Ask the Doctor: I’m unwillingly starving myself

Dear Doctor, my name is Angela and I’m 29 years old. For the last month or so my appetite has greatly gone down. Even when I’m hungry I still can’t seem to go beyond a sandwich. I used to have a hearty appetite but now, I only seem to like taking juice and yogurt. I thought I was coming down with something so I had a little blood test but there was nothing. I then assumed I was pregnant but my period stayed steady! What is going on with me? I have tried appetite enhancing pills but nothing seems to work. Because of not eating well, I have become weaker. I get dizzy a lot and feel nauseated. Any advice you can give me? Angela, Kimironko Dear Angela, At 29 years of age one normally has a good appetite because the body has to remain fit for physical work and reproduction. Loss of appetite can be due to functional disorders of the bowel like chronic constipation, functional dyspepsia, acid peptic disease, e.t.c. Here, along with loss of appetite, a person will experience burning pain in the chest or stomach, dull abdominal pain, nausea, bile reflux, e.t.c. Even with a good appetite a person is not able to eat much as the bowels are already full, causing heaviness with whatever a person eats. Irregular eating and sleep time also tends to kill one’s appetite. Chronic infections like tuberculosis also result in loss of appetite. But in this case, along with anorexia, there will be one or more of the following symptoms like night fever, sweating and or cough. Loss of appetite can be due to hormonal disorders like hypothyroidism, and adrenal insufficiency Loss of appetite can also result due to the presence of cancer somewhere in the body. Liver and kidney disorders are also a cause for loss of appetite and nausea. You have not stated whether you have any other symptoms apart from loss of appetite and weakness and if there has been any weight loss. If none of the other problems mentioned above are present, blood tests reveal nothing conclusive, then most likely the loss of appetite could be due to mental stress or anxiety. Whatever the reason for anorexia, it is bound to lead to weakness and feeling dizzy as the body does not get enough calories and nutrients. Appetite stimulating drugs are not the answer as their effect is transient. They also cause somnolence as a side effect which may be mistaken for feeling dizzy. Even if you do not have an appetite, take small quantities of food three or four times every day. If possible, eat at a fixed time every day. Thus, as the body gets conditioned, it will demand food at that time, for example, the appetite will build up. Include more of fresh green vegetables, fruits, whole grains and cereals. Drink at least seven to eight glasses of water every day. Avoid taking sodas or juice just before food as they can also interfere with the amount of food to be taken. Regular physical exercise keeps the body healthy by all means and also boosts one’s appetite. Therefore try to do exercise daily. It is equally important to be relaxed both physically as well as mentally. If the appetite improves after adopting the above measures, continue with them. If there is no change after say even three to four months, get tests done for hypothyroidism and other hormonal disorders. Dr. Rachna Pande is a Specialist in Internal Medicine at Ruhengeri Hospital

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Ask the Doctor: I’m unwillingly starving myself