Mhmm… Appetite and desire in balance

What stimulates appetite — or suppresses it?

Appetite and hunger are controlled by complex processes in the body. Central roles are played by body signals, hormones and chemical messengers in the brain, so-called neurotransmitters. These signals and substances are closely connected and trigger activity in the hunger and satiety centres of the hypothalamus, a part of the diencephalon.

Eating behaviour is influenced not only by the body itself but also by external cues such as the look and smell of meals.

Mental factors and conscious decisions also affect whether we feel hungry. Appetite is experienced as an emotional perception, while hunger is a physical signal that drives food intake, especially when the stomach is empty or blood sugar is low.

Loss of appetite, also known as inappetence, indicates a disruption in the system and can have physical or psychological causes. This complexity often makes it difficult to identify the exact cause.

What are the symptoms of loss of appetite?

Recognising symptoms is important to identify possible underlying factors and to address nutritional problems early. Symptoms of loss of appetite include weight loss, reduced food intake, nutrient deficiencies, fatigue and weakness, mood swings, digestive problems, muscle wasting and poor wound healing.

What is the difference between loss of appetite and anorexia?

Loss of appetite and anorexia are two distinct conditions that are often confused but have different causes and consequences. Loss of appetite is a general symptom characterised by a reduced desire or interest in food. It can be triggered by many factors such as stress, illness or medication and is usually temporary.

Anorexia, also called anorexia nervosa, is a serious eating disorder. It occurs particularly in adolescents and young adults and is characterised by deliberate starvation, often accompanied by excessive physical activity. Affected people have a distorted self-image and perceive themselves as “too fat” despite being underweight, which can lead to life-threatening starvation. This extreme fasting suppresses appetite in the long term and leads to persistent loss of appetite.

While loss of appetite is a symptom of many possible causes, anorexia is an independent mental disorder that requires professional treatment and should not be masked with herbal remedies.

What causes loss of appetite in older adults?

In older age, various factors can lead to loss of appetite, including the natural decline in taste and smell, which can reduce the pleasure of eating. Dental problems, chewing and swallowing difficulties and age-related illnesses also play a role. Loneliness and the loss of loved ones can further reduce the desire to eat. Nutrition specialists therefore recommend making the diet of older people especially rich in vitamins and minerals.

Other causes of decreased appetite in older adults include lack of physical activity, chronic pain, poorly fitting dentures, blandly seasoned food and burdensome medications or therapies. Age-related smell disorders, gastrointestinal diseases or disorders of other internal organs, as well as mental problems such as depression or dementia, can also contribute.

Loss of appetite in older people often leads to malnutrition and unintended weight loss, which can have serious health consequences. Because older people rarely regain their baseline weight after successful treatment of appetite loss, it is important to take preventive measures early. In addition, many older people suffer from dry mouth, swallowing problems or heartburn, which further reduce the pleasure of eating.

Which illnesses can cause loss of appetite?

Loss of appetite can be triggered by a wide range of physical and psychological illnesses. Common causes include inflammations of the mouth and throat such as painful aphthae, sore throat or inflamed gums. Bacterial infections such as tonsillitis or pharyngitis also frequently lead to loss of appetite.

Other common causes are disorders of the digestive organs. These include gastritis, functional dyspepsia (irritable stomach), gastroenteritis and food poisoning, which are often accompanied by symptoms such as vomiting and diarrhoea. Food intolerances such as lactose intolerance, fructose intolerance and coeliac disease can also reduce appetite.

Serious illnesses such as cancer and the associated treatments, stomach or duodenal ulcers, chronic inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease, hepatitis and liver cirrhosis can also lead to loss of appetite. Gallstones, pancreatitis and appendicitis are also often associated with appetite loss.

Psychological causes also play an important role. Depression, anorexia nervosa and substance dependence can greatly reduce the desire to eat. Infectious diseases such as HIV/AIDS, tapeworm infestation, yellow fever, tonsillitis, infectious mononucleosis, mumps and chickenpox frequently cause loss of appetite.

Other conditions that can cause loss of appetite include diabetes, dementias, Addison’s disease, kidney disease, heart conditions such as heart failure and endocarditis, hypothyroidism and migraine.

These diverse causes make it clear that loss of appetite is a complex symptom that requires thorough medical evaluation and, if necessary, targeted treatment.

Treatment: When to see a doctor for loss of appetite?

Temporary loss of appetite is often not a cause for concern, especially if it is related to stressful situations, a cold or gastroenteritis. During pregnancy, a temporary loss of appetite can also be normal, since energy and nutrient requirements increase only slightly and it is not necessary, as is often mistakenly thought, „for two" to eat.

If more serious physical or psychological causes are suspected, especially in the presence of severe accompanying symptoms such as nausea, medical advice should definitely be sought. This also applies if the loss of appetite persists for a longer period and there is a risk of malnutrition. In such cases, it is advisable to consult a general practitioner.

If medications are the cause of the loss of appetite, it is important to discuss this with the treating physician. It may be necessary to adjust the medication to remedy the loss of appetite.

How to stimulate appetite again: useful tips

• Make sure to take time to eat and create a pleasant, sociable environment. Choose the foods you particularly enjoy. 
• Use appetite-stimulating remedies. These include bitters (wormwood, angelica root) and ginger tea. Rosemary, coriander and dandelion stimulate saliva production and gastric juice secretion – you can flavour dishes with them or drink them as tea. 
• Exercise outdoors and sport have been shown to stimulate appetite.
• If stress is behind the loss of appetite, targeted relaxation can help. Meditation, yoga and other relaxation techniques have a positive effect. They help to calm down and reduce stress triggers.
• Arrange food attractively, use fresh herbs and strongly scented spices, watch cooking shows and read cookbooks. This helps to create a pleasant atmosphere before eating and stimulates the appetite.
• If a gastrointestinal illness is present, it is advisable to eat bland food several times throughout the day in smaller portions. This can occasionally include liquid nutrition such as yoghurt, soup or smoothies. As a rule, alcohol, caffeine and nicotine should be avoided. 
• For psychologically based loss of appetite, consider contacting a psychological or psychotherapeutic practice.
• If medications cause appetite loss, ask your doctor about alternative active substances or substitute preparations.
• Be sure to see your GP if loss of appetite persists for a long time and malnutrition is likely.
• For physical causes, dietary counselling can support therapy. If the doctor has given the all-clear, review your lifestyle: your diet, sleep pattern and physical activity. Try to include a varied diet with many fresh plant-based ingredients.
• Avoid excessive alcohol consumption and consider herbal remedies or teas with appetite-stimulating ingredients, such as gentian or centaury. However, consult your doctor or pharmacist first, especially during pregnancy.

Loss of appetite can be caused by a variety of factors, from physical and psychological illnesses to age-related changes. The causes are often complex and require a thorough examination to find targeted treatment options. Early recognition and management of loss of appetite is crucial to avoid serious health consequences such as malnutrition and weight loss.