Appetite Loss

Changes in appetite is a common problem for patients with cancer. Appetite loss, also known as anorexia, describes the feeling of not being hungry and having no desire to eat or taste any food. One will then eat less than usual or feel full after eating just small amounts of food. If appetite loss is prolonged, it can lead to insufficient nutrients in your body, unhealthy weight loss and slower recovery.

Eating well is important, particularly during cancer treatment. It can help you cope better with side effects and fight any infections better. Your body will also be able to rebuild healthy tissues faster. It is thus important to speak to your doctor or nurse if you lose your appetite.

Causes of Appetite loss

Appetite loss can be temporary or it can last longer, depending on its cause and treatment. Some causes of appetite loss are:

Medications (e.g. chemotherapy, targeted treatments, immunotherapy, radiotherapy)
Side effects of cancer and its treatments (e.g. nausea and vomiting, mouth ulcers, dry mouth, constipation or diarrhea, pain, fatigue)
Site of the cancer, causing nausea and/or poor digestion
Depression or anxiety
Other medical conditions (e.g. infections, thyroid problems, kidney or liver impairment)

What you need to look out for

Weight loss
Loss of muscles and strength
Not feeling hungry, or feeling full after eating only small amounts of food

How it can be treated

Your doctor will ask you further questions (e.g. when it started, associated symptoms) and conduct a physical examination, to determine the cause of your appetite loss. Your doctor may also order for further investigations (e.g. x-rays) if needed. As the treatment for appetite loss depends on its cause, your healthcare team will be able to advise you in detail on the management plan that is most suited to your condition.

Some common treatment approaches include:

Treating the cancer
Treating side effects of cancer and its treatment (e.g. constipation, nausea, pain, depression)
Changing or stopping medications that cause appetite loss
Prescribing medications that may improve appetite. Examples are:
- Hormonal medications
- Steroids
- Medications that promote gut movement
Referring you to a dietitian who can give you additional advice on meal planning and nutritional supplements

What you can do

The following are some of the do’s and don’ts to help you to eat better, alongside the treatment for your appetite loss. If you have problems of dry mouth, mouth ulcers or taste changes, you may go to the individual pages to learn more about what you can do.

Meals and food

Take small frequent meals – 5-6 small meals instead of 3 large meals per day

Take foods and drinks that are high in protein, calories and nutrients (e.g. milk shakes, eggs, ice cream, cheese, fruits, nuts, juices, smoothies). Increase calories by adding sauces, gravy and creams to food

Prepare food that is appealing and flavourful. You can try adding spices, condiments, or marinate meat with sweet marinades or teriyaki sauce

Try something new as it might spark your appetite

Keep your favourite snacks on hand so that you can snack whenever you want to

Use larger plates for your meals so that the amount of food to be taken will not look overwhelming

Avoid heavy meals, greasy or fried foods, and foods that cause gas and bloating (e.g. beans, cauliflower, broccoli, cabbage, carbonated drinks)

Avoid low-calorie foods that are filling (e.g. lettuce, broth, diet soda)

Avoid limiting the amount or types of food you eat. You can speak to your doctor or nurse if you have specific concerns about what you can or cannot eat

Avoid drinking fluids with meals as this can make you feel full more easily. Try to take your fluids in between meals

Environment

Make eating a special event. Try to eat with family and friends. People often eat more when they are socialising

Eat in pleasant and conducive surroundings. Watch your favourite television programme while eating

Avoid eating in unpleasant areas such as where the smells are obnoxious or bothersome to you, as this will affect your appetite

Lifestyle

Daily light exercises such as a short walk can relieve stress, improve mood, help with sleep and appetite

Keep your mouth moist and clean

When to call your cancer care team

Please inform your doctor or nurse if you experience any appetite loss, or if you experience any of the following that can indicate complications of your condition:

Losing excessive weight despite good eating habits
Difficulty or painful swallowing
Nausea or vomiting
Abdominal pain
Feeling depressed, or anxious

If you have any questions regarding the above, please call the Cancer Helpline at +65 6225 5655 or approach your doctor or nurse for further details.

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The above contents are made available as part of TEMASEK FOUNDATION-ACCESS (Accessible Cancer Care to Enable Support for Survivors) PROGRAMME, a holistic care programme to support cancer patients during their care and recovery journey.

The contents have been approved by the Cancer Education Information Service, National Cancer Centre Singapore (NCCS), for people with cancer and their families and caregivers. However, this information serves only as a guide and should not be used as a substitute for medical diagnosis, treatment or advice. For specific medical conditions, please seek expert medical advice from your healthcare team.

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