• Loss of appetite

    Posted on June 11, 2021 by in Digestion

    Loss of appetite

    No appetite, but euphoric? Or feeling tired and lacking drive? There are innumerable causes behind loss of appetite. 

    What is a bad appetite?

    No appetite? This can happen to anyone and usually goes away again. Sometimes stress puts a damper on your appetite or an upset stomach spoils your appetite. If someone has a low need for food intake, there are two possibilities: Either they belong to the notoriously frugal eaters who are not immediately lacking in appetite, but are usually slim. Or their appetite has changed. If someone who had previously had a reputation for being a good eater now has to force himself to take every bite, something is wrong.

    Appetite means the desire to eat and enjoy. With a loss of appetite, also known as inappetence, this need is gone. Some have a particular aversion to certain foods, such as meat. If the loss of appetite lasts longer, the feeling of hunger also gradually subsides. As a rule, the weight curve then points downwards. If someone feels no desire to eat anything for a long time, even though he has hardly eaten anything for hours or days, doctors also speak of anorexia.

    Diencephalon

    In the diencephalon, the hypothalamus (light green in the picture) and nearby core areas (purple) regulate vegetative reactions and feelings such as appetite. The cerebrum is also involved

    Anorexia nervosa or anorexia is different. This is a mentally caused eating disorder in young people. While girls and boys are almost equally affected as adolescents, the disease is more common in women than in men. It goes hand in hand with a disturbed image of one’s own body and greatly changed eating habits. Those affected use all means to counter their – initially completely normal – appetite. In this respect, the term anorexia nervosa is actually not entirely appropriate for anorexia. In the further course, however, appetite and feelings of hunger disappear, and those affected lose weight. Malnutrition seriously derails the body’s inner balance, which can be fatal.

    What makes you hungry – or lose appetite?

    Complex processes regulate feelings such as hunger, satiety and the desire to eat. Body signals, hormones and messenger substances in the brain, so-called neurotransmitters, interact closely. Your activities are concentrated in the hunger and satiety centre of the hypothalamus. This is part of the diencephalon. Sensory stimuli, the psyche and volitional decisions also have an effect on eating behaviour via other control bodies in the brain: a feast for the eyes in the form of deliciously prepared snacks, a delicious scent from the kitchen makes our mouths water.

    While appetite is a psychological perception, hunger is considered a purely physical signal. With a painfully empty stomach, only one thing counts: Eat your fill as soon as possible. Hunger is a need and sends people and animals alike in search of food. Because in order to survive, the body needs substance and energy.

    An important signal generator for the hunger centre is, for example, the internal clock, which tells us that it is time to eat. Even those who freeze when hungry and – very importantly – have low blood sugar, or who eat too hastily without chewing properly, call their hunger centre on the scene.

    If there is a lack of appetite, then something is going wrong in the system. What it is in individual cases is not always easy to determine because of the complexity of the processes – physical and mental changes are closely linked.

    No appetite: when to see a doctor?

    You should always take this seriously. Even more so if there is unwanted weight loss or other complaints. If it seems plausible that you are eating less due to stress, watch yourself carefully for a few days on the scales and feel for possible physical changes. If the weight curve continues to decline, you should definitely consult a doctor.

    Loss of appetite: accompanying symptoms

    Lack of appetite is a general symptom that can occur in numerous diseases. If those affected complaints such as nausea, vomiting or unwanted weight loss are often in the foreground, including loss of appetite.

    However, even with a normal or good appetite, someone can inadvertently lose body weight. This is typical, for example, of an overactive thyroid. Even weight gain occurs when there is a loss of appetite – for example with an underactive thyroid or heart failure. However, the scales do not show any increase in the “fat belt” in this case. The reason is the storage of water in the tissue – in the case of heart failure or hypofunction of the thyroid gland, a changed structure of the skin and the underlying tissue. This can be seen and felt particularly well on the swollen lower legs.

    Nausea and vomiting often accompany the loss of appetite. Medical treatments could also play a role in this.

    If loss of appetite and nausea are paired with constipation, there could be also renal colic, this could mean, for example, an overactive parathyroid gland.

    However, completely different combinations of symptoms are also possible, such as loss of appetite plus a clear feeling of illness, sore throat, other severe pain, for example in certain joints or headaches, cough, shortness of breath, fatigue, fever, conspicuous skin symptoms and much more.

    Overview: The main causes of loss of appetite

    Older people

    Older people often struggle with appetite and inadequate nutrition

    Loss of appetite is often part of everyday life in older people. They are also not doing well when they feel thirsty. Both thirst and appetite decrease with age.

    Chronically wasting diseases – such as those of the heart, lungs or malignant diseases – are known to often affect the appetite. This is why some people feel alarmed even when they have a short appetite crisis. But maybe it’s just because of the new drug he’s been taking recently? Some medicines can cause appetite loss as a side effect, as discussed earlier.

    Sometimes someone’s appetite can be lost if they have difficulty swallowing or if there is an obstacle to passage in the digestive tract, for example in the esophagus or at the gastric outlet. Those affected often only consume small amounts of food for fear of pain or a backlog.

    Again, weight loss associated with loss of appetite is always a warning sign. It becomes acutely threatening if a patient also shows signs of illness such as disturbances of balance, drowsiness or clouding of consciousness, reduced urine output or very high fever: In this case call the emergency room immediately.

    While unwanted weight loss is more of an issue here, it is not the main topic.
    In view of the many causes of loss of appetite, this article shows an excerpt. A division into five groups:

    • Mental stress and mental illness
    • Physical illnesses
    • Medication and other therapies
    • Alcohol, drugs, poisoning
    • Life phases, living conditions

    The following sections deal with the effects of the psyche on appetite, stress, computer game addiction and depression. Physical illnesses that can dispel the appetite include inflammation in the mouth and throat, illnesses in the abdomen, infectious diseases / so-called childhood diseases, metabolic disorders and hormonal diseases, heart diseases, kidney failure, autoimmune diseases, disorders of the salt balance and cancer.

     

    Mental stress and mental illness

    Lack of time

    Lack of time, deadline pressure, stress: solutions can be found in team or therapy discussions

    – Stress: If you ask around who is not stressed, usually only a minority feels addressed. In other words: stress everywhere. The fundamentally sensible alarm condition that spurs us on can turn into the opposite if it constantly energizes us. In the end, there may be burnout syndrome. Changes in appetite in both directions – too little, but sometimes too many cravings, especially sweet things – are just two of many stress symptoms. It is not uncommon for one to prefer sweets.

    – Computer game addiction (Internet game addiction): This non-substance-related addiction has been discussed more and more recently, but it has not yet been recognized as an addictive disease with a risk of abuse and addiction. Among other things, there is a lack of clarity about how widespread the whole thing really is. At first glance, internet gambling addiction is not always easy to distinguish from other mental illnesses. Sometimes some behaviours resemble hyperkinetic disorder. These include attention hyperactivity disorder (ADHD).
    It is up to specialist doctors and psychologists to assess this.

    Those affected, often children and young people, but also entire families, spend hours in front of the computer and indulge in the virtual world of experience, where they may feel more comfortable than in real everyday life. If the computer is out of reach, some people feel nervous, irritated, sometimes aggressive, have no drive, neglect themselves, which also includes neglecting personal needs and habits such as eating, sleeping and social contacts. If you think you or your child needs help, talk to your family doctor first.

    – depression: More than a low mood and constant brooding, unlike a natural grief reaction, tougher than dejection and discouragement during a life crisis: Is that depression? Depression is deep and takes hold of the person affected. Often there is no concrete trigger for the persistently depressed state of mind – or the noticeable overactivity and work addiction. Depression has many faces and the range of possible signs is great. As for the appetite, quite often it decreases, but sometimes it is increased.

     

    Physical illnesses

    – Diseases in the abdominal cavity: This primarily concerns the digestive tract and the liver, our central metabolic organ. Occasionally, circulatory disorders in the abdomen affect the appetite.

    Loss of appetite

    Loss of appetite can be caused by a stomach problem

    – – Acute inflammation of the stomach lining (gastritis): Many associate loss of appetite with an upset stomach. They are often right there. In fact, gastritis is one of the most common causes of loss of appetite. Stress, excessive alcohol, nicotine or coffee, and medication such as certain pain relievers (non-steroidal anti-inflammatory drugs) are common triggers. Gastritis can also occur with a gastrointestinal infection.
    Symptoms: Sudden loss of appetite, unpleasant taste in the mouth, pain in the upper abdomen, belching, feeling of fullness, sometimes vomiting.

    – – Acute gastrointestinal inflammation (gastroenteritis): Infectious agents are predominantly responsible for the disease, which is also known as vomiting, diarrhea or gastrointestinal flu – various viruses, for example, noroviruses, or bacteria such as Campylobacter, Salmonella or Escherichia (E) Coli. They often also cause traveller’s diarrhea – the type of diarrhea that many people get who move to tropical or subtropical areas and are not used to the local hygiene conditions.
    But you don’t have to wander so far into the distance: Infections with certain E. coli bacteria (EHEC) can also cause problems in our latitudes.
    Parasites such as amoebas or giardia are less likely to trigger gastroenteritis.
    Symptoms: loss of appetite, nausea, possibly vomiting, followed a few hours later by diarrhea, abdominal pain or cramps. The stool can become watery, slimy or bloody, and the loss of fluid due to vomiting and diarrhea can be significant. Sometimes there is also a fever.

    – – gastric surgery (stomach removal): Was the stomach partially removed, there is often loss of appetite. Because of this and other consequences, such as accelerated food passage, those affected lose weight. Deficiency symptoms may also occur. In most cases, however, it is possible to adapt the diet to the new situation over time the result stabilizes on the scales – but mostly at a lower level.

    Tatort

    Problem area lower abdomen on the right: an inflamed appendix or Crohn’s disease sometimes causes pain. And with it the appetite dies

    – – Appendicitis: The triggering is usually a build-up of secretion or feces and an inflammation promoted by this, originating from intestinal bacteria, in the so-called appendix. This is the small appendage of the actual appendix on the right side of the abdomen. The entire structure represents the beginning of the large intestine. If the appendix kinks, food components can become trapped and cause inflammation. Pre-existing intestinal inflammation and, more rarely, worms are possible causes.
    Symptoms: Even if the symptoms are not always clear, initially loss of appetite and wandering abdominal pain that settles in the right lower abdomen after a certain time can indicate appendicitis. Nausea, vomiting, constipation and fever are also more common.

    – Chronic inflammatory bowel disease, here: Crohn’s disease: Crohn’s disease can cause inflammatory changes in sections of the entire gastrointestinal tract – from the mouth to the anus. In addition, organs such as joints, skin, eyes or liver. What exactly causes Crohn’s disease is unknown. Obviously, genetic predisposition, immune processes and environmental factors play a role.
    The main symptoms are partly watery, partly slimy diarrhea and abdominal pain, often on the right side of the abdomen or lower abdomen. The symptoms come on in bursts. In addition, there is often loss of appetite, weight loss and fatigue, sometimes fever. Rashes or skin infections, inflammation of the eyes with redness and blurred vision, itching due to certain changes in the liver, or painful joints in the limbs and spine indicate that the disease is active beyond the intestines.

    – – Circulatory disorders of the intestine (chronic mesenteric ischemia, angina abdominalis) : The cause is usually a hardening of the arteries (arteriosclerosis), which gradually leads to the narrowing or occlusion of an intestinal vessel, or a local venous thrombosis. In order to avoid the symptoms – bulging pain that occurs almost regularly after eating – those affected eat little (er) and usually also lose weight. Even if this side effect pleases one or the other, it should urgently be examined in order to prevent damage to the intestine and subsequent problems. After all, pain is always a warning sign. Among other things, an examination such as duplex sonography (vascular ultrasound ) can provide valuable information.
    Symptoms: Abdominal pain that occurs about twenty to sixty minutes after eating and lasts for a long time, about one to four hours, is typical.

    Liver disease

    Liver disease also often causes loss of appetite

    – – Hepatitis: Hepatitis means inflammation of the liver. Liver cells are damaged in the process. Diseases of the central metabolic organ can reduce appetite very often. If jaundice also occurs, the trace usually leads directly to the liver. There are numerous causes – from infections caused by special hepatitis viruses and other viruses to bacteria, metabolic and immune disorders to drugs, chemicals, poisons and stimulants such as alcohol. Acute hepatitis can cause more symptoms than chronic hepatitis.
    Common symptoms with hepatitis is loss of appetite, possibly nausea, as well as malaise or a feeling of illness similar to flu. When the liver is enlarged it can cause pressure or pain in the right upper abdomen. Depending on the cause, there may be a variety of symptoms, such as a slight fever, swelling of the lymph nodes, itching, jaundice, dark urine and discoloured stools, as well as joint problems and rashes.

    – – Liver cirrhosis: In cirrhosis, liver tissue gradually perishes and is replaced by randomly proliferating connective tissue. There are many causes, including chronic liver inflammation, Alcohol abuse, inflammation of the bile ducts and so-called storage diseases such as Wilson’s disease (copper storage disease). The cirrhotic liver hardens, forms lumps, and often shrinks. This can lead to functional failures and so-called portal vein hypertension. The portal vein brings nutrient-rich blood from the bowels to the liver. If the pressure in this area increases, the blood takes a detour. When overloaded, it is not uncommon for varicose veins to form in the esophagus from overcrowded veins, which can bleed dangerously. On the other hand, the liver is no longer properly performing its important metabolic and detoxification tasks.
    About the symptoms include loss of appetite, decreased performance, abdominal pain that cannot always be precisely located, gas, weight loss and a tendency to bruise.

    Inflamed tonsils

    Inflamed tonsils with pus sticks (schematic)

    – Inflammation in the mouth and throat: The entire upper area of ​​the digestive tract – from the tip of the tongue to the larynx – is extremely sensitive. No wonder that inflammation of the mucous membrane is slightly painful here and spoils the appetite. Often, but not exclusively, pathogens are responsible for the inflammation.

    Mechanical forces such as pressure from a prosthesis or excessive brushing during dental care, which can provoke gum damage, also play a role. The annoying aphthous ulcers are widespread, the actual cause of which is still largely unclear. A weak immune system, chemotherapy or too little saliva can particularly affect the oral mucosa. Tumors in the mouth area can also cause problems. Among other things, so-called squamous cell carcinomas occur. High-proof alcohol and smoking, especially cigarettes without filters, significantly increase the risk here.

    Warning: If you discover a wound in the mouth that has not healed after two weeks, see a dentist or specialist in oral and maxillofacial surgery immediately.
    Symptoms: Depending on the cause, redness, blisters, ulcers or yellowish-white coatings appear in the mouth or throat, often painful, possibly also with bleeding. Loss of appetite can be the result of a certain underlying disease, such as febrile tonsillitis (angina tonsillaris), or it can be directly related to pain when chewing and swallowing. Often there is also an unpleasant taste in the mouth and bad breath.

    – Infectious diseases: In many infections, loss of appetite can generally accompany typical symptoms such as fever, nausea and vomiting. Since the latter is perceived as particularly unpleasant, they usually leave a stronger impression and are cited as symptoms more often than the (mostly included) loss of appetite. Below are some examples.

    – – tonsillitis (angina tonsillaris): There are different types of tonsillitis. Viruses are by far the most common pathogens. Classic acute angina is caused by bacteria called group A streptococci. The tonsils become inflamed, often also the surrounding tissue. The tonsils are reddened and have pus on them. The lymph nodes on the neck and corner of the jaw swell and are tender on pressure. Mostly older school children and young adults are affected.
    Symptoms: loss of appetite, difficulty swallowing, sore throat, lumpy speech, fatigue, fever, increased salivation and bad breath.

     – – Pfeiffer’s glandular fever (infectious mononucleosis): The virus infection, also known as the “kissing disease”, is transmitted through contact with saliva containing pathogens – hence the name. The Ebstein-Barr virus (EBV), which belongs to the herpes viruses, is responsible. The infection causes symptoms particularly in adolescents and young adults, while children and toddlers experience practically no symptoms or only slight signs of a cold. Among other things, the viruses infect certain white blood cells, distribute themselves in various organs, including lymph nodes and the spleen, and remain in the body for life. They can become active again later and thus make the saliva contagious again. Most of the time, the disease occurs only once in the person affected. The infection usually recedes after a few weeks.
    Symptoms: There is often a slight fever, sore throat, headache and body aches as well as swelling of the lymph nodes, for example in the neck. A special form of tonsillitis develops in half of those affected. A rash, swelling of the liver and spleen, loss of appetite, and other symptoms are also possible.

    Travel and appetite

    Travel and appetite don’t always go well

    – – Infestation with tapeworms (cestodes): Tapeworm diseases that can be accompanied by loss of appetite include, for example, infections with beef tapeworm (Taenia saginata). Sources of infection are dishes with raw or undercooked meat that contains larvae. The disease has become very rare in developed countries due to the hygiene standards. Some people bring the parasite with them from a long-distance trip.
    Symptoms: Tapeworm diseases are often symptom-free. Occasionally they make themselves felt with symptoms such as gastrointestinal diseases: There is loss of appetite, malaise, changeable digestive disorders with diarrhea and constipation. Sometimes weight loss is in the foreground (possibly even in spite of the increased feeling of hunger), but headaches and dizziness are also possible. The tapeworm occasionally causes inflammation of the appendix, gallbladder or pancreas. The worm infestation often gets noted accidentally during a stool examination or repulsed, whitish, moving limbs of the tapeworm are noticed in the stool (proglottids). Under the magnifying glass, the parasitologist can identify features that allow a more precise assignment of the proglottids.
    A special drug is indicated that is taken as a single dose, possibly with a repeat after ten days.

    Caution: The dog and fox tapeworms (Echinococci of the types granulosus and multilocularis) also belong to the group of tapeworms; but they cause different clinical pictures.

     

    Loss of appetite: diagnosis and therapy

    If the appetite is only temporarily absent, no medical examinations are necessary. On the other hand, persistent loss of appetite and weight must be thoroughly investigated. This first includes a detailed discussion about your medical history if it is not already known. The physical exam that follows can provide further information. It is quite possible that the doctor will refer you to a specialist in the course of the diagnosis. Therapy depends on the diagnosis. If the loss of appetite persists, your doctor will do what is necessary to prevent malnutrition and other complications for you. This includes nutritional advice, possibly the replacement of missing vitamins and minerals, possibly also a special nutritional therapy.

    medicinal plants

    Preparations made from centaury (photo) and other medicinal plants help against a slight loss of appetite

    More appetite: how to help yourself

    You can take a closer look at your living habits: diet, sleep rhythm, the frequency of physical activity. Try to find out where there is room for improvement.

    • Go to a wholesome, varied diet with lots of fresh, plant-based ingredients. This makes eating easier and you also get your vitamin and mineral target.
    • Always eat what you like.
    • If possible, prepare several small meals for yourself. Take these at times that are convenient for you.
    • The eyes also eat: delicious preparations stimulate the appetite.
    • Save on alcohol.
    • Herbal remedies or teas, for example with ingredients from medicinal plants such as yellow gentian, centaury, dandelion, yarrow, wormwood, Ceylon cinnamon or ginger can help against loss of appetite.
    • Exercise regularly in the fresh air.
    • Relaxation methods such as autogenic training or progressive muscle relaxation according to Jacobson can support stress management.

     

    Whatever the cause of your loss of appetite is, we can support you by making sure that your digestive tract is clear and ready to work.

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