Every now and then a patient will come in for a check-up and I notice that they've lost weight. They tell me that they just really don't feel much like eating lately. The first thing I ask them, especially my older patients, is if they're depressed as depression is one of the leading causes of loss of appetite. However, a number of other things, both physical and mental, can lead to a appetite loss in people of all ages. Let me explain.
Causes of Appetite Loss
As I noted above, in some people, depression can cause a loss of appetite. They seem to just lose interest in everything they usually find enjoyable, including food. The clinical name for this is anhedonia or lack of interest in enjoyable things.
Grief and anxiety that occurs after the loss of a loved one, even a cherished pet, can be the reason some people have a temporary loss of appetite.
However, if grief and depression have been ruled out as the contributing factors, then I start looking for physical causes. These can include:
•Disease states - cancer, liver disease, kidney failure, chronic obstructive lung disease, heart failure, AIDS, heart failure, pregnancy.
•Medications - certain antibiotics, chemotherapy drugs, pain medications.
•Street drugs - amphetamines, cocaine, heroin.
•Smoking - nicotine acts as an appetite depressant. In addition, the toxins in tobacco smoke can dull/alter taste buds so food doesn't taste good therefore you eat less. This is the reason people gain weight when they stop smoking.
•Chronic congestion - blocked sinuses from sinus infections, allergies, and viral illness like colds or flu can alter your sense of smell, which in turn alters your sense of taste.
•Dental problems - chewing may be causing discomfort with bad teeth or sensitive mouth tissues may take appetite away.
•Aging - slower metabolism, decrease in muscle mass, duller taste, may contribute to a decrease in appetite.
What You Can Do About It
If you are experiencing appetite loss to the point where you are losing weight continuously, you should contact your doctor for an evaluation. Here are some things your doctor will assess in order to treat you properly for it:
•How bad is it? - Are you able to eat at all? Or, do you eat only once a day? How much weight have you lost as a result?
•How long? - How long have you experienced it?
•Accompanying Event - Did it coincide with the loss of a loved one or some other upsetting, life-changing event? Events like this include divorce, loss of a job, loss of a home, sick parents or children, etc.
•Other Symptoms - are there other symptoms that accompany it, i.e., nausea, pain, difficulty eliminating, diarrhea, heart palpitations, loss of memory.
Your doctor may give you several tests to help diagnose the cause. These include:
•Abdominal ultrasound/upper GI - these tests look for abnormalities/problems within the abdomen and organs of the abdominal cavity (liver, kidneys, etc) that may be causing pain and/or nausea.
•Sigmoidoscopy/colonoscopy - in some instances, food blockages in the intestinal tract can cause loss of appetite by putting pressure on the stomach.
•Kidney, liver function tests - out of whack range results for these tests may indicate reasons why you are feeling queasy, have abdominal discomfort, and not feel much like eating.
•Blood tests - a few vials of blood may be taken to evaluate for deficiencies.
How your appetite loss is treated depends on what's causing it. Here are some common treatments for it corresponding to its cause:
•Disease - if an illness dampens your desire to eat, then your doctor may give you an appetite stimulant to make you feel like eating more while the condition is being treated.
•Depression - you may be given an antidepressant, which can stimulate appetite, to get you through this rough period in your life.
•Abdominal/dental pain/nausea - necessary tests should be done to determine/treat the underlying condition. After these symptoms are treated then appetite should resume to its normal level.
•Nutritional/Aging - sometimes a deficiency in the mineral zinc, especially in older people, can alter taste buds so that food just doesn't taste good. Supplementing with zinc can help bring back your desire for food.
Many people experience a period of loss of appetite throughout their life. It is usually nothing to worry about and is very short-lived depending on the underlying cause of it. When poor appetite lasts longer than several days to a week, perhaps accompanied by pain, frequent fatigue, changes in taste or sensory perception, that's the time you should visit your healthcare professional.