Decreased appetite

Alternative names 
Loss of appetite; Appetite - decreased

Definition
This symptom describes a decreased or lack of appetite despite basic caloric needs.

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

Loss of appetite can cause unintentional weight loss.

Common Causes

     
  • Emotional upset, nervousness, loneliness, boredom, tension, anxiety, bereavement, and depression  
  • Anorexia Nervosa  
  • Acute and chronic infections  
  • HIV  
  • Pregnancy (first trimester)  
  • Cancer  
  • Hypothyroidism  
  • Medications and street drugs       o Chemotherapeutic agents       o Amphetamines       o Sympathomimetics including ephedrine       o Antibiotics       o Cough and cold preparations       o Codeine       o Morphine       o Demerol       o Digitalis

Home Care

Protein and calorie intake can be increased by intake of 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.

A 24-hour diet history should be recorded each day. If an anorexic person consistently exaggerates food intake (a common occurrence in anorexia nervosa), strict calorie and nutrient counts should be maintained by someone else.

For loss of appetite caused by taking medications, talk to your health care provider about adjusting the dosage or changing drugs. NEVER CHANGE MEDICATIONS WITHOUT FIRST CONSULTING YOUR HEALTH CARE PROVIDER.

See also weight management.

Call your health care provider if

Call your health care provider if involuntary weight loss exceeds 7% of total body weight within a month.

Note: To calculate percent weight lost, divide pounds lost by the previous weight and multiply times 100. For example, a person weighing 125 pounds loses 10 pounds:

     
  • 10 divided by 125 = 0.08  
  • 0.08 times 100 = 8%

What to expect at your health care provider’s office
The diet and medical history will be obtained and a physical examination performed, including height and weight.

Medical history questions documenting loss of appetite in detail may include:

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

Diagnostic tests that may be performed include:

     
  • Barium enema, sigmoidoscopy, or colonoscopy (if colon cancer is suspected)  
  • Liver function tests  
  • Kidney function tests  
  • Thyroid function tests  
  • Abdominal ultrasound (if a specific abdominal cause is suspected)  
  • Upper GI series  
  • Pregnancy test  
  • Urine drug screening  
  • HIV test

In severe malnutrition, supplemental intravenous nutritional support may be ordered. Some patients must be hospitalized for nutritional support.

Johns Hopkins patient information

Last revised: December 5, 2012
by David A. Scott, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.