Loss of Appetite
What is loss of appetite?
Loss of appetite, or poor appetite is a common symptom of advanced age, cancer (especially of the colon, ovary or pancreas), chronic disease, or medication side effects. The first trimester of pregnancy is commonly associated with poor appetite that may be accompanied by nausea and vomiting.
The medical term for complete loss of appetite is anorexia. (Anorexia nervosa is an eating disorder marked by an abnormal fear of gaining weight. The affected individual is hungry, but severely restricts the amount of food they eat to prevent gaining weight.) Loss of appetite is a decreased desire to eat. It may occur with conditions affecting the digestive system or along with more generalized conditions, such as infection, dehydration, or chronic disease.
Medications, such as antibiotics, chemotherapy, and narcotics, are common causes of loss of appetite. Chronic diseases, including heart failure, chronic obstructive pulmonary disease (COPD, includes emphysema and chronic bronchitis), hepatitis, and kidney failure, can all lead to poor appetite too. Changes to the sensations of smell or taste can result in poor appetite. Depending on the cause, loss of appetite can come and go or be constant.
Loss of appetite rarely leads to a life-threatening condition. However, poor appetite can be associated with dehydration that, left untreated, can result in electrolyte imbalance, shock, or coma. Seek immediate medical care (call 911) if you, or someone you are with, have symptoms of severe dehydration, such as confusion or loss of consciousness for even a brief moment, cold skin, or reduced urine output.
If your poor appetite is persistent or concerning, seek prompt medical care.
What other symptoms might occur with 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.
Digestive system symptoms that may occur along with poor appetite
Reduced appetite may accompany other symptoms affecting the digestive system including:
Abdominal pain or cramping
Changes in taste or smell
Chronic or persistent diarrhea
- Nausea with or without vomiting
Other symptoms that may occur along with poor appetite
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)
- Unexplained weight loss
Serious symptoms that might indicate a life-threatening condition
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:
What causes loss of appetite?
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.
Disease causes of loss of appetite
Chronic conditions causing poor appetite include:
Cancers (ovarian, pancreatic, colon, or stomach, for example)
Gallbladder disease such as cholecystitis (inflammation of the gallbladder)
Hypothyroidism (underactive thyroid)
- Kidney or liver failure
Drug causes of loss of appetite
Drugs that may reduce appetite include:
Other common causes of appetite loss
Poor appetite can also have other common causes including:
Aging (elderly adults very often have poor appetite)
First trimester of pregnancy
Loss of taste or smell
Nausea with or without vomiting
Negative emotions (anxiety, depression, grief or sadness)
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)
- Liver failure
When should you see a doctor for loss of appetite?
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.
General loss of appetite
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
Loss of appetite due to serious conditions
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
How is the cause of loss of appetite diagnosed?
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.
Questions for diagnosing the cause of loss of appetite
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.
How do you treat loss of appetite?
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 and care for loss of appetite
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 and complementary treatments for loss of appetite
Alternative or natural treatments for loss of appetite include:
Bitter, edible plants, such as endive and dandelion
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
What are the potential complications of loss of appetite?
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
Spread of cancer
Spread of infection
Vitamin, mineral, and other nutrient deficiencies
- Wasting syndrome (cachexia)