Management of Nutritional Disorders

Undernutrition

Treating poor nutrition depends on what is causing it. For example, fixing painful teeth or poorly fitting dentures can help a person eat better. Low vitamin B12 may need a supplement. A person who is dehydrated may simply need to drink more fluids. Medications may need to be adjusted.

Note that using drugs to increase appetite does not appear to prolong life and can cause serious side effects in older adults.

• Food should be the right texture and should look and smell good. Pay attention to color, texture, temperature, and presentation.
• Improve food intake by offering foods the person enjoys.
• Avoid special restrictive diets unless there is a clear medical reason.
• Set out meals or give reminders to people with memory problems.
• Provide help with eating if needed.
• Add protein and calorie supplements between meals.

Drug Treatment for Undernutrition Syndromes

• For most appetite-stimulating drugs, the risks outweigh the benefits.
• Mirtazapine is one drug that can be used in low doses to increase appetite.

Feeding

Some cases of poor nutrition are due to trouble eating or swallowing. Other ways to get enough nutrition may be needed. Options include:

• Hand feeding by a caregiver
• Tube feeding into the digestive system, or an intravenous line (IV) into a vein

Feeding tubes have not been shown to improve survival, reduce pneumonia or other infections, or prevent pressure sores in patients with advanced dementia. Risks of feeding tubes include pneumonia from food entering the lungs, fluid imbalances, diarrhea, and skin infections. Feeding tubes can sometimes help, such as when a person has a short-term swallowing problem after a stroke or surgery, or if something is blocking the food pipe due to cancer in the head or neck area.

Obesity Management

The best approach to obesity is to set a target weight that fits your height and body type, and work toward slow, steady weight loss.

Be cautious with low-calorie diets for older adults. Research shows that older adults who lose weight tend to lose muscle before fat. Because of this, reducing calories should go along with more physical activity and higher protein intake.

A dietitian or nutritionist can help you find a diet that you can enjoy while losing weight.

Counseling can help older adults eat well. You can find a registered dietitian in your area by visiting the website of the Academy of Nutrition and Dietetics.

Medications

Most studies of weight loss drugs did not include many older adults. Because of this, the safety and effectiveness of these drugs for older adults is not fully known. They may also interact with other medications. GLP-1 drugs (such as liraglutide, tirzepatide, and semaglutide) can help with weight loss but may also cause muscle loss.

Devices and Surgical Treatments

More older adults are having weight loss (bariatric) surgery. Types of surgery include sleeve gastrectomy, adjustable gastric band, Roux-en-Y gastric bypass, and banded gastric plication. There is currently no agreement on which procedure is safest or best for older adults, or on age limits for these surgeries.

Special Risks

• People with limited money may not be able to afford healthy food. They may also live in areas with few good food options. Government food programs may help. Look into local food banks or community resources.
• Culture, religion, and personal food beliefs can affect what people eat. For example, some Asian diets are high in salt. Some religions require fasting. A nutritionist can help you find a healthy diet that fits your needs and beliefs. You can also find culturally appropriate diets at Oldways, a nonprofit that promotes healthy eating for different cultures and regions.
• People with swallowing or dental problems can benefit from a dental exam and refitting of dentures. Speech therapy and diet changes can also help older adults with swallowing difficulties.
• Tell your healthcare provider if you take any supplements or herbal products. Many can interact with medications in serious or even life-threatening ways. For example:
• Large doses of vitamin A can cause bone problems
• Large doses of vitamin B6 can damage nerves
• Many herbal remedies can be toxic

Learn more about healthy eating as you age at the U.S. National Institute on Aging’s nutrition website.

Counseling can help older adults eat well. You can find a registered dietitian in your area by visiting the website of the Academy of Nutrition and Dietetics.

Last Updated May 2026