What causes loss of appetite?

Loss of appetite or anorexia is a distressing condition for any individual. It is because of our appetite that we eat, feel satiated and energetic to carry on our daily work. But when a person loses appetite and interest to eat anything it becomes worrisome. Loss of appetite may be for a short duration say about 2 or 3 days. This could be due to some mental stress, overwork, acute sickness like flu or tonsillitis. But it usually recovers spontaneously when the problem is corrected. The loss of appetite can be of longer duration when it is more worrying. It can be due to chronic infections like tuberculosis, HIV. Disorders of the liver, gall bladder and kidneys also result in anorexia. In fact a person saying he has no appetite and refusing food may be the first indicator of a chronic illness. Malignancy in any part of the body induces anorexia along with other problems. Chronic cardiac failure leads to impaired perfusion of the gut as of other organs. This impairs digestion and also causes anorexia. Chronic digestive problems like constipation, dyspepsia or state of hyperacidity, also impair the appetite of a person. One can have anorexia due to chronic smoking and or alcohol use. Some drugs like metformin (anti diabetic drug), anti migraine and antidepressant drugs, among others, suppress appetite. Anorexia nervosa is a neurotic condition where an individual mostly a young woman starves herself to remain slim. Similarly anorexia mirabilis is a neurotic condition where a middle aged woman stops taking food for sake of piety. Whatever may be the cause for loss of appetite, if of long standing, it impairs the nutritional status of a person. Being deprived of essential calories an individual becomes weak and looks emaciated. He develops multiple deficiencies due to inadequate intake of essential nutrients like iron, calcium and vitamins, among others, along with calories. This makes him feel weak. He suffers from vague body pain and is unable to carry on his work efficiently. In advanced cases, small activities like walking around in a room or dressing up also become difficult for the affected person. Therefore, it is imperative to treat the cause of anorexia and help a person regain his normal strength thereby improving his quality of life. Diagnosis of the underlying cause of anorexia is based on the duration of the anorexia and associated symptoms. It is confirmed by means of specific tests. In case of specific causes like tuberculosis causing anorexia, the appetite improves spontaneously after specific treatment. If anorexia is due to eating disorders like anorexia nervosa, counseling and regular supervision of the individual is needed to see that she starts eating properly. Drugs are available to improve appetite. But it is not desirable to use them indiscriminately. It causes side effects like drowsiness, instability in walking, dryness of mouth and even obesity. Thus instead of improving the overall well being of a person it tends to make him feel more sick. Attention to the nutritional status of the person is vital till his appetite improves. He /she should be fed with small quantities of food 3,4 times every day. This helps in maintaining the energy levels and also the normal physiology of the digestive system. It also provides the essential nutrients necessary for normal healthy functioning of the body. Supplements of vitamins and essential nutrient substances aid in regaining good health of a person suffering from anorexia. Quitting alcohol and smoking are useful in improving the overall health of an individual. Some obese people feel happy if they develop anorexia, thinking that this will help them to shed weight. But they should realise that anorexia is not healthy and they should get it treated. Dr. Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital

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What causes loss of appetite?