect appetite and weight. These can include changes in sense of taste and smell, difficulty with chewing and swallowing, and effects of medications. Unfortunately, many physicians are not trained in interventions for these specific causes of weight loss, and many of those changes that I listed don’t respond to medications. I will often refer my patients to a dietician or speech language pathologist to help with managing weight loss and help discern the causative factors.In a situation like the one you describe, persistent advocacy about your concerns and asking to see other experts may be the best way to go.Thank you for your reply. I don’t believe that the weight loss is being caused by the Parkinson’s or the heart failure. I think it most likely means a cancer recurrence. He continues to lose weight. He is down to 129.6 now, and the doctors are beginning to notice, finally. Today he want to see an oncologist, who noticed the weight loss and suggested beginning cancer treatment might help. It is my understanding that once cachexia gets started that it is something of a speeding train. Hopefully, I am wrong and he will stick around for a few more years.Sorry to hear about the recurrence, but I’m glad that you feel your concerns are now being heard and addressed.Cachexia is a form of catabolism, a breaking down of muscle with inflammation, usually related to cancer, AIDS, or another advanced illness. Treatment involves supplementing diet and stimulating appetite, among other things. Cachexia can be hard to reverse, and usually the goal is to enhance the person’s comfort and enjoyment of food as much as possible.My wife. Lillian 87 has been losing weight and muscle mass very fast. She is down to 93 lbs. The doctors have given her many, many, many blood tests – all negative. She had a stool test – negative. She had a cat scan of the brain – negative. She had a frontal body scan – negative. If you have any ideas, please help. Thank you Leslie Kernisan, MD, MPHI can understand being worried about weight loss, and it sounds as though most of the workup has been very reassuring, although I’m not sure what a “frontal body scan” is. I can’t give medical advice over the internet, but in a situation where there’s a concern about weight loss, it is important to look carefully at dietary intake as well. Sometimes a nutritionist or registered dietician can be helpful if serious causes of weight loss are ruled out. The dietician may also be able to recommend supplements or dietary modifications that can put the brakes on weight loss and encourage healthy weight gain.Mom is 92 yrs old. She sleeps a lot and she doesn’t eat very much but she had to have sweets everyday and sometimes she has stomach problem first she has acid reflux and also when she eats she has to go to the bathroom or sometimee she is constipation. She has lost weightIt sounds like there are some symptoms related to the GI tract: variation in bowel habit and reflux symptoms. When I see an older person with complaints about digestion and weight loss, I usually turn to one of my colleagues in gastroenterology to make sure there isn’t an issue that they need to look into. Of course, a thorough evaluation by a primary care provider is the first step.Hello, My mom is 79 years old, 5’11” and recently had a physical and she weighs 95 pounds. She is also losing her memory. Her doctor is going to prescribe an appetite stimulant and also recommended for my parents to buy a protein supplement, I forget the name, but she only drinks 1 oz. in the am and 1 oz. in the pm. My parents live in Florida and my family and I live in California. I feel helpless at this point and wanted to know what you would recommend for my mom. Thank you for your time and for your help. Sincerely, StaceyHi Stacey. It must be so hard to be worried about your mom from a distance. I’m glad to hear that your mom is seeing her doctor, because weight loss can be a cause or effect of memory changes, and that can be tough to iron out. If I saw an older person with the numbers that you shared, I would want to have a thorough assessment done, including bloodwork and some imaging. I see a lot of older adults with weight loss and reduced appetite in my practice, so asking for a Geriatrics referral if possible might be a good idea.Many underlying conditions can contribute to weight loss, as Dr Kernisan points out. If all of those underlying conditions have been ruled out, nutritional supplements may be used, and guidance from a registered dietician or nutritionist would be helpful.My father is 63-years old, and has slimmed down too much over the last few months. His weight at present is only about 48 kg. We got concerned and had him go through a full body check up, but all of his results seemed normal. And the doctor had nothing particular to add. I can’t feed him with eggs and other high calorie foods, since his cholesterol levels are pretty high as it is. But recently, he’s been losing weight again, and I’m unsure as to how to proceed. He himself insists that he’s alright at every turn, and gets irritated at my nagging. What would you suggest I do?I’m sorry to hear about your dad and not surprised that nagging isn’t helpful.I often work with a registered dietician or nutritionist when there’s no obvious cause for weight loss and there are specific issues about supplements (like wanting to avoid eggs or other high cholesterol sources). Sometimes when individuals lose weight, their cholesterol levels normalize so that might be worth reviewing as well.My 87-year old father has dropped 30 pounds during the last two years, unintentionally. He has an incredibly robust appetite, eats way more than my husband, but can’t seem to gain weight. He’s been staying with us the last two months, so I know he’s eating well.I took him to the doctor, they did thorough work up — blood tests, comprehensive questions, CT scans. They found nothing. It’s like he’s not absorbing nutrients, like malabsorption.During this same time, he’s been suffering from mild cognitive impairment or mild dementia. Don’t know what to do at this point.Sorry to hear about your dad’s weight loss, and it’s great to hear that he’s eating well now.Malabsorption in medical terms is usually related to a gastrointestinal issues, and may be detectable with bloodwork (for example, you may see low levels of fat soluble vitamins or other elements in the bloodstream), so some of that may have been ruled out with a “thorough workup”. Some medications can affect absorption of nutrients, so that may be worth reviewing in more depth.Dementia can affect appetite and food intake, and it may be that your dad is eating well now that he’s living with you but wasn’t doing so on his own. He may also be more physically active now and burning more calories. In a situation like this, weekly weigh ins may be helpful to see if the weight loss is ongoing or stabilizing. If a pattern of ongoing loss is apparent, I would go back to the PCP for more advice.Hello! Same as most of the comments: My Mother is under doctors and nurses care for anemia dementia and neck pain. Due to covid her care is very under par and I feel I am on my own. I have been trying to get her psychotic meds reduced which make her have loss of appetite. My question to you is: “Besides Centrum Silver, isn’t there a B12 shot or supplements she can take to add nutrients to her system? She does eat, but not gaining weight.Hi Jenny and thanks for sharing your mom’s story. It sounds like you’re a great advocate for her health care, which must be challenging right now.We usually don’t recommend additional “nutrients” for weight gain in older adults, unless there’s a specific deficiency. If your mom has had blood tests recently, her doctor may be able to tell you if there’s a low level of some mineral, like calcium or magnesium, or if her Vitamin B12 needs to be replenished.Dietary supplements like Boost or Ensure can be a good way to get additional calories and protein, but they can sometimes satisfy the appetite such that a person has less hunger at meal times. Usually a small amount of a dietary supplement over a longer period of time (like taking 30ml five or six times a day) can add those extra calories that can stabilize or increase body mass.You’re on the right track thinking about a medication review as well, although many antipsychotic meds tend to promote putting on the pounds.The material on this site, including any exchanges in the comments section of the blog, is for informational and educational purposes only.Any comments Dr Kernisan may make regarding an individual’s story or comments should not be construed as establishing a physician-patient relationship between Dr Kernisan and a caregiver, or care recipient.None of Dr Kernisan’s website or group information should be considered a substitute for individualized medical assessment, diagnosis, or treatment.

Austerity measures are created solely by the restriction of fee press. let me tell you more…Firstly, please look at CNN today. They are running a story with a bit of a negative slant on it that The White House is "blaming pre-existing conditions" on COVID-19. This is the most important story that had been in any media since Covid19 began, however, the article and what has been said by The White House is just the tip on the iceberg. I put this all into better context down below as it's the first clue of a whole thesis I have produced which is for want of a better way of putting it, the most important work on the long and winding road to finding an effective treatment for COVID19. Before I say more, I do not have a "cure" to the virus, I do though know how to suppress the virus and how to improve the recovery rate substantially. However, whilst I have written two hundred pages on this. It is better that I have a press interview.. However, to answer your question above.The issue is that 99.9% of people and that is on both the left and the right look simply to the words that President Trump and other leaders use to make their assessments and judgments upon the words being said mostly and do not ever properly assess what it is that could be being implied or gestured and other meanings that could have.There is not one single world leader either today or for as long as I have been doing strategy work that actually is communicating simply what their words say. Whilst psychologists consider more than 80% of all our communication is non-verbal.1. Many words and phrases that can be spoken can be interpreted in various ways.2. Body language and the positioning of the body account for a lot.3. Phrases and words that are used can be essentially 'de-coded" in various ways.4. It's feasible to make the assumption that President Trump or other leaders in their statements is only making a statement directed to the public, however, he could be making the statement to a specific individual and there is a word or phrase that he is using that will on the surface appear "childlike", however, could have another meaning to someone else. What the issue is though is that you will be seeing that statement made in the context of how you see politics, what you hear in the press, how you consider President Trump is, the times we live in, the main areas of responsibility. So, therefore, you are seeing the message in one context and yet may not have the same concept and context as someone else sees this message.The tradition of saying something on the surface and implying something else goes without saying and yet having double or triple meanings or saying one thing and implying another is as old as language itself. So whilst that is one level of potential understanding, misunderstanding or misinterpretation that is feasible. There is much more to this and to Western politics to consider.You and I are in the UK. I can say to you with complete certainty and prove this too, that in terms of "The Truth", (IE a correlation between subjective truth, political truth, objective truth. the whole truth.) This has been absent from UK politics for a very long time, to be specific since 2004, the first term of Tony Blair as Prime Minister.On this basis, I currently have a case submitted to The House of Common's Inquiry on Human Rights and Freedom of Speach inquiry. In essence, there has been much more not said in Uk politics and not widely understood and appreciated in terms of political strategy than has been said. That in the past few years has spread out from the Uk to International politics including US politics. So what I'm saying here is that there are almost no British nor US voters that have a proper and correct understanding of how and where a significant amount of the political strategy originates that is the policy strategy work that they hear on the television every day. (In the text written above I presented information that never got correct analysis in the media due to this.)However, rather than get stuck in just content, this has been going on in the UK since Blair and in the USA particularly now.In order to understand what has actually occurred throughout the Blair, Brown, Cameron, Livingstone, Johnson as Mayor years running up to Brexit is not something that the British voter widely knows anything about at all in the context of political strategy work. This is due let's just say to the selective use of language and media in UK politics and the focus of the narrative being between two seemingly opposing political parties and yet the true origination of work unknown. All I have to say to you being British is "Dodgy Dossier" and you understand what I'm saying, yet since a few months after that time that is what has continued on, yet it was not a student who's work was being copied, it was my work. Yet, the student got his situation heard in the UK media, however, no media would cover my story. No MP's would resolve this either. So there has been one very big lie in UK politics for long enough to have led to 30 years of my work being copied and misrepresented in its entirety. It is the copied version of my original content that has made up so much of the political debate. I would estimate 25%all discussions in the UK from 2004-2016 in some way related to my work, yet never once in it;s proter and correct form. However, from me observing them using my work, sometimes getting it correct and sometimes getting it completely wrong. I have been able to observe, learn from their successes and failures alike and that is why today, I'm the best strategist in the world in terms of solving socio-political issues. So the upside to this is that there are "Integrated Strategies" written today to most, nearly all of the most substantial problems in the world today. The downside is that there have been many of these in existence for years but due to my work not being permitted to be in the media, very few people know about this. The main people that know are International leaders. these are published mostly on my LinkedIn page, however the most complex is the strategy for Climate change which is published in a book called A Big Strategy. You will know som of this by the copied name Big Society.So the copying and sharing of my original strategy work from the leaders of one political party to another has been a 100% consistent trend in UK politics from 1994-2016. That original work that was being called upon and used was a changed version of my work. Further work I did I sent through to US Presidents. This was both President Obama and Trump. Some of my work contributed to The Paris Climate Accord. Other work found itself being quoted and copied in movements as diverse as The Tea Party Movement and Berney Sanders.So to be specific Berny Sanders Green Deal, is a term that originated in my work that Tony Blair used and incorporated into what he called The Third Way, Browns' Lifestyle Centre's, Cameron's green Investment Bank, feed in Tariffs, Boris Bikes, Busking Licences and many, many more.. The changes and many improvements that happened to London's Transport, this was both under Ken Livingstone and Boris Johnson. A Big Society too and then Jeremy Corbyn's use of the term "A Big" as the first phase of the Labour manifesto under his leadership. This was an attempt to reclaim back The Big Idea for Community, that by The Tories very admission at The Tory Party Conference 2009 in Birmingham, as broadcast Internationally by The BBC. explained what happened; I quote, the so-called four architects of Big Society. "We inherited a document from the dusty filing cabinets of New Labour, An Integrated transport System, don't worry we will not let untrained and unqualified consultants loose on the business world." Whilst that line ended my relationship with my ex-girlfriend and the press did not let us reply. After writing letters to Phillip Hammond who was my MP he admitted that The Conservative Party had used my work, which was against our wishes, yet that this was a matter we should take up with "New Labour" years after they had got back to being Labour.However, the crux of the matter is that four Prime Ministers and US Presidents have all been calling upon the same political strategy work produced by the same person, myself and yet changed to suit their own agenda. The work, however, in its original form, as published in my articles and in my book A Big Strategy and Film Ecoplaza has actually produced answers to more socio-environmental-political and peace-related issues than any other writer, author, strategist or thinker has throughout the entirety of the 20th Century. In fact, the strategies have produced answers to solve more International conflicts and these have been a success due to the way in which President Trump and other leaders have interpreted and used this work. So let me get this straight. The work used in the UK was taken under false pretenses under New Labour. The work I sent to Presidents in the USA I did so as I do apparently have a talent and I knew I could help the world by "decoding the problem" and providing the solution. I am essentially a cryptologist. Every problem in the world can be cracked with a strategy and that includes Covid19 which I decyphered in March and have improved upon my strategy for that until one month ago until then I have been waiting for the "experts" to catch up with my work. Today is the first day where there has been real progress with them catching up with my strategy, as is presented on CNN today, and yet that is only the first 20% of the full answer I have.So the way I produce these is in a particular way that I call "Integrated Strategies" and so with this work being so well known amongst all the most influential world leaders and yet unknown by the general public actually in any country. There is so much more going on than is not known by the public nor discussed in the press. This I'm very sad about as I believe there should be complete transparency on the use of political strategy, however, as the biggest world-changing problems have been getting solved like this I have just kept writing more and more strategies as my agenda is for people and planet and that is all people and the whole planet. It is that interest that I produce my "unconventional" work for that then comes out in the press as other people's ideas and is then considered conventional.So in the context of President Trump lets do some analysis here. When he took office there were very many serious wars either happening or potentially occurring in countries including Afghanistan, Iraq, Syria, Pakistan, Libya, Ukraine, Yemen, Troops amassing on the border of Russia, and then the issues in The Koreas'. Then there is Iran, which has not been easy and yet military action was very, fortunately, stopped at the last moment. This was stopped a few hours after one of my consultancy documents arrived in Washington. Calling that off by President Trump was one of the very best decisions he has made.However, today every one of those situations is improved upon to what it was then. Whilst President Obama came into office saying he wanted to end wars and whilst in some areas, there was progress many of these have been stopped, reduced, and improved since President Trump took office. So you may ask yourself how could this have been considering that he had employed, Hawk advisors in some cases. In fact, President Trump recently implied that he does not only listen to his policy advisors in the context of foreign policy. The reason is that he is actually doing something that is very admirable indeed and nobody knows. He will pursue a course of action, however, if there is a better course of action presented that creates a viable and effective peaceful way out very consistently he has taken that decision, thank goodness or otherwise we would have been in a very unsafe world today. The implications of what was happening could have easily ended up a very major war on more than four occasions in the past four years. To cite one example, with Korea's Prime mInister May was preparing to send an Aircraft carrier to the region, at the time I was working fulltime 24/7 on "An Integrated Strategy" to peace. At that time the peace strategy was instigated in actually a very effective way. All sides have been more calm and peaceful since. However, there is progress that can be made and I would very much like to offer further help to the peace process in the Korea's if I can.So what I can say is that there are answers to a great many problems in the world today. These potential answers have from 1994 until now been written and produced and copied in the way that leaders choose to do so. Of this work what Boris Johnson copied for London when he was Mayor and what President Trump has used after I voluntarily sent through roadmap strategies for various potential conflicts has been for the most part either very well interpreted or excellently interpreted and instigated. However, Big Society was all wrong and this is a massive regret as the media at the time just would not cover my side of the story and so I could have explained properly how it all worked. The fact is that that concept had required research in the community from 1990-2004 working full time and there was just not anybody else that knew the work properly and so no matter which "trendy London Consultant" they went to, they were all just clueless as it was not their work to begin with, they did not have the knowledge and experience that produced the findings in the first place. They were working with the findings and then attempting very publicly to reverse engineer these and it just was ridiculous, a complete waste of money and time. yet that's what happens when you have a political mindset that it is ok to steel other people's work. A media that is so crony based it goes along with the lies. Thus leaving both a confusing political landscape and an ineffective opposition to be able to debate strategy work that neither the Prime Minister, none of his Ministers and nobody on the opposition benches fully understands. So the public reached the conclusion that it was all just nonsense. Which was the perfect analysis of what was presented? Yet not a true representation of the original work at all. It is so different in fact it is like saying An air balloon does not make a good lampshade. Anyway there are 350 pages of a book written on the correct version, A Big Strategy.However, as a result of what David Cameron dis with the work there were some very good aspects.As a result of seeing how the USA later on and many countries in the world are more stable and at peace, today rather than as they were one decade ago is a benefit today. This has been essential in having the sense of general calm in the world that has enabled there to have been at least a reasonably good response to Covid19 in many countries, whereas if there had been ongoing wars, then the pandemic would be very much worse that it is.President Trump is as much a negotiator as he is a President. That is the truth of it. The other truth is that he says some clearly off the wall comments and some of his political ideas I question very much such as his stance on Climate Change which has been central to my world for thirty years. However, what is the truth is that he has in many cases very skillfully calmed tensions in the world. He may have done so in a way that to the public looks like one tweet or statement after another, however, he does appear to have good or excellent relations with many world leaders from the most politically diverse perspectives. This in itself is something that no other President had achieved so well since Ronald Reagan and even he was not on as good terms with some countries that President Trump today is. So to confirm everything I have written above can be confirmed in some statements made in the Uk and International press. Most of this can be confirmed in letters that I have been very eager to present and have the situation resolved. However, the truth is we live in a world where political leaders in both the UK and the USA want to be seen to be the great strategists as well as the great negotiators and so, therefore, I have been written out of all the press.The evaluation of my comments and communications made in the press by leaders is my own opinion though. What I know is that I have worked almost everyday for 30 years, covered the original development costs myself of many of the most important decisions and policies made since 2004 in the Uk and in recent years in other countries too. this is a terrible strain on myself and other people and yet no press will tell the truth. Without resources I can do very little in comparrison to what I otherwise could do.Neither the left or the right media in either the UK or the USA want to tell the full truth so that's how it is we live in a world of second hand-copied or stolen ideas and nobody ever gets to see, hear, know about or discuss the true and original content. The press maintains the line that all the best ideas come out of Westminster and Washington and that is actually about as true as saying that Friday and Monday are on the same day. So we live in a world that has almost all of the real news misrepresented. That is on the most important issues.So in terms of the complex choices of a time like this. The issues that would have made today much more complex than they currently are in terms of International relations have for the most part been improved upon over the course of many years and a part of that can be attributed to the strategy work and roadmaps to peace I have written, however much more than that it has been due to decisions and personal relations which have improved with leaders including President Trump and Boris Johnson too internationally. To completely resolve major International issues may have been too much too quickly, however, there is not any one International issue today more complicated today without a potential answer written or at least instigated in part than there were seven years ago.So to further emphasize this there have not been any President in US history that has had to contend with more than four wars during their term of office. President Trump and President Obama both had to.So to put the present world security down to President Trump alone is not correct. President Trump and President Obama, have both contributed towards that, and in addition, the peace roadmaps produced have shown ways through issues than may never have otherwise been perceived.What additionally assisted this was the fact that voters in the US have been opposed to wars for various reasons. The UK and EU countries through their silence have really let it be known that they are not at all interested either in the International conflicts of past decades continuing. This too simultaneously has again been assisted along by Russia, China, India and Pakistan who have also all taken steps towards a narrative of wider peace in various contexts that does not always obtain thorough media consideration.However, in the times of http://Covid19.my view is that there has not been any country that has really excelled throughout. There have not been wide enough questions asked at the beginning as to what exactly this virus is. Today, there has been an increased list by Dr Tim Spector at Imperial College of the symptoms, which is very welcome. However, in terms of really getting to the crux of the virus's inherent weaknesses, that I have found through my work. We are perhaps in the first day of this starting to be revealed in the International press. In this answer, I will explain this, although I do not have space to cite all my references and experience of how I obtained these findings. So I provide conclusions mostly, yet explain the case.There is a constant reference in all the media that the only possible way to treat the virus is with a vaccine. Before I go further I do also hope there is a fast and effective vaccine as that really is the easiest. Yet to place full emphasis on a vaccine only is completely, totally and utterly wrong when seen in the context of the findings I have. Additionally, not acknowledging the findings I have may have already resulted in the deaths of hundreds of thousands of people and for every day this is not fully presented what I believe are unnecessary deaths compound upon themselves. So this really could not be more serious. The thesis I have is now many weeks old. Yet, whilst my work was going to be covered by the press they didn't. So I feel a certain responsibility to try to be heard and for people to share this.Vaccinations, most illnesses that are known to man and cured by medicine are not vaccine based. There have been vast amounts of data generated statistically not even openly discussed by scientists nor by leaders. Such as this.Why is it that cats and dogs that are not socially distancing from people are not catching this virus except in only a very few cases?What is it that cats and dogs have in terms of immunity that people do not?There are actually no major outbreaks with any other species other than mankind, why?What is it that makes humans much more vulnerable to this virus?What is it that is different in the way humans live on this planet and animals do that could be causing hundreds of thousands of our species to be affected and not other species?Why is it that countries that have less or no processed wheat in their diet and high levels of fermented foods are 100% of the time in every statistical case more resistant to this virus?Why is it that the people most susceptible to this virus are people that have underlying health issues, live in the wealthiest countries?Why are countries in Asian and African countries less susceptible to the virus?Why is it that two countries Nepal and Vietnam that have between them double the population of the Uk, are less able to socially distance due to relative wealth levels have between them a few hundred cases and only one fatality?What are the common denominators between all of the most affected countries?What are the common denominators between the least affected countries?Why is it that all the European countries that have the most processed flour derived diets as the main part of their staple diet have hundreds of thousands more cases than countries that do not have highly processed white flour as the main staple in their diet?Why is it that every statistic in the world provides a pattern that the more fermented foods and basic natural diet of pulses grains and starches, the more resistant the people are?With 91% of Uk fatalities being of people with secondary illnesses, what is the common denominator between these patients that makes them that could make them the most susceptible?Could it be the same factor that those that eat fermented foods have, a diet rich in probiotics, that they have removed by taking antibiotics for their secondary illness?Why are communities in more underfunded areas most susceptible?Why are BAME groups in the USA and UK more susceptible to the virus than other groups?Why are BAME groups inside New York City more susceptible to COVID19 than BAME communities in New York State?Why is it that 50.5% of patients that died in a New York hospital originally went in with digestive complaints, yet this has been consistently referred to as a respiratory disease? Not a Respiratory and digestive disease. Or more like it a digestive disease that without the effective treatment of probiotics can lead to respiratory disease.Why is it that Diohrea has been cited as a very common symptom and yet the link to digestion as being a potential cause and cure of this virus until today is unconsidered, and only today is just starting to be hinted at?Why is it that the UK is putting in another 43 Million into vaccinations when even if there was a successful vaccine found tomorrow only one billion treatments could be produced in one year. This would be halved if two treatments were required?Where supply to much of the world would be difficult or impossible due to the needs of refrigeration? When the suitability of a vaccine can be questioned due to the virus has changed and changed already more than thirty times?At the vaccine treatment rate 1/2 Billion doses per year that require more than ten years to treat everyone?Why is there such certainty that it can only be a virus cure when in 50 years they have failed to produce a vaccine for Cancer and in 30 years they have failed to produce an effective vaccination for HIV/Aids?Why do they believe Covid19 is easier when it's symptoms are so very different?Why is it that prior to their even being any proper scientific investigation and press coverage on any of every clear statistically evident links between food, diet, recovery and prevention that can be seen in all world statistics when considering countries that have a high fermented food dies, low use of antibiotics and high intake of fermented foods?Why is the uK sending children back to school who although they may not be at risk themselves, other than with the related Kawasaki Virus could bring Covid19 back home with them to families that through this knowledge known could better protect themselves?Why are doctors, nurses, and care home staff not being introduced to findings on fermented foods, and this being potentially another way for them to prevent infection in addition to PPE?Why were people in the hospital sent back to care homes?Why is there still a worldwide PPE shortage, five months into this, operating a sewing machine, making a single please, and sewing on a piece of string is easy?Why is the simple truth not being said that for the size of the country the UK has the most cases?Why is it that wheat and fermented foods link is not being considered when 50% of all NHS allergy inquiries are wheat-related?The subject of Covid19 is, of course, complicated and I do not wish to simplify this,. however, the links between probiotics, fermented foods, and processed wheat thesis is consistent 100% of the time in every country. The sooner this knowledge is known the more people can help protect themselves. Therefore, stronger we all are in preventing and recovering from the virus.The reason that cats and dogs are more resistant is that they have stronger digestive systems than people. They can eat raw meat, old meat, and so many other items that humans cannot eat. They have 1Ph. in terms of acidity. If cats and dogs are in the same environment and close proximity as someone that is infected, it is impossible for them to not also be absorbing the virus. Yet, their bodies can cope with the virus? Why? The reason is due to their digestive system and the fewer antibiotics that they take. It is the same with children. They are more resistant to Covid19 as their digestive systems are more in tact. They have had less wheat in their diets which can be abrasive in the digestive tract. The symptoms they can get more often though ar Kawasaki Virus, which gives them rashes and what is termed COVID toes. These are black toes. What do systems other than Western Medicine associate the feet with? the expelling and detoxification of the body. What are the feet known for yeasts? Yeasts, that are affected by digestion. One way to reduce foot odor is to improve your diet.Whilst one hundred countries are calling for an independent Inquiry, I certainly support this. The first key finding is that scientists and leaders have been trying to fit Covid19 to the medicine not fit the medicine to Covid19. The disparity between the statistics in all the countries in the world in terms of recovery rates should have been considered in mid-March. The picture since then to today has been getting clearer and clearer. The best science is never applied when looking only at some of the science, some of the statistics and some of the potential medicines. Until the phrase the only possible cure to this is a vaccine, know for certain that everything other than the best science is being applied. This s a global disaster and if blame is to be directed anywhere, then it should be directed everywhere. Yet creating the fastest and more expedient answer is what is required, it is that and only that that will help the most people today.I do very much support the principle of using. the best science. however, when science fails to ask questions and derive answers such as why are domestic dogs and cats so much more resistant to Covid19 than human beings and they do not consider work that provides such an answer as valid, then it's wrong.91% of deaths in the UK of people with secondary illnesses that require anti-biotic medicine that affects the natural pro-biotic flora of the digestive system.The reason I know all this is that I contracted Covid19 in January and treated it myself, whilst according to science, that is only my own subjective anecdotal evidence and therefore they are justified in largely ignoring it. However, when you begin to see a picture emerge that the same digestive related links are occurring throughout the entire human population and observations in animals confirm this too, then you have begun to wonder why even today it is being perpetuated that the only possible treatment to Covid19 is a vaccination. I completely disagree with this nonsense. As for al the track and trace, and apps, etc this still does not answer the fact that South Korea (Kimchi) and Germany, Russia and China (Sourcraut, Kombucha, Kefir) and Greece (Greek Yogurt, Dolmans, Tasiki) and Latvia, Lithuania, Eastern Europe,, Israel (Pickled foods, Sourcraut, Sourdough bread) have been so much more resistant to Covid19 than British, Americans, Spanish and Italians who all have high intakes of antibiotics, low intake of probiotics, high intake of processed wheat in their diets.Considering that every country wants to return to normal I question why the vaccination mantra is the voice allowed in the press when at best this cannot feasibly provide an answer this year, possibly next year or feasibly even this decade for the world. Is it not much easier just to properly research and consider all the statistical evidence as found on worldometre dot com and rather than just look in the laboratories with one eye open and one eye closed into a microscope and also search for the more obvious answer in the supermarket instead?So how should government policies adapt to this knowledge?In my view present this as all as statistical science rather than medical science at this stage. Therefore claims can be made. Such as statistics show very clear evidence and correlation in adding fermented foods to your diet. If you have symptoms to reduce processed wheat intake. This does not change the diet necessarily much more so adding to diet these fermented foods. By the way, various fermented foods have been proven in laboratory settings to be effective against coronaviruses. This whole thesis does align to very similar findings already known. In my view this should be known and presented before people go back to work.Currently, I'm being encouraged not to speak out about this. yet, I have to speak out and hopefully be heard.So returning to your original question, yes Covid19 is complex, very complex. Yes, we do need the best answers and these have to be produced and generated on a 24/7 basis. In order to do that requires.1. Proper media explanation of what has been occurring with strategists in US and Uk politics of work being copied. The original strategist should be directly involved in innovating plans and not having to write blogs like this so some agents can just borrow ideas that suit them.2. The "Integrated Strategy For the NHS" which was written in 2017 and mentioned in The House of Commons, could be instigated. This provides multiple levels of benefit and support and help for the NHS and NHS staff. This can then be replicated as a model in other countries. Therefore, helping all medical staff and enabling them to obtain the support and benefits they require. This was based upon the very successful "Integrated Transport System" which solved London's transport crisis of 2004 so much so it enabled the UK to obtain The Olympic Games bid, as cited by The Olympic Committee, as based upon the improvements made to transport in London over other cities. When instigated this Integrated Strategy helps improve working conditions and care. This is very replicable in other countries.2. There should be open discussion and debate with different schools of medicine. Not just great ideas presented by leaders but proper discussion, debate, and analysis possibly including leaders in the discussion and certainly including contrasting views and opinions in order to derive improved information and knowledge on all sides of the debate.3. Strategy adoption and improvement on an ongoing base is essential. The more this virus is concentrated in one place the stronger it actually is. There are various other natural herbs I used that helped me recover in 48 hours from the worst of the virus. Yet, ultimately it is the boosting of the IMmune system that helps the most so there should be good knowledge put out to the public on what is proven to be effective scientifically. The stronger we are the weaker this virus is, food is where we obtain our strength in the short term. Better medical treatments in the longer term, these may well include vaccines, yet these are not available now, but food is.4. All of the questions above my thesis answer and provides scientifically provable answers. The reason is that diet is central to Covid19 both in terms of the cause, the level of which people are affected, and the recovery. If this is not discussed today in the press, it will come out later on. So the sooner this is spoken of the better.Finally, I do not claim to have all the answers to this, there are many required and it is a process for finding them. However, since March my findings have been well advanced of what is presented in the press. There is no time to delay with this, every second counts and there is not a solution to this for any one person until there is a solution to this for all. Everyone is vulnerable to this virus, whether they have had it or not. This virus keeps mutating and therefore is a continuing danger that can only possibly be overcome by using the best science that can be created, discussed used, and applied. There are no second chances with Covid19, So the answer to your question is getting the first truthful media on what has occurred in the UK since 2014, and this fermented foods hypothesis that was derived from this discussed at the very earliest opportunity.Whilst people have ignored the fact that for 15 years that UK political strategy work is being copied and that this reduces the capacity of the work very substantially. Today as a result of that people are dying. Whilst voters look to leaders, it is impossible to be a full-time politician and to be an exceptional strategist all the time on every issue. The reason is that being a politician requires a completely different mindset to being a strategist. Strategists require. space and a lot of time to think I lived 14 years in the desert to be the strategist I am today. Politician's lives are filled up with so much business and cramming of facts and figures that it's impossible to do the two. So whilst the press present the idea that these politicians have these ideas, it is all just incorrect. So really until people think to hold on we need the truth first and foremst rather than buying into the illusion that politicians can be great orators and strategists at the same time. This world is too complicated for that. Figuring out how to solve these issues is a full-time job and requires employees I cannot afford to pay, just in order to be able to have anything close to a normal 9-5 life. Currently and for the past 7 years almost every minute of the day is spent on work only. Yet, I know if I stop then wrong decisions get made. So I am in a situation I cannot walk away from as there is a dependency on the work I have been generating for many years and yet by being in this situation that was never of my making. It was due to the original copying of my work never being known. So the lie perpetuates and simply gets bigger. The fact is there are four political systems that are operational in this world. Capitalism, Socialism, and something are different from all of those which is "Integrated Strategies". If this was known and in the media and people realized the difference between "Integrated Strategies" and the other three then many of the issues of the world especially related to Covid19, climate change, refugees, homelessness, social regeneration and assisting small businesses. However, the way in which both the left and the right perceive this is that it's just a collection of ideas to be added to existing ideas.However, whilst the public really has very little idea of any of this. International leaders do know about whats occurred and use and benefit from this work.. There is an overall International improvement without a doubt from my work, and yet having this work in it's proper and correct form not known or understood and only wrongly represented is the difference between so many answers in the world either being effective or not being effective. The capacity of Integrated Strategies has produced an answer, a feasible thesis to potentially treat Cofid19 and yet that is not considered: newsworthy, not worthy of debate at Oxford University nor any other Institution working on Cvid19 and in my opinion months behind this work. I could debate this and answer all of the questions above with my thesis, and they could not do the same. So all I can say is Integrated Strategies are a part of Uk and more so today, International politics. They have been for more than fifteen years. Yet this, not known nor discussed does not add to democracy and open debate, this perpetuates illusions and holds back scientific findings that can answer many questions that other scientific methodologies cannot answer as expediently. This is why four Prime Minister in the Uk and various leaders from the broadest range of science and political science seen the benefits of calling upon and utilizing the findings of this work. Whether any of this in its correct form will ever be known and properly represented though is an issue that has been for many years beyond my hopes.Remember love. There is more than you have been told, ask for more….