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.

Loss of appetite; Decreased appetite

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.

• 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)

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 you are losing a lot of weight without trying.

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.

Increased appetite means you have an excess desire for food.

Hyperphagia; Increased appetite; Hunger; Excessive hunger; Polyphagia

An increased appetite can be a symptom of different diseases. For example, it may be due to certain mental conditions and endocrine glanddisorders.

An increased appetite can come and go (intermittent), or it can last for long periods of time (persistent), depending on the cause. It does not always result in weight gain.

The terms "hyperphagia" and "polyphagia" refer to someone who is focused only on eating, or who eats excessively before feeling full.

Causes of increased appetite include:

• Anxiety
• Certain drugs (such as corticosteroids, cyproheptadine, and tricyclic antidepressants)
• Bulimia (most common in women 18 - 30 years old)
• Diabetes mellitus (including gestational diabetes)
• Graves' disease
• Hyperthyroidism
• Hypoglycemia
• Premenstrual syndrome

Emotional support, and in some cases counseling, are recommended.

If a medication is causing increased appetite and weight gain, your health care provider may decrease your dosage or recommend a different drug. Never stop taking your medication without first talking to your health care provider.

Contact your health care provider if:

• You have an unexplained, persistent increase in appetite
• You have other unexplained symptoms

Your health care provider will perform a physical exam. During the physical examination, the health care provider will probably weigh you. You also may have a psychological evaluation

The doctor will ask you questions about your medical history, with emphasis on your eating habits. Questions may include:

• Eating habits
  • Have you changed your eating habits?
  • Have you begun dieting?
  • Do you have concerns about your weight?
  • What do you eat in a typical day?
  • How much do you eat?
• Medication
  • What medications are you taking?
  • Are you taking any new medications, or have you changed the dose of your medications?
  • Do you use any illicit drugs? If so, which ones?
• Time pattern
  • Does the hunger occur during the sleep period?
  • Does the hunger seem to occur in a pattern related to your menstrual cycle?
• Other
  • What other symptoms are you having at the same time?
  • Have you noticed an increase in anxiety?
  • Do you frequently urinate?
  • Do you have an increased heart rate?
  • Do you have palpitations?
  • Do you feel more thirsty?
  • Have you had an unintentional weight gain?
  • Do you experience intentional or unintentional vomiting?

Tests that may be done includee:

• Blood tests, including a chemistry profile
• Thyroid function tests

Jensen MD. Obesity. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 239.

Saper CB. Autonomic disorders and their management. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 445.