Appetite Loss

Patients with life-threatening diseases often lose their appetite and may lose weight. Weight loss can be a result of a complex set of conditions including disease effects, medication, metabolic changes, and psychological factors. When severe, loss of appetite is called cachexia, and characterized by a marked loss of muscle mass.

Causes of weight loss include:

  • Inadequate intake of nutrients because of poor appetite
  • Poor absorption of food that is consumed
  • Changes in metabolism
  • Certain cancer treatments

Management of weight loss depends on the patient's goals. It may include:

  • Eating small, frequent meals
  • Eating high-calorie, high-protein foods and nutritional supplements
  • Educating the patient and family about the ineffectiveness of forced eating
  • Receiving nutritional counseling
  • Feeding through artificial means (such as a tube or IV)
  • Eating and drinking whatever the patient prefers
  • Relieving thirst by sucking on ice chips or a moist cloth

Medication can include:

  • Corticosteroids, which stimulate appetite but do not increase weight
  • Megestrol acetate, which stimulates appetite and causes slight weight gain
  • Dextromethasone, which stimulates appetite and causes slight weight gain
  • Dronabinol, which prevents nausea and vomiting, and increases appetite, enhances a sense of well-being and causes weight-gain Cyproheptadine, which mildly enhances appetite, increases food intake and enhances weight gain
  • Pentoxifylline, which potentially acts to lower levels of a substance (tumor necrosis factor) that contributes to weight loss in cancer patients.

What you can do to help:

  • Do not force-feed the person who is ill
  • Do not get angry if the patient does not want to eat
  • Prepare familiar favorite foods
  • Try encouraging light exercise or walking before meals
  • Encourage eating meals at the table with others
  • Serve meals over a prolonged period of time in a relaxed environment
  • Place meals on smaller plates with smaller servings more frequently
  • Cover or avoid unpleasant odors
  • Serve a glass of wine before meals to stimulate appetite, with physician approval
  • Offer frequent high protein, high calorie snacks (pudding, ice cream, milk shakes)
  • Try new spices or flavorings for foods
  • Prevent early feelings of fullness by serving beverages between meals, not with meals; encouraging slow eating; and avoiding too many vegetables and carbonated drinks

When to call the doctor:

  • If the patient reduces normal food intake for a long period of time
  • If the patient loses 5 pounds or more in a short time
  • If there is pain with chewing and/or swallowing
  • If the patient experiences dizziness upon standing
  • If the patient does not urinate for an entire day, or does not have a bowel movement for many days