I recently trained a female client in her 60s who has a high level of body fat. She also has MS. Although she experienced tremendous progress with gains in strength, balance and coordination, she had not lost body fat (even with caloric manipulations). Can MS affect fat loss directly or indirectly?
Unfortunately, MS is a debilitating disease that can cause muscle atrophy. Depending on your client’s condition, she may or may not be suffering from muscle loss at this time. Muscle loss will cause a decline in energy expenditure, resulting in a lower amount of fat being burned. (Note: Even if your client is experiencing strength gains, she may be losing muscle. Strength is not always associated with an increased level of muscle mass.)
If your client is not losing muscle, you may want to recalculate her caloric intake or reevaluate whether she truly understands how to monitor that component of her diet. Research has shown that the majority of people under report calories being ingested.
It is difficult to give a black and white answer to your question due to a lack of knowledge on the specifics of your client. She may be on medication that is hindering her ability to lose body fat or that may cause bloating. The best advice I can give would be to consult with her physician on her condition and review the article Training the Client with Multiple Sclerosis by Michael Youssouf.