Appetite - decreased

Answer 1

Definition

Appetite is the desire to eat. A decreased appetite is when you have a reduced desire to eat. This occurs despite the body's basic caloric (energy) needs.

Alternative Names

Loss of appetite; Decreased appetite

Considerations

Any illness can affect a previously hearty appetite. If the illness is treatable, the appetite should return when the condition is cured.

Loss of appetite can cause unintentional weight loss.

Depression in the elderly is a common cause of weight loss that is not explained by other factors.

Common Causes

• Anorexia nervosa
• Cancer
• Chronic liver disease
• Chronic kidney failure
• Emotional upset, nervousness, loneliness, boredom, tension, anxiety, loss, and depression
• HIV
• Hypothyroidism
• Infections
• Medications and street drugs
  • Amphetamines
  • Antibiotics
  • Chemotherapy drugs
  • Codeine
  • Cough and cold medications
  • Digitalis
  • Demerol
  • Morphine
  • Sympathomimetics, including ephedrine
• Pregnancy (first trimester)

Home Care

Increase proteinand calorie intake by eating high-calorie, nutritious snacks or several small meals during the day. Liquid protein drinks may be helpful.

Family members should try to supply favorite foods to help stimulate the person's appetite.

Keep a record of what you eat and drink for 24 hours. This is called a diet history.

If a person with anorexia nervosa consistently exaggerates food intake, someone else should keep strict calorie and nutrient counts.

For loss of appetite caused by taking medications, ask your health care provider about changing the dosage or drug. Never stop taking medications without first talking to your health care provider.

See also: Weight management

Call your health care provider if

Call your health care provider if you are losing a lot of weight without trying.

What to expect at your health care provider's office

Your doctor will perform a physical exam and will check your height and weight. Your diet and medical history will be reviewed. The doctor wll ask questions about your decreased appetite, including:

• Quality
  • Is the decreased appetite severe or mild?
  • How much weight have you lost?
• Time pattern
  • Is loss of appetite a new symptom?
  • If so, did it start after an upsetting event, such as the death of a family member?
• What other symptoms are present?

Tests that may be done to determine the cause of a decreased appetite may include:

• Abdominal ultrasound
• Barium enema, sigmoidoscopy, or colonoscopy (if colon cancer is suspected)
• Complete blood count (CBC)
• Erythrocyte sedimentation rate
• HIV test
• Kidney function tests
• Liver function tests
• Pregnancy test
• Thyroid function tests
• Upper GI series
• Urine drug screening

In cases of severe malnutrition, nutrients are given through a vein (intravenously). This may require a hospital stay.

Answer 2

Definition

A decreased appetite is when you have a reduced desire to eat. The medical term for a loss of appetite is anorexia.

Alternative Names

Loss of appetite; Decreased appetite; Anorexia

Considerations

Any illness can affect a previously hearty appetite. If the illness is treatable, the appetite should return when the condition is cured.

Loss of appetite can cause unintentional weight loss.

Common Causes

A decreased appetite is almost always seen among elderly adults, and no cause may be found. However, sadness, depression, grief, or anxiety are a common cause of weight loss that is not explained by other factors, especially among the elderly.

Cancer may also cause decreased appetite. You may lose weight without trying. Cancers that may cause you to lose your appetite include:

• Colon cancer
• Ovarian cancer
• Stomach cancer
• Pancreatic cancer

Other causes of decreased appetite include:

• Chronic liver disease
• Chronic kidney failure
• COPD
• Dementia
• Heart failure
• Hepatitis
• HIV
• Hypothyroidism
• Pregnancy (first trimester)
• Use of certain medications, including antibiotics, chemotherapy drugs, codeine, and morphine
• Use of street drugs including amphetamines (speed), cocaine, and heroin

Home Care

People with a cancer or a chronic illness will need to learn how to increase proteinand calorie intake by eating high-calorie, nutritious snacks or several small meals during the day. Liquid protein drinks may be helpful.

Family members should try to supply favorite foods to help stimulate the person's appetite.

Keep a record of what you eat and drink for 24 hours. This is called a diet history.

Call your health care provider if

Call your health care provider if you are losing a lot of weight without trying.

Encourage the person to seek medical help if their decreased appetite occurs along with other signs of depression, drug or alcohol abuse, or an eating disorder.

For loss of appetite caused by taking medications, ask your health care provider about changing the dosage or drug. Never stop taking medications without first talking to your health care provider.

What to expect at your health care provider's office

The health care provider will perform a physical exam and will check the person's height and weight.

The health care provider will ask questions about the person's diet and medical history. Questions may include:

• Is the decreased appetite severe or mild?
• Has the person lost any weight? How much?
• Is the decreased appetite a new symptom?
• If so, did it start after an upsetting event, such as a death of a family member or friend?
• What other symptoms are present?

Tests that may be done to determine the cause of a decreased appetite include:

• Abdominal ultrasound
• Barium enema, sigmoidoscopy, or colonoscopy (if colon cancer is suspected)
• Complete blood count (CBC)
• Erythrocyte sedimentation rate
• HIV test
• Kidney function tests
• Liver function tests
• Pregnancy test
• Thyroid function tests
• Upper GI series
• Urine drug screening

In cases of severe malnutrition, nutrients are given through a vein (intravenously). This may require a hospital stay.

References

Mason JB. Nutritional Assessment and Management of the Malnourished Patient. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease.9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 4.

Stewart GD. Skipworth RJE, Fearon KCH. The Anorexia-Cachexia Syndrome. In: Walsh D, Caraceni AT, Fainsinger R, et al, eds. Palliative Medicine. 1st ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 106.

Reviewed By

Review Date: 07/22/2010

Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.