As a dietitian, I often hear the same sentence from families:
"She's just not that hungry anymore."
It sounds harmless.
After all, appetite changes are a normal part of ageing... aren't they?
Sometimes they are.
But sometimes, they're the first sign of malnutrition, and by the time it's obvious, significant muscle, strength and independence may already have been lost.
Let me tell you about Margaret.
Something Wasn't Quite Right
Something wasn't quite right with Margaret.
Not urgent.
Just... quieter than before.
Margaret is 78 and lives at home with her husband. They've always managed well together. Shared meals, familiar routines, and a comfortable rhythm to everyday life.
Then she became unwell.
Nothing life-threatening. Just enough to reduce her appetite.
When she recovered, her appetite never fully returned.
At first, nobody worried.
She simply ate a little less.
Half a sandwich instead of a whole one.
Skipped breakfast now and then.
Left vegetables on her plate.
Cooking began to feel like hard work.
Eating felt like another chore.
Her husband would often say,
"She's just not that hungry anymore."
The Weight Loss Happened So Gradually
Over the next six months, Margaret slowly lost weight.
Not enough for anyone to sound the alarm.
But enough that subtle changes started appearing.
She became:
- More tired than usual
- Less confident on her feet
- Less interested in going out
- Weaker getting up from a chair
- More prone to naps during the day
She simply wasn't herself anymore.
Routine blood tests later showed:
- Low iron
- Low vitamin D
- Poor nutritional intake
What Margaret was experiencing wasn't simply "getting older."
It was malnutrition.
What Is Malnutrition?
Many people think malnutrition only happens during famine or in very underweight people.
The reality is very different.
Malnutrition occurs when the body doesn't receive enough energy, protein, or essential nutrients to meet its needs.
This can happen even when someone is eating every day.
Older adults are particularly at risk because illness, medications, changes in taste, dental problems, fatigue, loneliness and reduced appetite can all make eating more difficult.
Over time the body adapts by breaking down muscle to meet its needs.
This leads to:
- Muscle loss (sarcopenia)
- Reduced strength
- Poor balance
- Increased falls risk
- Slower recovery from illness
- Reduced immunity
- Greater loss of independence
Why Older Adults Are at Higher Risk
After the age of 65, appetite naturally declines in many people.
This is sometimes called the "anorexia of ageing."
Add in factors such as:
- Recent illness
- Hospital admission
- Difficulty shopping
- Cooking for one or two people
- Medication side effects
- Dental issues
- Chronic disease
- Living alone
- Caring for a spouse
…and it becomes much easier for nutrition to slowly slip away unnoticed.
Often both partners are ageing together.
One may be caring for the other while also struggling themselves.
Malnutrition Isn't Fixed by "Eating More"
One of the biggest misconceptions is that people simply need to eat bigger meals.
Often they can't.
Their appetite isn't there.
The goal is to make every mouthful count.
As an Accredited Practising Dietitian, my focus is usually on:
- Increasing protein without increasing meal size
- Boosting energy intake using everyday foods
- Making meals easier to prepare
- Supporting appetite recovery after illness
- Creating realistic routines that suit both partners
- Preventing further muscle loss
Sometimes very small dietary changes can make a significant difference.
Signs Families Should Watch For
If you're concerned about an older parent, partner or friend, look out for:
- Unintentional weight loss
- Clothes becoming loose
- Eating much smaller portions
- Skipping meals
- Loss of strength
- Fatigue
- Frequent illness
- Slower recovery after infection
- Difficulty standing from a chair
- Reduced interest in food
The earlier malnutrition is recognised, the easier it is to reverse.
Margaret Didn't Need a Diet
Margaret didn't need another restrictive eating plan.
She didn't need someone telling her to "just eat more."
She needed support.
Support that recognised how ageing, illness and reduced appetite work together.
With practical nutrition strategies, appropriate protein intake, and foods that were easier to prepare and enjoyable to eat, Margaret gradually regained weight, strength and confidence.
When Should You See a Dietitian?
If you or someone you love has:
- Lost weight without trying
- Has little appetite after illness
- Feels weaker than before
- Is recovering from a hospital stay
- Is eating less than usual
don't assume it's just part of getting older.
Early nutrition support can help prevent further muscle loss and improve recovery, independence and quality of life.
At The Cooroy Dietitian, I work with older adults and their families to manage malnutrition, unintentional weight loss, poor appetite, sarcopenia, and recovery after illness using practical, personalised nutrition advice.
Sometimes the smallest changes in appetite tell the biggest story.
And the sooner we listen, the better the outcome.
Frequently Asked Questions
Can you be malnourished if you're overweight?
Yes. Malnutrition is about inadequate intake of energy, protein, and nutrients—not just body weight. Someone can have excess body fat but still lose muscle and become nutritionally deficient.
What causes loss of appetite in older adults?
Common causes include illness, medications, changes in taste and smell, dental problems, depression, chronic disease, and the natural changes that occur with ageing.
Can malnutrition be reversed?
In many cases, yes. Early intervention with the right nutrition plan can improve strength, energy levels, muscle mass, and overall quality of life.
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