Dear Doctor, 

I am a 22-year-old male university student who has of late lost appetite. I have visited different doctors but they all say everything looks okay. However, I have lost weight. What can I do to improve my health?

Gasana

Dear Gasana,

Mental stress, anxiety, lack of sleep, irregular sleep and meal schedules can all impair appetite. If one has indigestion or dyspepsia, or constipation, there would be no desire to eat food. However this may be associated with bloating sensation in the stomach, sensation to vomit, burning pain, etc.

Regular alcohol intake causes dyspepsia and also mars appetite. Infections of the intestines can cause anorexia as one of the manifestations. Any febrile illness like malaria, typhoid, etc. can cause loss of appetite as well.

Metabolic and hormonal disorders can also impair appetite. Some drugs like antidiabetic drug metformin causes anorexia as adverse effect.

Also, serious conditions such as liver infections, hepatitis, kidney failure, heart failure, tuberculosis, HIV/AIDS and malignancy can reduce appetite. But along with loss of appetite one may have associated features of the underlying illness like yellow coloration of eyes, breathlessness, puffiness of face and body, chronic cough and night fever among others.

It is advised to learn to relax both physically as well as mentally. Alcohol must also be avoided. Meals should be taken at regular times as much as possible. Try to take small quantities of food 3 to 4 times every day, instead of one big amount at a time. This helps in digestion and assimilation of food and avoids placing a big load on the stomach which causes dyspepsia. Meals should be balanced including all vital nutrients like proteins, carbohydrates, fats, vitamins, proteins and minerals.

Regular intake of fresh vegetables, fruits, whole grains, nuts, milk and milk products, fish and other meat helps to achieve this. A dietitian can help to calculate the quantity and portions of each food needed by you as per the height, weight and level of physical activity. Maintaining good food hygiene helps to ward off intestinal infections.

Drinking lots of water would help to avoid constipation. Regular physical exercise will keep the body fit and also help in inducing appetite. Metabolic and hormonal disorders can be excluded by simple blood tests.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital