Answers
Loss of appetite: why am I not feeling hungry, and when is it serious?
Short answer
Not feeling hungry for a few days with a fever, a stomach upset, stress or a change in routine is common and settles on its own. Poor appetite that lasts more than 2 to 3 weeks, or comes with weight loss, needs a check-up: it can be an early sign of hepatitis, an ulcer, TB, thyroid or sugar problems, low mood or a medicine side effect, and sometimes of a growth. Most causes are found with simple tests.
Common, short-lived causes
These usually improve within a few days to two weeks, once the illness passes or the medicine is reviewed.
- A viral fever, cold or stomach infection
- Acidity, indigestion or constipation
- Stress, worry, exams or poor sleep
- Very hot weather, or a few days of heavy festive eating
- New medicines, such as some antibiotics, iron tablets, some diabetes medicines and weight-loss injections
Causes that need a check-up
Less commonly, a growth in the stomach, pancreas, liver or bowel first shows itself as poor appetite and weight loss. This is why appetite that stays low is never brushed aside.
- Liver: hepatitis often begins with loss of appetite, nausea and a dislike of oily food, a few days before the eyes turn yellow
- Stomach: H. pylori infection, gastritis or an ulcer
- TB of the lungs or belly, usually with fever, night sweats and weight loss
- Thyroid problems, uncontrolled diabetes, kidney disease or anaemia
- Low mood, depression or anxiety, which very often show up as poor appetite
Tests your doctor may advise
After talking to you and examining you, the doctor usually starts with your weight, a blood count, blood sugar, liver and kidney tests and a thyroid test. An H. pylori test and an ultrasound of the abdomen are often added. An upper GI endoscopy is advised if there are warning signs, if the problem is new after about 45 to 50 years of age, or if the first tests do not explain it. Weighing yourself every week helps the doctor see whether you are actually losing weight.
What helps meanwhile
Children under 12 with poor appetite should be seen by their paediatrician.
- Eat small meals or snacks every 2 to 3 hours instead of waiting to feel hungry
- Make every bite count: add protein such as dal, curd, paneer, eggs, fish or chicken to each meal
- Sip water between meals rather than filling up with water just before eating
- A short walk before meals, fresh air and regular sleep can bring hunger back
- Do not take appetite tonics or syrups on your own: they do not treat the cause, and some contain medicines with side effects
Warning signs: see a doctor soon
Vomiting blood, severe belly pain, or new confusion and drowsiness in someone with liver disease is an emergency: call 112 or go to the nearest emergency department.
- Poor appetite for more than 2 to 3 weeks
- Weight loss without trying, especially more than about 5% of your weight in 6 to 12 months
- Yellow eyes, dark urine or itching
- Feeling full after a few bites, repeated vomiting or difficulty swallowing
- Black stools, blood in the stool, or fever and night sweats for weeks
Eating well when you are not hungry
Eat more
- Small meals or snacks every 2 to 3 hours: a banana, curd, roasted chana, a handful of nuts, or a glass of milk or lassi
- Protein at every meal: dal, paneer, curd, eggs, fish or chicken
- Foods you enjoy, with a little lemon, jeera or fresh chutney for taste
Cut down
- Tea, coffee and biscuits in place of meals
- Lots of water or cold drinks just before or with meals, which fill the stomach
- Fried, very rich food that sits heavy, and alcohol
Good to know
- When appetite is low, make each bite count: milk in dalia, an egg or paneer in a paratha, curd with rice.
- If you are eating less but your weight is steady, the cause is usually not serious; weight loss is what needs a check-up.
Common questions
Can acidity or gas take away my appetite?
Yes. Gastritis, indigestion and constipation can all make you feel full and not want to eat. If appetite comes back once these settle, that is reassuring. If it does not return in 2 to 3 weeks, get checked.
I have no appetite and feel sick at the smell of food. Could it be jaundice?
It can be. Hepatitis A and E often start with fever, loss of appetite, nausea and a dislike of oily food a few days before the eyes turn yellow. A liver function test can confirm it. Avoid unnecessary medicines and herbal remedies, which can strain the liver.
Can stress or low mood cause loss of appetite?
Yes, very often. If poor appetite comes with low mood, poor sleep or losing interest in things you enjoy, speak to your doctor. This is common and treatable.
Is it normal to eat less in old age?
Appetite falls a little with age, but a clear drop with weight loss is not normal. Medicines, teeth, mood, thyroid and the gut should all be checked.