Is a poor appetite dangerous? | Guest column

Liz Taylor

Liz Taylor


Special to the Sounder

I once consulted with a company to evaluate the health of people over 80 who had applied for long-term care insurance. The goal: to ensure they were healthy enough not to use their insurance benefits right away.

This job gave me two surprising gifts. One, it uplifted and revised my attitude about aging. Until then, I’d worked among the frailest of the frail, often in nursing homes. I’d assumed (as do most of us) that severe disability, ill health and dementia are normal for the very old. I felt bleak about my own aging.

Then I began visiting people in their 80s who were zesty, interesting, able, funny and fun — and as healthy as I was, 40 years their junior. I’ll never forget the architect who, at 82, had the energy to remodel his kitchen (torture at any age), and the couple in their mid-80s who still single-handedly ran a farm.

The second gift was subtler. I began to notice a connection between pudginess and good health. Many of the skinniest older people I interviewed flunked my evaluation, while the plumper ones – not fat, but slightly round – passed readily. Research has since confirmed that weight loss in older people can be a symptom of problems, some quite serious. Common causes of appetite loss in older people are a reduced sense of taste and smell, medications, chronic pain, multiple illnesses, depression and problems with dentures.

Now there’s a screening tool to predict which older people with appetite problems are likely to lose weight. “It tells us whether a poor appetite is likely to kill you,” says its designer, Margaret-Mary Wilson, M.D., formerly associate professor of internal medicine and geriatrics at Saint Louis University in Missouri. The test is called SNAQ for Simplified Nutritional Appetite Questionnaire.

1. My appetite is:

a) very poor

b) poor

c) average

d) good

e) very good

2. When I eat:

a) I feel full after eating only a few mouthfuls.

b) I feel full after eating about a third of a meal.

c) I feel full after eating more than half a meal.

d) I feel full after eating most of the meal.

e) I hardly ever feel full.

3. Food tastes:

a) very bad

b) bad

c) average

d) good

e) very good

4. Normally, I eat:

a) less than a meal a day

b) one meal a day

c) two meals a day

d) three meals a day

e) more than three meals a day



To score, assign points to each answer: a = 1 through e = 5. If the numbers add up to 14 or less, the person is at significant risk of losing at least 5 percent of her weight within six months and should see a doctor. Info can be found at