How to Gain Weight with MND? Your Nutritional Guide

January 7, 2026 •

4 min read

For individuals with motor neurone disease (MND), unintentional weight loss is a common and serious symptom, and studies have shown that maintaining weight can assist in prolonging life. This guide offers crucial information on how to gain weight with MND, detailing strategic dietary changes, food choices, and professional support options.

Quick Summary

Many people with MND face weight loss due to muscle wasting, high energy needs, and eating difficulties. This article covers dietary changes, food modifications, and professional support to help manage nutrition and support weight gain.

Key Points

Increase Caloric Density: Fortify everyday foods by adding high-calorie ingredients like butter, cream, and oil without increasing portion size.
Eat Little and Often: Replace three large meals with smaller, more frequent meals and snacks to manage mealtime fatigue and reduced appetite.
Modify Food Textures: Adjust food and liquid consistency to make chewing and swallowing safer and less tiring, following professional advice.
Utilize Nutritional Supplements: Use high-calorie drinks, powders, or energy bars as recommended by a dietitian to meet increased energy needs.
Address Dysphagia: Work with a speech pathologist and dietitian to develop strategies for managing swallowing difficulties safely.
Consider Tube Feeding: Discuss gastrostomy options with your healthcare team early on to proactively manage nutritional intake as symptoms progress.
Manage Mealtime Fatigue: Use ergonomic eating aids and plan meals when energy is highest to reduce effort and frustration.

Understanding Weight Loss in MND

Motor Neurone Disease (MND), including Amyotrophic Lateral Sclerosis (ALS), is a progressive condition that leads to muscle weakness and wasting. Weight loss is a significant concern for many patients and can be caused by several factors, including: increased resting energy expenditure (hypermetabolism), fatigue, difficulty with chewing and swallowing (dysphagia), and reduced appetite. Addressing this weight loss is vital for maintaining energy levels, improving overall well-being, and potentially slowing the disease's progression. A proactive approach to nutritional management, often guided by a multidisciplinary healthcare team, is essential.

Strategic Dietary Approaches to Increase Calories

To combat weight loss, the primary focus is on increasing caloric and nutrient intake without necessarily increasing the volume of food consumed. The following strategies can be implemented, often in consultation with a dietitian:

Food Fortification: Enriching meals with extra calories and protein is a simple but effective technique.

Add extra butter, margarine, or oil to vegetables, potatoes, and pasta dishes.
Stir full-fat milk, cream, or milk powder into soups, sauces, and porridge.
Mix cheese, creamy sauces, or ground nuts into casseroles and mashed vegetables.

High-Calorie Snacks: Incorporating frequent snacks between meals can significantly boost daily calorie intake.

Full-fat yogurt or Greek yogurt topped with fruit purees or nut butters.
Milkshakes or high-calorie smoothies made with full-fat milk, ice cream, and fruit.
Puddings and custard made with full-cream dairy.
Small portions of cakes or biscuits if swallowing is not an issue.

Utilizing High-Calorie Beverages: For many with MND, liquids are easier to consume than solids. Calorie-dense drinks are a convenient option.

Milk-based drinks like creamy coffee, hot chocolate, or commercial nutritional supplements.
Thickened juices or broths can help meet fluid and caloric needs, especially when thin liquids pose a risk.

Managing Dysphagia and Mealtime Challenges

Swallowing difficulties can make eating a stressful and tiring experience. A speech pathologist and dietitian can provide guidance on safe swallowing and proper food consistency.

Texture Modifications: Adhering to guidelines like IDDSI (International Dysphagia Diet Standardisation Initiative) can help ensure food is safe to swallow.

Pureed foods: Smooth, moist, and free from lumps, these can be fortified for extra calories.
Minced and moist foods: Finely minced meat mixed with a rich sauce or gravy.
Soft and bite-sized: Tender meats and soft vegetables cut into small pieces.

Mealtime Fatigue Management: Fatigue can significantly reduce a person’s ability to eat a full meal.

Eat smaller meals more frequently throughout the day, particularly when energy levels are highest.
Use mealtime aids such as easy-grip cutlery and non-slip mats, as recommended by an occupational therapist.
Create a calm, relaxed environment for eating to minimize anxiety.
Utilize pre-made meals or prepare and freeze batches of food to save energy on cooking.

Advanced Nutritional Support: Tube Feeding

As MND progresses, swallowing can become too difficult or risky. In these cases, a feeding tube (gastrostomy) may be considered to ensure adequate nutrition and hydration. This decision is often discussed with the healthcare team early in the disease progression.

Gastrostomy (PEG/RIG): A tube is placed directly into the stomach through the abdomen. This allows for the administration of liquid feeds, fluids, and medication directly into the stomach.
Continued Oral Enjoyment: A feeding tube does not mean a person can no longer eat by mouth. Many individuals use the tube for primary nutrition while still enjoying small amounts of favorite foods safely.

Comparison of Oral Supplementation and Tube Feeding


Feature	Oral Nutritional Supplementation	Gastrostomy (Tube Feeding)
Application	Used in earlier stages or to supplement regular food when appetite is reduced or intake is insufficient.	Considered when swallowing becomes unsafe or too tiring, or when oral intake alone cannot meet nutritional needs.
Process	Consumption of high-calorie, high-protein liquid drinks, powders, or bars by mouth.	Liquid formula and fluids are delivered directly into the stomach via a tube.
Energy & Volume	Increases energy and protein intake without a large increase in food volume.	Provides a reliable and consistent method for delivering high-calorie nutrition, fluids, and medication.
Effort	Requires minimal effort to consume, especially if liquids are chosen.	Bypasses the effort and fatigue associated with oral eating.
Swallowing Safety	Does not eliminate aspiration risk if not properly managed, requires texture consistency adjustments.	Reduces the risk of aspiration pneumonia and choking associated with swallowing difficulties.
Maintenance	Regular shopping for supplements; requires compliance with intake schedule.	Requires stoma care, flushing the tube, and managing feeding equipment.

Conclusion

Effectively managing weight with MND is a crucial aspect of overall care, significantly impacting quality of life and potentially survival. It requires a flexible and proactive strategy, adapting to the progressive nature of the condition. From fortifying meals with extra calories and managing texture modifications for dysphagia, to the consideration of a gastrostomy for advanced needs, a personalized nutritional plan is key. Close collaboration with a multidisciplinary team, including a dietitian and speech pathologist, ensures the safest and most effective approach to meeting nutritional needs. For more detailed information, consult the Motor Neurone Disease Association resources.

Frequently Asked Questions

People with MND lose weight due to several factors, including muscle wasting, increased energy expenditure, and a reduced ability to consume enough food and fluid due to chewing and swallowing difficulties (dysphagia).

Food fortification involves adding high-calorie, nutrient-dense ingredients like butter, cream, milk powder, or oil to regular meals to increase the caloric content without increasing the portion size.

Good options include full-fat dairy products, avocados, nut butters, milkshakes, smoothies, and soft, energy-dense foods like mashed potatoes enriched with butter and cream.

Managing dysphagia involves modifying food textures to make them safer to swallow, using thickeners for liquids, adopting proper eating posture, and utilizing specialized utensils. A speech pathologist can provide tailored advice.

A gastrostomy should be considered when oral feeding becomes unsafe, too tiring, or is no longer sufficient to meet nutritional needs. It's often recommended to discuss this option proactively with the healthcare team.

To manage mealtime fatigue, eat smaller, more frequent meals, utilize mealtime aids, prepare food in advance, and eat when energy levels are highest. Consider discussing fatigue management strategies with an occupational therapist.

A dietitian assesses nutritional status, creates personalized dietary plans, provides high-energy meal ideas, advises on supplements and fortification, and offers support for tube feeding decisions.