I’ve gained a bit of weight recently. Well, more than a bit. In fact I have gained so much weight over the last year that few of my clothes still fit or can only be worn in circumstances where blood supply to the lower limbs is not essential.
My son, ever the comedian, walks past me and pretends to be drawn in by the gravitational field of my stomach. Okay it was funny once. Still, it amuses him. In any case, as I frequently point out to him, I was not always thus. I was as slim as a rake at 15. My rib cage would have made a quite passable xylophone. Visitors to our home would speculate on why my parents were apparently starving me.
But fast forward four decades or so and it’s a different story. I am, in my own context, the size of a barrage balloon. In the decade since I was diagnosed with Parkinson’s, I have gained approximately 4 stones.
Now my weight, like everybody’s weight, is a balance between caloric input and energy expenditure. In plain terms, this means how much you eat and how much you exercise. It’s not rocket science – every extra doughnut means another half-hour on the exercise bike or whatever.
So where do I lay the blame for this precipitous increase in weight? Obviously diet and exercise are the first places to look. Certainly I don’t get anywhere near as much exercise as I would like or as I recognise would be beneficial. I don’t know whether I make excuses too readily or if my day is simply fuller than will accommodate. Either way it doesn’t seem to happen.
So what about diet? Well I do have a certain penchant for Jaffa cakes (which are, incidentally, a cake and not a biscuit despite what people may tell you) and soft French cheeses. And most of the time, when I am working on my own, I may tend to nibble. On the whole however, I forget mealtimes. Many’s the time that I will reach 5 PM and realise that I have eaten neither breakfast nor lunch. On other occasions I may feast on leftover pizza for breakfast and fast food for lunch and the odd Murray mint in the afternoon.
My point – and you’ll be glad to know that not only is there one but I have finally reached it – is this. People with Parkinson’s (PWPs) don’t always know when they should eat and when they should not. In the absence of external cues, such as the entire office decamping to the Pret a Manger, we do not seem to recognise physiological hunger and satiety cues in the same way as people without Parkinson’s. In other words, we don’t seem to realise when we’re hungry and when we are full.
In some ways this should be no surprise. There is a gathering school of thought that Parkinson’s starts in the gut nerves before progressing to the brain areas that control movement. That would fit. If those nerves that tell us it’s time for a sandwich or that we don’t need a second helping of raspberry ripple are damaged, our frame of reference goes with it.
This can probably go one of two ways. Either one simply forgets to eat or one nibbles most of the time. Obviously it’s clear which camp I occupy but for every one of me, there is another human skeleton who has simply forgotten to eat. And if you live on your own, without the social reminders to eat at predefined times, the problem is exacerbated.
I feel that this is probably an underresearched area. We know that diet can influence the absorption and effectiveness of medication. So shouldn’t we be trying to find out more about this and how it may influence day-to-day management of the condition?
Just a thought.