It had been festering for a long time … an infection that didn’t show up on routine tests. But we knew sometime was not right. Cal was not eating as enthusiastically as he usually does. And he was steadily losing weight.

His routine doc was stumped and sent him to a specialist. Further testing found the answer to his weakened condition—a small fracture and infection in his jaw that had doused his appetite and made eating painful.

Once the diagnosis was confirmed, surgery was fairly simple. In fact, he was able to stand up for the entire procedure and go home soon afterward.

Now came the road to recovery. Cal was prescribed daily antibiotics to fight his infection and probiotics to counterbalance the affects of the medication. And he needed nutrition therapy to pack muscle and strength back into his depleted body.

Boy, did he get it. Twice a day, in addition to his usual food, he got a concoction of high-protein and high-calorie foods, along with an extra dose of added fats including the omega-3 variety. Each day, his appetite (and his mood) improved. Now, two weeks later, he’s eating like a horse.

Oh, did I mention that Cal is a horse? He apparently got kicked by one of his pasture companions, which led to his medical emergency.

In people as well as horses, the road back from undesirable weight loss and malnutrition can be complicated. An underlying medical condition that affects one’s ability to eat often opens the door to a host of other health problems.

Who’s at risk? According to the National Institutes of Health (NIH), a person whose weight has dipped below a body mass index (BMI) of 18.5 has a higher chance of problems caused by malnutrition. (Calculate BMI at https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm.)

Bite for bite, a person who needs to gain weight needs extra nutrient-rich foods with special attention to these:

Protein! When the body is injured and/or fighting infections, it burns extra protein. If one can’t eat enough to keep up with the demand, muscles begin to break down as the body searches desperately for this valuable nutrient. Depending on a person’s medical condition, the need for protein could double following a serious illness or injury. Cal gets protein-rich alfalfa pellets. Humans might look to other high quality protein sources like eggs, cheese, yogurt, lean meat, fish, poultry and soy foods.

Calories! Calories only come from three sources: protein, fat and carbohydrates (sugars and starches). Extra fats and carbs help “spare” valuable protein so it is available to power up immunity and restore strength and muscle mass. Healthful fats include avocados, nut butters and vegetable oils. Healthful carbs include whole grains, fruit and starchy vegetables.

Experiencing unintentional weight loss? Get medical help first. Then seek a registered dietitian nutritionist. It’s worth the effort.

(Barbara Quinn is a registered dietitian and certified diabetes educator affiliated with Community Hospital of the Monterey Peninsula. She is the author of “Quinn-Essential Nutrition” (Westbow Press, 2015). Email her at to barbara@quinnessentialnutrition.com.)

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