Lack of appetite

Specialty of Internal medicine

What is a lack of appetite?

A lack of appetite can be persistent or temporary. It can be caused by several factors, some of them originating from an underlying condition which could have potentially dangerous repercussions. This often leads to a sudden weight loss and to both physical and psychological debilitation.

What are the consequences?

The most common consequences of decreased appetite are:

  • A failure in getting all the necessary nutrients and calorific intake to preserve your health and to avoid physical and psychological wasting;
  • Emaciation;
  • Dehydration (this could be particularly dangerous for children and for the elderly, especially during hotter weather).

Which tests might be done if you have decreased appetite?

Your doctor may prescribe you one or more of the following tests to determine whether the decreased appetite is caused by an underlying condition:

  • Complete blood count;
  • Stool test;
  • Coeliac test;
  • Testing for Helicobacter pylori bacteria;
  • Screening tests to assess your liver’s health;
  • Further blood tests to make sure you don’t have any vitamin deficiencies.

What causes a lack of appetite?

Decreased appetite can be caused by numerous factors. These are the most frequent ones for prolonged decreased appetite:

  • Potential conditions: anorexia nervosa, bulimia, almost every type of tumour, breathing problems such as COPD (chronic obstructive pulmonary disease), HIV infection, liver diseases (hepatitis or liver failure), hypothyroidism, gastrointestinal infections or other heart conditions;
  • Being on certain medications (for instance, chemotherapy drugs or some antibiotics);
  • Food intolerances;
  • Physiological reasons: these shouldn’t alarm you, as they might be natural changes; you should still tell your doctor about them though, to make sure there are no other concurrent causes. These include seasonal weather changes, pregnancy, teething (for new-borns) or diet changes (for instance, when travelling to another country and you’re not used to local food);
  • Psychological reasons: grieving, depression or other types of psychological distress are very common reasons for loss of appetite; Periods of heavy stress or major changes (starting a new job, moving to another place, the end of a relationship) can also lead to a lack of appetite.

How is it treated?

There are several ways of addressing this problem, depending on what is causing it:

  • Eating high calories and nutrient dense foods - it may help to eat several small meals during the day instead of eating the traditional three large meals a day; You should eat foods rich in vitamins (especially B-group vitamins), proteins and fatty acids;
  • Exercising regularly helps to naturally stimulate your appetite;
  • Try to eat with other people as much as possible, making meal time a ritual and a convivial moment with your friends and family. It could be helpful to cook with someone; trying new recipes to stimulate your curiosity and making food a “playful” activity could help as well;
  • If eating becomes as hard as to provoke a sensation of rejection and nausea, your doctor may prescribe you some supplements or appetite stimulants;
  • Once all physical reasons have been ruled out, the decreased appetite may be regarded as a psychological condition. Depending on how severe it is, you may have to see a psychologist or psychotherapist, getting started on a journey that could help you overcome this problem and get back to physical and psychological health and well-being. You may also want to consider stress management techniques: in this sense, doing yoga, relaxation techniques, meditating or spending some time doing what you like may be helpful. Keeping a diary about what stresses you out or talking about it with friends or family could help as well.

Which doctor should I see?

First, you should talk about it with your GP, who will prescribe some tests to rule out the possibility of underlying conditions. Based on the exams’ results, your GP will refer you to the right specialist.

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