Loss of Appetite: Common Causes, What to Track and When to See a Provider

What it involves

MedlinePlus describes a decreased appetite as a reduced desire to eat, and notes that the medical term is anorexia, which here means the symptom, not the eating disorder of the same name. It says any illness can lower appetite, and that a lost appetite can lead to weight loss.

Who this is for

• Patients who have not wanted to eat for more than a short stretch and are losing weight
• Older adults whose family has noticed smaller meals and thinner clothing
• Patients feeling sad, anxious or worn down who have also stopped enjoying food
• Patients who started a new medicine and noticed food seems less appealing

What to expect

• Questions about how severe the change is, whether you have lost weight and when it began
• A height and weight check and a physical exam, as MedlinePlus lists for this symptom
• Blood work where it helps look for a cause, since the practice lists blood work among its services
• A plan that may include a medicine review, a mood check, nutrition tips or further testing

Short-lived versus lasting

A cold, a stomach bug or a rough week can take away hunger for a few days, and MedlinePlus says that if the illness is treatable, appetite should return when the condition clears. The pattern worth attention is a loss of appetite that does not bounce back, one that keeps shrinking meals or one that arrives with other changes. The encyclopedia notes that a reduced appetite is often seen in older adults, and that in many cases no physical cause is found. Even so, it is worth mentioning at a visit.

Causes on the MedlinePlus list

The list is long. Emotions such as sadness, depression or grief can lead to a lost appetite. Physical causes named include chronic liver disease, chronic kidney disease, COPD, dementia, heart failure, hepatitis, HIV, an underactive thyroid and the first trimester of pregnancy. Certain medicines, including antibiotics, chemotherapy drugs, codeine and morphine, can reduce appetite, as can street drugs. Cancer is also on the list, including cancers of the colon, ovary, stomach and pancreas. Because the list is so broad, the history does most of the work.

When mood is part of it

Low mood can quietly take away the pleasure of eating, and MedlinePlus advises seeking help if decreased appetite comes with other signs of depression, or with prescription medicine, illegal drug or alcohol use, or an eating disorder. The depression screening guide explains the short questionnaire a provider may use. If worry is the driver, the anxiety symptoms guide covers that route. Talking about mood is a normal part of a primary care visit and does not mean anything is wrong with you.

Weight loss is the signal to watch

MedlinePlus says to contact a provider if you lose more than 10 pounds, about 4.5 kilograms, without trying. A smaller loss that keeps going is also worth a call. Weighing yourself on the same scale at the same time of day once a week gives your provider a real trend rather than a guess. The unintentional weight loss guide explains the work-up that follows when the scale keeps dropping, and the fatigue guide covers the tiredness that often comes with it.

What a visit usually covers

According to the encyclopedia, the provider performs a physical exam and checks height and weight, then asks about diet and medical history. Questions include how severe the change is, how much weight has been lost, whether it is a new symptom, whether it began after an upsetting event and what other symptoms are present. Tests that may be done include imaging such as x-ray or ultrasound, and blood and urine tests. Blood work and urinalysis are common starting points, and the complete blood count guide explains one of them.

Keeping up nutrition meanwhile

For people whose appetite is low because of a chronic illness, MedlinePlus advises raising protein and calorie intake with high-calorie, nutritious snacks or several small meals during the day, and says liquid protein drinks may help. It suggests families offer favorite foods, and recommends keeping a diet record of what you eat and drink for 24 hours or longer. Bring that record to the visit. If a medicine is behind the problem, ask your provider about changing the dose or drug, and do not stop any medicine without first talking to them.

Sources

• MedlinePlus — Appetite, decreased