This leaflet is for you if you have lost weight without meaning to or are feeling weaker and have a poor appetite after being unwell or having an operation. 

Losing weight without meaning to is not a healthy sign. Therefore, simple changes to what you eat and drink may help you have more energy, increase your stamina after an acute period of illness, and increase your ability to fight off infection.

Helpful hints 

  • Eat little and often: aim for three small meals and two to three snacks a day. 
  • Have your main meal at the time of day you feel your appetite is best. 
  • Keep a store of easy to prepare foods e.g., Ready meals, long life milk, instant puddings, cereals, tinned meats and fish, biscuits, nuts, and chocolates. 
  • Try eating cold foods if the smell of cooking is putting you off eating. 
  • Drinking before a meal can fill you up, so wait to drink after your meal. 
  • Avoid foods that are labelled ‘diet’, ‘reduced/low fat’ or ‘sugar free’. 
  • If you can, monitor your weight regularly but no more than once a week. You can weigh yourself at your GP surgery if you don’t have weighing scales at home. 

Increasing your calorie and protein intake 

You can add small amounts of high calorie ingredients to your normal food and drinks, which will help increase the nutritional content without increasing the portion size. This is known as food fortification. 

Here are some food fortification ideas: 

  • Add dairy products e.g., cheese, butter, or milk to:
    Soup, potatoes (especially mashed), pasta, sauces, vegetables, and eggs. 
  • Add skimmed milk powder (available from supermarkets) to:
    Milk or milky drinks, puddings, mashed potato, creamy soups, and sauces. 
  • Add single or double cream to:
    Porridge, sauces, soup, potatoes, puddings, fruit, hot milky drinks, smoothies, and milkshakes. 
  • Add sugar, jam, or honey to:
    Porridge, puddings, hot drinks, on top of toast, to glaze vegetables. 
  • Add nuts and nut butters such as peanut butter to:
    Porridge, cakes and desserts, smoothies, milkshakes, toast, bread, and sauces. 
  • Add oil, butter, ghee, or margarine to:
    Potatoes, vegetables, eggs, rice, fish, meat, and in your cooking. 

Other food fortification ingredients you can use:

  • Salad cream 
  • Coconut cream 
  • Dried fruit 
  • Stewed fruit 
  • Creamy sauces
  • Chocolate spread 
  • Ice cream 
  • Golden syrup 
  • Evaporated or condensed milk 

Fortified meal ideas

Below are some meal and snack ideas that incorporate food fortification methods. Aim to 
have three meals and two to three snacks per day. 

Breakfast ideas 

  • Cereal with full fat or fortified milk plus sugar / jam / dried fruit / nuts / cream / yoghurt / banana / honey. 
  • Toast / croissant / English muffin / mini pancake with butter / jam / honey. 
  • Scrambled egg, bacon, sausage with toast / bread. 
  • Glass of full fat or fortified milk with biscuits. 

Light meal ideas 

  • Toast with scrambled egg / cheese / baked beans / sardines / bacon / sausage / avocado. 
  • Sandwich or roll with cheese / egg mayonnaise / tuna mayonnaise / meat / pate / nut spread. 
  • Omelette with cheese / ham / toast. 
  • Jacket potato with cheese / tuna mayonnaise / baked beans / coleslaw. 
  • Tinned macaroni cheese / ravioli / stew / casserole. 
  • ‘Cream of’ soup with bread and butter / sandwich. 
  • Pita bread with hummus and olives. 

Puddings 

  • Try to have a pudding once or twice a day with cream, condensed milk, ice cream, custard, or full fat yoghurt. 
  • Thick and creamy yoghurt. 
  • Milky puddings e.g., rice pudding, custard, semolina, Angel Delight – make these with fortified milk. 
  • Sponge pudding / crumble / pie and custard. 
  • Trifle or mousse. 
  • Ice cream / kulfi. 

Sweet snacks 

  • Biscuits, cakes, chocolate 
  • Toast / crumpet / teacake / bagel with butter and jam, honey, or peanut butter. 
  • Individual dessert e.g., thick, and creamy yoghurt, mousse, trifle, custard pot / rice pudding pot. 
  • Halva. 

Savoury snacks 

  • Nuts and dried fruit
  • Crackers / breadsticks with cheese or dips (e.g., hummus)
  • Mini pork pie / sausage roll / scotch egg.
  • Crisps / pretzels - avoid low fat options.

Fortified milk 

Use fortified milk in all your milky drinks, cereals, puddings, and in your cooking. To fortify milk, mix: 

  • Four tablespoons of skimmed milk powder.
  • One pint of full fat (blue top) milk.

Use this as you would use normal milk to get extra calories and protein into your diet. 

Nourishing drinks 

Staying hydrated is important. Try to have six to eight cups of fluids a day: fortified milk, tea, and milky drinks all count. Aim to including some of these nourishing drinks as they will provide extra calories and protein. 

  • Milky drinks made with fortified milk e.g., milky coffee, hot chocolate, Ovaltine, Horlicks, milkshakes, smoothies, yoghurt drinks (e.g., Lassi).

Nourishing drinks recipes 

  • Simple Milkshake: 200ml fortified milk, one scoop of ice cream or one small yoghurt, fresh fruit, or flavoured milkshake powder = approx. 300kcal and 10g protein.
  • Fruit Smoothie: 150ml of orange juice, one banana, two teaspoons of honey, four tablespoons of tinned peaches (in syrup) = approx. 265kcal and 2g protein.
  • Iced Coffee: 200ml fortified milk, two teaspoons of instant coffee, two tablespoons of sugar = approx. 330kcal and 11g protein.
  • Chocolate Dream: 200ml fortified milk (warm), one tablespoon drinking chocolate, sugar to taste = approx. 230kcal and 17g protein.

‘Over the counter’ supplements

Fortified drinks can be bought over the counter from most chemists and supermarkets. Examples are Complan, Meritene or Nourishment, available in a range of savoury or sweet flavours. They can be bought made up or as a powder, preferably made up with milk but can also be made up with water. 

Please note that these are not any better or worse than a nourishing snack, so consider trying one of the snack or light meal ideas above. 

Keeping active 

Physical activity is important to support the maintenance of muscle mass and strength. It can also help improve your appetite. If you can, incorporate resistance-based exercise into your lifestyle. 

Patient Association has a variety of educational webinars and leaflets to help you learn about how to prevent and manage under-nutrition. Visit the Patient Association website for more information.

Moving Medicine has a variety of resources to support you getting active after some time in the hospital. Access their leaflets at the Moving Medicine website, selecting the “Hospital Associated Deconditioning” section.

Please contact your GP practice if you are struggling with food shopping, meal preparation, or low mood which is affecting your appetite. They can signpost you to find further support such as meal delivery services, lunch clubs, or other support services. 

After a month, if you continue to lose weight and your appetite does not improve, it is very important to let your hospital doctor or GP know.