Loss of Appetite

Loss of appetite may accompany other symptoms that vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the digestive tract may also involve other body systems.

Reduced appetite may accompany other symptoms affecting the digestive system including:

• Abdominal pain or cramping

• Changes in taste or smell

• Chronic or persistent diarrhea

• Constipation

• Heartburn

• Indigestion

• Jaundice

• Nausea with or without vomiting

Symptoms related to other body systems include:

• Cough that gets more severe over time

• Difficulty breathing or rapid breathing

• General ill feeling

• Irritability and mood changes

• Malaise or lethargy

• Ongoing low-grade fever

• Partial or complete loss of smell

• Rapid heart rate (tachycardia)

• Severe fatigue

• Unexplained weight loss

In some cases, poor appetite may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

• Change in level of consciousness or alertness, such as passing out or unresponsiveness

• Decreased urine output

• High fever (higher than 101°F)

• Severe abdominal pain

• Severe dizziness or sudden loss of balance

Loss of appetite results from a decrease in the desire to eat and is commonly seen in the elderly, whose daily caloric demand decreases with reduced physical activity. Those with cognitive impairment forget to prepare meals. Many individuals with early dementia lose the sense of smell and with that the enjoyment of food. It is not always clear why anorexia occurs but may be due in part to negative emotions, such as anxiety, depression or sadness. Any health condition that interferes with the palatability of food or interferes with the mechanisms of food ingestion can also lead to anorexia.

Different types of cancers, including the illness itself and treatments, such as chemotherapy and radiation therapy, are a common cause of reduced appetite. Chronic conditions, such as heart or kidney failure or chronic obstructive pulmonary disease (COPD), may be accompanied by poor appetite due to difficulty breathing, weakness, and general malaise. Poor appetite is commonly a result of narcotic medications, such as codeine or morphine.

Chronic conditions causing poor appetite include:

• Cancers (ovarian, pancreatic, colon, or stomach, for example)

• Chronic obstructive pulmonary disease (COPD, includes emphysema and chronic bronchitis)

• Congestive heart failure

• Gallbladder disease such as cholecystitis (inflammation of the gallbladder)

• Gastrointestinal infections

• Hepatitis

• HIV/AIDS

• Hypothyroidism (underactive thyroid)

• Kidney or liver failure

Drugs that may reduce appetite include:

• Amphetamines

• Antibiotics

• Chemotherapy drugs

• Cocaine

• Codeine

• Heroin

• Radiation therapy

Poor appetite can also have other common causes including:

• Aging (elderly adults very often have poor appetite)

• Difficulty swallowing

• First trimester of pregnancy

• Loss of taste or smell

• Nausea with or without vomiting

• Negative emotions (anxiety, depression, grief or sadness)

• Pain

Serious or life-threatening causes of loss of appetite

In some cases, loss of appetite may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

• Dehydration (loss of body fluids and electrolytes, which can be life-threatening when severe and untreated)

• Kidney failure

• Liver failure

Many types of medical conditions and situations can cause loss of appetite. Most causes of poor appetite are not serious and the problem resolves on its own with time. However, there are times when seeing a healthcare provider for loss of appetite is important for possibly identifying an underlying cause.

For general loss of appetite or loss of appetite during or following a brief illness, see a doctor if the problem persists more than a few days.

See a doctor promptly if reduced appetite occurs with:

• Medication, but do not stop taking the medicine without first consulting the prescribing doctor or a pharmacist

• Signs of substance abuse, such as alcoholism

• Signs of an eating disorder

• Signs of depression or other mental illness

• Unexpected weight loss

Seek care immediately (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

• Change in level of consciousness or alertness, such as passing out or unresponsiveness

• Decreased urine output

• High fever (higher than 101°F)

• Severe abdominal pain

• Severe dizziness or sudden loss of balance

For loss of appetite in someone with a serious underlying illness, such as cancer, contact a doctor promptly if the person:

• Cannot keep down food or drink without vomiting

• Has not eaten in at least 24 hours

• Has pain even with prescribed pain medication

• Has pain with eating

• Is producing little to no urine

• Loses about three pounds or more in a week

A physical exam and symptom evaluation may be necessary to diagnose the cause of poor appetite. Chronic anorexia is usually due to an underlying disease. The doctor or other healthcare provider will order blood tests, urine tests, and possibly imaging tests like ultrasound to learn more about your overall health. Provide as much information as possible about your overall health, medical history, and lifestyle.

To diagnose your condition, your doctor or licensed healthcare practitioner will ask you several questions related to your appetite including:

• Do you always feel like your appetite is poor?

• Do you have any other symptoms?

• How long have you been experiencing loss of appetite?

• Have you experienced it previously?

• How often and how much alcohol do you drink? 

• Do you take any other types of drugs or substances (including supplements and vitamins)?

• What medications are you taking?

• Have you lost weight recently?

• What, if anything, triggers your loss of appetite, such as smelling food?

It is not always possible to find an explanation for poor appetite. If the problem persists and your provider is unable to determine a cause, seeking a second opinion may give you more information and answers.

When reduced appetite is due to a treatable condition, diagnosing and treating the illness will likely increase appetite. Treatments for loss of appetite depend on the cause, but may include:

• Appetite stimulants, such as dronabinol (Marinol) and megestrol (Megace ES)

• Antidepressants, such as fluoxetine (Prozac, Sarafem)

• Corticosteroids, such as oxandrolone, prescribed in low doses

• Feeding intervention, such as a feeding tube (enteral nutrition) or intravenous nutrition (parenteral nutrition

• Nutritional counseling, especially for people with a chronic condition, cancer, or cancer treatment

Home remedies include strategies to stimulate appetite and provide enough nutrition to prevent complications of loss of appetite:

• Alter the temperature of the food or drink

• Cook or prepare meals with spices known to stimulate salivation and aid digestion, such as garlic, ginger, fennel, basil, parsley, turmeric, pepper, cardamom, rosemary, and cinnamon, among others

• Drink a small amount of alcohol about 30 minutes before eating (non-pregnant adults only)

• Eat bland meals like rice, oatmeal and toast if loss of appetite occurs with nausea or vomiting

• Eat flexibly rather than at scheduled meal times (for elderly people, scheduled meal times may be better)

• Eat small meals of favorite foods several times a day

• Eat socially, with a loved friend or family member

• Exercise lightly, such as walking or riding an exercise bike

• Have fun with food, such as artful arrangements of food on a plate or using decorations

• Increase caloric intake with high-calorie, healthy snacks like peanut butter on crackers

• Marinate meat and vegetables before cooking

• Pack shakes and smoothies with protein, or buy prepared protein drinks

• Stay hydrated with water and electrolyte-containing drinks 

• Suck on throat lozenges to stimulate saliva production

Alternative or natural treatments for loss of appetite include:

• Acupuncture

• Bitter, edible plants, such as endive and dandelion

• Medical marijuana

• Spices and herbs, including black pepper, cardamom seeds or powder, ginger, mustard, and turmeric

• Stress reduction practices, which may include exercise, meditation, counseling, or herbal supplements

Because loss of appetite can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your healthcare professional design specifically for you to reduce the risk of potential complications including:

• Loss of strength

• Malnutrition

• Decreased immunity

• Spread of cancer

• Spread of infection

• Vitamin, mineral, and other nutrient deficiencies

• Wasting syndrome (cachexia)