At a glance......
Appetite loss is the desire to eat food, sometimes due to hunger. Appealing foods can stimulate appetite even when hunger is absent, although appetite can be greatly reduced by satiety. Appetite exists in all higher life-forms and serves to regulate adequate energy intake to maintain metabolic needs. It is regulated by a close interplay between the digestive tract, adipose tissue, and the brain. Appetite has a relationship with every individual’s behavior. Appetitive behavior also known as approach behavior, and consummatory behaviors, are the only processes that involve energy intake, whereas all other behaviors affect the release of energy. When stressed, appetite levels may increase and result in an increase of food intake. Decreased desire to eat is termed anorexia, while polyphagia (or “hyperphagia”) is increased eating. Dysregulation of appetite contributes to anorexia nervosa, bulimia nervosa, cachexia, overeating, and binge eating disorder.
Causes of Appetite Loss
- Infections – Many infections, from the common cold to the flu to mononucleosis can kill your appetite.
- Stomach bugs – Food poisoning and infections of the stomach and gastrointestinal tract are very common causes of a loss of appetite.
- Cancer – If you have a tumor, your body often will respond by suppressing your appetite. This makes your ability to fight the tumor off even worse, unfortunately.
- Peptic Ulcer Disease – A peptic ulcer is a break in the inner lining of the stomach. The sore will typically resolve on its own within several months but while present can cause pain, nausea, and decreased appetite.
- Hypothyroidism – When the thyroid stops producing enough thyroid hormone, an underactive thyroid is diagnosed. This can lead to fatigue, mood swings, and decreased appetite.
- Kidney or liver failure – If these organs are not filtering the blood correctly, toxins that build up can lead to a loss of appetite.
- Eating disorders – These often lead to abnormal responses to food and need to be diagnosed promptly.
- Acute or chronic bacterial or viral infections
- Metabolic problems, such as hypothyroidism
- Gastrointestinal conditions – such as gastritis, duodenitis or oesophagitis
- Psychiatric disorders, such as depression, anxiety, alcohol or drug dependence
- Cognitive impairment
- nausea and vomiting
- Sore mouth, dry mouth, difficulty chewing or swallowing, taste and smell changes
- Pain or pain medicines
- Unpleasant odours or sights
- A low red blood cell count, or anemia
- Being less active
- Difficulty breathing
- Feeling depressed or anxious
- Feeling of fullness due to a buildup of fluid in the abdomen (called ascites)
What are diseases characterized by loss of appetite
- Addison disease
- Still’s disease
- Still-chauffard disease (Juvenile rheumatoid arthritis)
- Typhoid fever
- Gastroesophageal reflux disease (GERD)
- Depression and stress during holidays
- Peptic ulcer (Stomach and Duodenal Ulcers)
- Seasonal affective disorder
Symptoms of Appetite Loss
- Significant unintentional weight loss
- New-onset dyspepsia, age more than 55
- Symptoms raising suspicion of malignancy
- Persistent low mood
- Features suggesting alcohol dependence
- Mini-mental state examination score, or equivalent, suggesting cognitive impairment.
- complaints that food tastes “funny”
- being put off by food smells
- not liking food that was once a favorite
- difficulty chewing and swallowing
- tiring of eating and giving up after a few mouthfuls
- eating only 1 or 2 types of foods
- feeling full sooner than expected, or early satiety
Diagnosis of Appetite Loss
- Blood tests
- Helicobacter pylori stool antigen (if evidence of dyspepsia)
- Chest X-ray if clinically indicated
- Ultrasound scan of the abdomen if indicated
- Depression screening
- An alcohol-use questionnaire, and
- Mini mental state examination (MMSE), or equivalent, cognitive test.
Treatment of Appetite Loss
- Megestrol acetate or medroxyprogesterone – which are forms of the progesterone hormone that can improve appetite and weight gain.
- Steroid medications – which can increase appetite, improve a person’s sense of well-being, and help with nausea, weakness, or pain.
- Metoclopramide – which helps move food out of the stomach and can prevent feeling full before eating enough food.
- Dronabinol – a cannabinoid made in the laboratory, which may stimulate appetite.
- Olanzapine – seems to promote weight gain as well as the ability to ameliorate obsessional behaviors concerning weight gain. zinc supplements have been shown to be helpful, and cortisol is also being investigated.
- Green Eating – If you can, eat some kale, collards, or arugula. They promote the body to make more digestive enzymes and increase appetite.
- Water – It is especially important to drink water when you have a little appetite so that you’re not battling dehydration on top of everything else. But water can also help speed up your digestive system if a slow system is a reason for not wanting to eat.
- Spices – Both fennel and caraway can be used to aid in digestion and boost appetite. Try adding some to water or food. This is a treatment designed to fight recurring decreased appetite.
- Exercise – Don’t go all out but take a quick stroll through the neighborhood or put in some time on the treadmill. If you can speed up your body’s energy use, your appetite should return.
- Supplements –There are over the counter products you can pick up that are designed to increase appetite. You can find pills and powders to try.
- Cognitive behavioral therapy (CBT) – which postulates that an individual’s feelings and behaviors are caused by their own thoughts instead of external stimuli such as other people, situations or events; the idea is to change how a person thinks and reacts to a situation even if the situation itself does not change.
- Acceptance and commitment therapy – a type of CBT
- Cognitive Remediation Therapy – a set of cognitive drills or compensatory interventions designed to enhance cognitive functioning.
- Dialectical behavior therapy
- Family therapy including “conjoint family therapy” , “separated family therapy”
- Maudsley family therapy.
- Behavioral therapy – focuses on gaining control and changing unwanted behaviors.
- Interpersonal psychotherapy
- Cognitive-emotional behavior therapy
- Music therapy
- Recreation therapy
- Art therapy
- Nutrition counseling and Medical nutrition therapy
Consider the following tips for getting proper nutrition when your appetite is low
- Eat 5 to 6 small meals a day, and snack whenever you are hungry.
- Do not limit how much you eat.
- Determine which times of day you are hungry and eat at those times.
- Eat nutritious snacks that are high in calories and protein. This includes dried fruits, nuts and nut butter, yogurt, cheeses, eggs, milkshakes, ice cream, cereal, pudding, and protein bars or granola bars.
- Keep your favorite foods on hand for snacking.
- Increase the calories and protein in foods by adding sauces, gravy, butter, cheese, sour cream, half and half, whipped cream, and nuts or nut butter.
- Drink larger amounts of fluids between meals, rather than with meals, which may make you feel full too quickly.
- Choose nutritious or filling drinks, such as milk or nutritional milkshakes or smoothies.
- Ask family members or friends to get groceries and prepare food for you when you are too tired to shop or cook. Also, consider buying precooked meals.
- Try to eat in pleasant surroundings and with family or friends.
- Try placing food on smaller plates rather than larger plates.
- If the smell or taste of food makes you nauseous, eat food that is cold or at room temperature. This will decrease its odor and reduce its taste.
- If you are having trouble tasting the food, try adding spices and condiments to make the foods more appealing.
- If you have changes in taste, such as a metallic taste in your mouth, try sucking on hard candy such as mints or lemon drops before eating a meal.
- Ask your doctor about ways to relieve gastrointestinal symptoms, such as nausea, vomiting, and constipation. Also tell your doctor if you are having any difficulty with managing pain.
- Try light exercise, such as a 20-minute walk, about an hour before meals to stimulate your appetite. Consult your health care team before starting an exercise program. Exercise also helps maintain muscle mass.