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Food First: Advice for eating well if you have lost weight or are underweight

You may need this advice if:

You or your family are concerned that you may be underweight or need nutritional advice You have lost a lot of weight unintentionally in the past three to six months

You have noticed that your clothes or rings have become loose recently

You have recently found that you have lost your appetite and/or interest in eating

Please note: unintentional weight loss over a 3-6 month period may indicate an undiagnosed medical condition. Seek advice from your GP to understand if you require further investigations.

Why do I need this advice?

Maintaining a healthy body weight and not becoming too thin is important. If you are underweight, or you have lost weight without meaning to you may be at risk of malnutrition. Many older people or people with some long term conditions are at risk of malnutrition because they cannot or do not, eat enough food to meet their body’s needs.


  • increases risk of illness
  • makes it harder for the body to fight infection and heal itself
  • increases the time it takes to recover from any illness reduces energy levels
  • reduces muscle strength
  • reduces mobility

To treat malnutrition our bodies need us to increase the amount of protein and energy (calories) we eat every day.

To stop losing weight and or to help weight gain generally we need to eat at least an extra 500 calories per day.

An increased protein intake can be achieved by choosing snacks and drinks containing protein, as well as eating high protein foods at meals.

Treating and preventing malnutrition can be very simple and normal foods play a big part – this approach is known as ‘Food First’. Food First just means using ordinary foods to increase intake of all the nutrients your body needs. The advice overleaf aims to help you do this.

What about healthy eating?

When someone is at risk of malnutrition, healthy eating guidelines do not apply. Avoid low fat, low sugar and diet food and drinks.

The following advice recommends eating some foods that are high in fat. Some people may worry that if they eat more high fat foods that this will harm their heart. However malnutrition itself is a risk to heart health.

What do I need to do to prevent further weight loss/promote weight gain?

The Food First approach is recommended which involves small modifications to your current diet. This involves three main elements:

  1. Aim to have 1 pint of full fat milk each day (see below) and,
  2. Include 2 high calorie snacks a day from the list below and,
  3. Aim to eat 3 meals a day that have been fortified (see below)

Aim to have 1 pint of full fat milk each day

  • If you use skimmed or semi-skimmed milk swap to full fat milk as this adds extra calories.
  • If you use full fat milk add 4 extra tablespoons of skimmed milk powder to each pint of milk and mix well. Use this milk to make drinks, on cereal and when cooking. We call this fortified milk.
  • If you use a milk alternative, for example soya, almond, hemp, oat, coconut etc, aim to have 1 pint a day and choose a higher calorie product where possible.
  • If you prefer flavoured drinks why not try making homemade supplement drinks. Alternatively over the counter nutritional supplements are readily available in supermarkets and pharmacies. E.g. Aymes Retail, Complan, Meritene or Nurishment.

Include 2 high calorie snacks a day

  • Including a snack mid-morning and mid-afternoon adds extra calories to your diet
  • Eating a little and often is an effective way of spreading your intake over the day which is more helpful if you have a small appetite.
  • Snacks can be sweet or savoury. Examples are:
    • Full fat yoghurts
    • Cheese cubes or triangles Nuts
    • Dried fruit
    • Savoury snacks – crisps, cheesy biscuits, Bombay mix, nachos
    • Squares of chocolate Biscuits
    • Cake
    • Tinned fruit with evaporated or condensed milk
    • Desserts – chilled or tinned rice pudding or custard, chocolate mousse, trifle


Aim to eat three meals a day fortified with other food items to make them more nutritious

If you have a small appetite fortifying foods to add extra energy, protein and other nutrients to them can make it easier for you to eat enough. We call this process food fortification.

Below are suggestions on how to fortify foods:

Try fortifying breakfast cereal with fortified milk, dried fruit, ground almonds, evaporated milk, cream, sugar, syrup, honey or coconut cream.

Bread or toast
Try adding plenty of butter or margarine and jam, marmalade, lemon curd, chocolate spread or cream cheese.

Main meals
Try fortifying meat dishes with grated cheese, cream cheese, mayonnaise, skimmed milk powder, butter/margarine, cream, milk based sauces or coconut cream.

Potatoes and vegetables
Try serving with milk based sauces made with fortified milk, cream cheese, mayonnaise, grated cheese or butter/margarine.

Try serving with condensed milk, ice cream, evaporated milk, custard made with fortified milk, honey, syrup or cream.

Lighter meals
Try fortifying soup with skimmed milk powder, evaporated milk, grated cheese, nut butter, ground almonds or cream

Try serving with plenty of mayonnaise, cream cheese, nut butter or butter/margarine, in addition to sandwich fillings

Other resources you may find useful: