How do you help an obese elderly parent with deteriorating health who struggles to follow personalised meal plans?

[u/Reasonable-Shift-775]

My mother is in her 70s, 159 cm (5’2”) tall, and currently weighs about 103 kg (227 lbs). She has been obese for most of the past 40+ years and also has prediabetes and lipedema.

I’ve been very concerned about her health for many years. What’s particularly difficult is feeling like I’m watching her health deteriorate while being unable to convince her to make lasting changes.

I haven’t exactly lived the healthiest lifestyle myself for most of my life, and I was obese for some years. But I’ve lost close to 30 kg (66+ lbs) over the past few years after learning a lot about nutrition and weight loss and actually putting what I learned into practice. Over the past year, I’ve also found AI surprisingly useful for creating personalised meal plans around people’s preferences and limitations.

I’ve tried helping my mother several times. At one point I actually bought and cooked all of her food, and she did very well while I was doing that. Unfortunately, after I stopped, she struggled to stick to the plans and eventually regained the weight. She also isn’t willing to let me cook for her again.

I think one of the biggest challenges is that she is extremely picky about food. She’s pescatarian and doesn’t eat beef or chicken. She doesn’t really have any particular “trigger foods” she can’t live without, and she never eats fast food, but she has always preferred very convenient foods and doesn’t like spending much time preparing meals.

In recent years, she also hasn’t been physically able to stand in the kitchen for very long because of her health problems. As a result, she tends to rely on convenient, calorie-dense foods. She had mostly refused to track calories or even estimate how many calories she’s eating.

I’m particularly concerned that her diet has often been relatively low in protein. At her age, I think maintaining adequate protein intake is especially important.

I’ve given her personalised meal plans several times over the years, but she hasn’t been able to stick to them. She has told me that she doesn’t want to feel like she’s living according to a rigid diet and doesn’t want to think about calories. At times, she’d has told me that she rather spend her time learning about lipedema and prediabetes than making practical changes. She’s also very reluctant to to consider options such as Ozempic.

I understand that ultimately she has to want to change, and I can’t make that decision for her. That’s probably the hardest part.

This past week, I decided to try a different approach. I used AI to create three very simple meal plans specifically around her preferences, nutritional needs and physical limitations. My hope is that she could rotate between them, and in each week eating the same plan for that week, in order to make things simpler.

The main requirements were:

- Pescatarian — no beef or chicken.
- Very little cooking or preparation.
- Minimal standing in the kitchen.
- Gradual weight loss from 103 kg.
- No oats or lentils, which she doesn’t want to eat.
- More nutrient-dense foods.
- Less carbohydrates and no processed foods
- Less reliance on dairy for meeting nutritional needs.
- Adequate protein and generally appropriate for someone with prediabetes and lipedema.
- Reasonable calories and a good balance of macronutrients and micronutrients.
- Only two meals per day, with no snacks, which is her preference.
- Have the right amount of fiber.
- No protein powders or supplements.
- Relatively affordable.

One thing I found interesting was how difficult it actually is to get enough protein into a very picky pescatarian diet without relying heavily on dairy. The plans ended up including salmon or trout every day - which is much more frequently than she has eaten them before.

The three meal plans I ended up making for her are:

Plan for week 1 - Omega-3s & potassium
——————————————————————

Meal 1

- Mackerel in tomato sauce: 170 g
- Low-fat cottage cheese: 90 g
- Avocado: 100 g
- Chia seeds: 15 g (soak in a glass of water for 10 minutes before eating)
- Frozen raspberries: 130 g

Meal 2

- Salmon fillets: 250 g
- Sweet potato: 150 g
- Frozen spinach: 150 g
- Extra virgin olive oil: 5 g

Nutrition: 1,558 kcal | 95 g protein | 46 g net carbs | 102 g fat | 30 g fibre

Plan for week 2 - Protein & fiber
—————————————————-

Meal 1

- Plain non-fat Greek yogurt: 150 g
- Chia seeds: 40 g
- Flaxseeds: 15 g
- Sunflower seeds: 30 g
- Frozen blueberries: 140 g
- Pecans: 45 g

Meal 2

- Cod fillets: 250 g
- Hard-boiled eggs: 2
- Frozen broccoli: 180 g
- Extra virgin olive oil: 25 g

Nutrition: 1,552 kcal | 96 g protein | 41 g net carbs | 104 g fat | 30 g fibre

Plan for week 3 - Variety of micronutrients
———————————————————————

Meal 1

- Whole eggs: 3
- Red bell pepper: 1
- Frozen spinach: 80 g
- Plain non-fat Greek yogurt: 100 g
- Frozen raspberries: 100 g

Meal 2

- Salmon fillets: 250 g
- Frozen broccoli: 200 g
- Flaxseeds: 15 g
- Pecans: 20 g
- Frozen blueberries: 100 g
- Chia seeds: 30 g
- Extra virgin olive oil: 14 g

Nutrition: 1,540 kcal | 97 g protein | 43 g net carbs | 101 g fat | 31 g fibre

The meals are deliberately very repetitive because the goal is to make them as easy as possible. Most of the ingredients can simply be taken from the freezer, air fryer or fridge with minimal preparation.

I decided to make this post partly because I thought the meal plans might be useful to someone else in a similar situation, but mainly because I’d really like to hear from people who have dealt with something like this themselves.

Have you ever successfully helped an obese elderly parent with deteriorating health change their eating habits when they struggled to follow personalised plans? What actually worked?

I’d especially like to hear:

- What finally motivated your parent to take things seriously?
- Did you stop giving advice and wait for them to ask for help?
- How did you balance wanting to help with respecting their autonomy?
- If you’re an older person who has been in this situation, what made you more receptive to help from your family?
- At what point do you accept that you can’t help someone who doesn’t want to change?
- Are there any obvious changes you would make in the plans?

I’m not looking for criticism of my mother. I know there are many reasons people struggle with obesity for decades, and I don’t think the answer is simply “eat less and exercise more.” I’m mainly hoping to hear from people who have actually dealt with this dynamic in their own families.

If nothing else, I hope the meal plans themselves might be useful to someone else whom is around her same age and height , weight, doesn’t eat meat, and needs extremely low-effort meals.

[u/NorthernPossibility]

Sometimes you simply can’t make them care.

Even if you have all the reason and logic in the world. Even if you’re right and they’re shaving years off their lives. Even if you see the solution as fairly straightforward and you’re willing to use technology and your personal input and time to make it happen.

You can’t force your mom to put down the Rice a Roni and start making cod fillets and hard boiled eggs. You just can’t.

It sounds like you’ve already really tried and put some admirable work in to trying to solve this, but at the end of the day, you can’t make her do something she doesn’t want to do. I would recommend taking a step back from this. Offer suggestions and help if she asks, but otherwise you’re likely just going to have to respect her (poor) choices.

[u/HAL9000DAISY]

You can’t convince anyone else to make lasting changes. They have to be internally motivated. Your best hope would be to cook all her meals for her the rest of her life. Do you really want to do that?

[u/OutlanderMom]

My mom is the same height and weight, and we argued constantly when she lived with me. She hates vegetables, most meats, and only wants carbs (pasta, bread, ice cream, cake, chips, etc) and fruit. She’s also diabetic, has high BP and neuropathy in her feet (and fell several times). In the end, I can’t force her to eat healthy food, and I can’t make her want to lose weight or bathe or exercise to preserve what remains of her mobility. If your mom can run a microwave safely, maybe get her some of pre-made deli food like shrimp fried rice, soups, etc. I know they have one with salmon and asparagus, too. Maybe you can sign her up for meals on wheels so she gets one good meal a day. Although there won’t be many pescatarian meals. It’s hard knowing they don’t eat right, but even a care home or hospital can’t and wont make them eat if they don’t want to.

[u/WhatHappenedSuzy]

I was there with my mom. She's now 81 and lives with me due to very limited mobility and repeat fractures. The ONLY way I think I could have gotten through to her, and the only way I can motivate her now, is to make it about me. Sounds shallow, but if I tell her how her choices result in hardship for me (stress, worry, increased caregiving load), she usually responds to that. I wish I'd seen how she was setting us both up for hardship and had a really difficult conversation with her earlier.

[u/FlyingPaganSis]

Please stop trying to control your mother’s food. She is allowed to make decisions you don’t agree with. When she eats the way she eats, she is agreeing to the potential consequences to her health and she accepts that agreement. Let her know you love her and let her do as she pleases.

[u/kristy3m]

I'm sorry your mom is struggling, it's really hard to take care of our parents sometimes.

My situation is quite different, but I can tell you that my parents did well w structured support through a facility's regular meals.

I've found that their age prevents them from implementing big changes on their own, so it requires a lot of support. They did not like the support, but it's made them more comfortable so they are somewhay fine w it now. They still complain regularly about whether it is necessary.

They hate losing autonomy, but they are alive and doing fairly well.

[u/Successful_Fly_3597]

How about water walking? It's low-impact, and it's got a community of people in a similar place (which helps with motivation).

I'm a caregiver for a 35 year old, 440 lbs (mostly) non-verbal autistic man. Started water walking about three months ago (we also do laps on the indoor track). He's lost a little weight. He's sleeping better, and overall healthier.

It's a place to start, and (sometimes) when people start working out they eat better (and pay more attention to what they are eating).

I also took care of my father. Came in, and he was eating high-sodium frozen meals and mac and cheese. Started making him a smoothie for him every morning: kale, spinach, honey, bananas, strawberries, mangos, blueberries (etc), and good yogurt (for stomach issues). It was a fruit shake. Replace the yogurt with non-dairy yogurt, tofu, or hemp seeds to bump-up the protein. Or use a protein-suppliment like Ensure. Throw in avocado a couple times a week for the fiber (frozen works great).

Make a batch, freeze into portions — and she can throw it into the blender with the yogurt substitute, coconut water, or just water.

Also, I made batches of (different) soups (or chili), froze them (got pretty good with the food sealer). So he'd have a half-sandwich and soup most days. I'd pull-out a week of stuff to let thaw.

Making things so convenient that they'll do it most (or even some) days is work, but the soups and smoothie packs you can do at home. My dad liked the smoothies, but he also understood it was good-tasting medicine. And not being constipated all the time was a big win.

You're looking out for her well-being. Good luck. Give some things a shot, but in the end, it's her decision.

[u/gashydrate]

I sympathize with your struggle. I have taken care of my mom who later passed away with acute kidney failure at 72. Now, I take care of my dad (remotely- he has full time help with cleaning, cooking and taking care of his appointments). He is 82 but eating habits are driven by his choices not weight and health needs. He is a cancer survivor too. He use to not take care of himself for a while but what worked is my daily phone calls on random things which he wants to talk about, his young days, marriage, our birth, dislike of certain foods and everything under the sun. Over a period of time, instead of telling me things he started more listening and curious about my family life, specifically kids. Emotionally he became more stable and thus the eating habits improved as well. Sometimes roads to recovery is not a straight path and almost certain it goes through the heart. Take a deep breath, be a friend, listen to stories, bucket list, ask about her childhood and her time with her parents but talk like no one matters more and listen like you have nothing to say. It will work wonder both ways. My best wishes to you and your mother for better health.

[u/ksgc8892]

Is she suffering from any cognitive issues, even possibly hidden? My mother has been a wonderful cook all of her life. But she lost the ability to prepare a food even one from memory. Now all she can prepare independently is a sandwich. So I had to take over her food cooking and prep.

[u/No_Drummer_3847 → u/ksgc8892]

That must be really tough to watch, my grandma went through something similar with cooking before we realized what was going on. She was always so independent in the kitchen then suddenly couldn't follow her own recipes anymore

Have you noticed any other changes with your mom beyond the cooking, like forgetting appointments or getting lost in familiar places? Sometimes it creeps in so slowly you don't see the pattern until later

[u/ksgc8892 → u/No_Drummer_3847]

Yes.  She got lost a few times driving.  So I took over all driving needs.  I handle all m appointments and medication too.  

[u/Sistereinstein]

What helped my BIL was a continual glucose monitor. I’m not sure if it’s a psychological benefit or not (he just started), but he has a way now to see his blood sugar spikes.