Weight loss in Parkinson’s disease

Abstract

Weight loss is frequent in patients with Parkinson's disease (PD). Reduced energy intake and/or increased energy expenditure have been postulated as the cause. Dysphagia, anorexia, and gastrointestinal dysfunction may be possible causes of reduced energy intake; whereas, rigidity, tremor, and levodopa-induced dyskinesia may increase energy expenditure. Levodopa may enhance glucose metabolism resulting in enhanced energy expenditure. Depression, anti-parkinsonian drugs, and medical complications such as pneumonia and malignancies also may facilitate weight loss in PD. Combinations of various degrees of these factors, especially in advanced PD, may produce weight loss. Such weight loss is associated with malnutrition which may precipitate infection and decubitis; accelerate motor, behavioral, and autonomic impairment; consequently spoiling one's quality of life. Attention must be paid as well to motor symptoms to prevent or reverse weight loss in PD patients.

Body weight and food intake in Parkinson's disease. A review of the association to non-motor symptoms

“…It has been shown that PD patients lose weight despite having adequate or even increased energy intakes (Kashihara, 2006). For what concerns eating habits, a preference for sweet food such as, for instance, cakes (Lorefält, Granérus, & Unosson, 2006), chocolate (Wolz et al, 2009), ice cream (Meyers, Amick, & Friedman, 2010), and carbohydrates (Adén et al, 2011;Hellenbrand et al, 1996;Lorefält et al, 2006), has been documented.…”

“…The purposes of the present review are, first, to summarize the studies that assessed the weight and eating habits in PD patients and, second, to examine the possible contribution of some non-motor symptoms to weight and food intake alterations. In particular, the review will consider nonmotor symptoms affecting sensory perception, cognition, mood and By and large, PD patients have been observed to lose weight and to be more frequently underweight (Body Mass Index, BMI < 20 kg/ m 2 ; Bachmann & Trenkwalder, 2006;Kashihara, 2006;Kistner et al, 2014, for recent reviews), with a high risk of malnutrition (Fereshtehnejad et al, 2014;Sheard, Ash, Mellick, Silburn, & Kerr, 2013a;Sheard, Ash, Silburn, & Kerr, 2013b). The weight loss has been described even before diagnosis (Chen et al, 2003).…”

“…In particular, several studies have reported alterations in body weight and food preference in patients with Parkinson's Disease (PD), a complex neurodegenerative disorder characterized by the loss of dopaminergic neurons in the substantia nigra (SN) pars compacta, and a deficiency of dopamine in the striatum and in other structures of the basal ganglia (Bachmann & Trenkwalder, 2006;Kashihara, 2006;Kistner, Lhommée, & Krack, 2014). However, the mechanisms underlying such alterations are not yet well understood.…”

Will it Ever Become Possible to Prevent Dopaminergic Neuronal Degeneration?

“…Possible determinants of weight loss in PD patients include hyposmia, impaired hand-mouth coordination, difficulty chewing, dysphagia, intestinal hypomotility, depression, decreased reward processing of DAergic mesolimbic regions, nausea, and anorexia as the side effects of medication, and increased energy requirements due to muscular rigidity and involuntary movements. There is enough evidence for recommending monitoring the body weight of PD patients as the disease progresses [147].…”

Review: A review of the use of zonisamide in Parkinson’s disease

“…Others. Weight loss [Kashihara, 2006] and fatigue [Friedman et al 2007] may be associated with PD and ZNS may potentiate them, therefore they should be taken into account when treating PD with ZNS.…”