Lack of appetite: causes in an adult and a child, therapy

Introduction

The lack of appetite in adults is indicated by the absence or decrease in the desire to eat, which can occur at any time in life. When there is a complete refusal of food, it is more correct to call this condition anorexia.

There are various reasons that can cause a decrease in the desire to eat, usually classified by:

• pathological,
• psychosomatic,
• physiological,
• psychiatric,
• and genetic reasons.

Many diseases cause loss of appetite, which is often associated with:

• nausea
• weight loss
• malnutrition.

In general, once the disease is cured (if curable), the appetite returns.

Lack of appetite in adults can also be due to certain states of anxiety or depression, seasonal changes, psychiatric disorders (eg, anorexia nervosa) or, to a lesser extent, genetic inheritance (often occurs in children than in adults if there are parents who, in turn, suffered from anorexia).

Loss of appetite can affect all age groups:

• adults,
• elderly,
• children

and cause not only loss of appetite and, consequently, weight, but also, if it persists for a long time, also psychophysical deterioration of the victim's condition.

In fact, you need to understand that food is not just a moment of pleasure in a person's life, but, most importantly, a vital act of survival: using food, we supply our body with all nutrients (vitamins, minerals, proteins, fats and sugars), which, among other things, are irreplaceable sources of energy, allowing you to perform all the mental and physical activities of daily life, such as walking, talking, thinking, memorization and so on ...

Causes

Among the many reasons for the lack of appetite are:

• chronic renal failure;
• heart failure;
• COPD (chronic obstructive pulmonary disease);
• hepatitis;
• metabolic diseases;
• endocrine disorders;
• HIV (Human Immunodeficiency Virus);
• pregnancy;
• fever;
• infections:
  • urinary tract infections (for example, cystitis);
  • respiratory tract (for example, bronchitis and pneumonia);
  • mouth and pharynx (for example, angina);
  • gastroenteritis;
  • sepsis;
• toothache;
• taking medications;
• drug use;
• alcohol abuse;
• tumors;
• dementia;
• depression;
• anxiety;
• anorexia nervosa;
• food intolerances /food allergy;
• malabsorption syndrome;
• recovery after surgery;
• exanthematic diseases (for example, piggy, whooping cough, rubella);
• flu and intestinal flu;
• change of season, climate;
• insomnia and sleep disturbances.

In during pregnancy lack of appetite develops mainly in the first trimester and often occurs due to morning sickness, which is observed in women awaiting awakening, and sometimes accompanies them during the day, reducing their desire there is.

Even some physiological conditions such as old age, may be associated with loss of appetite: especially in the case of elderly people left alone (death of a partner, distance of children or others family members), toothlessness, depression, dementia, or other diseases that include the use of many drugs each day.

In children the teething phase can be associated with a refusal to eat due to the presence of pain, inflammation and irritation of the gums and mouth, which are aggravated by eating. Other causes may include oral diseases, infections or parasites, vaccinations, influenza, problems with school or family, emotional stress, weaning disorders, seasonal changes.

One of the typical symptoms tumors is severe weight loss due to decreased appetite due to various conditions that can affect a neoplastic patient:

• feeling sad or outright depressed after being diagnosed with cancer;
• the presence of pain;
• treatment (chemotherapy, radiation therapy).

Certain cancers are more likely to be associated with loss of appetite, such as colon cancer, stomach, pancreas, liver and ovarian cancer.

Almost all medications are considered a possible side effect of nausea or vomiting and therefore also cause a lack of appetite or change the sense of tasteby making food less enjoyable; for example, chemotherapy drugs, antibiotics, codeine, morphine.

On the other side, anorexia nervosa typical in most adolescents with eating disorder, characterized by uncontrollable delusions of their own weight and a distorted perception of their physical fitness. The reason is still not fully understood and is believed to be sought in possible genetic factors. imbalance of the hypothalamus or some neurotransmitters, conflict relationship between mother and child and rigid education.

In the case of anorexia nervosa, lack of appetite is associated with abnormal anorexic desire to lose weight, or rather, with the fear of gaining weight, with which he fights on a daily basis in various ways: with severe limitations in food intake, vomiting after meals, use of laxatives, enemas and diuretics, intense physical activity.

Dangers

Lack of appetite may be due to a transient and reversible condition, in which case it should not cause serious concern because it is usually resolved quickly with appropriate funds. The affected person will regain the desire to eat and any weight loss, without long-term consequences or complications.

However, in cases where the lack of appetite can be prolonged, it may be due to organic disease, therefore, it is necessary to identify and treat the disease with appropriate care in order to avoid the occurrence of other more serious symptoms.

Among the main risks associated with a condition of long-term loss of appetite are the appearance of other symptoms, such as:

• feeling of general malaise;
• severe weight loss;
• slight irritability;
• increased heart rate (tachycardia of the heart);
• anemia with iron deficiency;
• nutritional deficiencies
• condition dehydration;
• exhaustion even after light work;
• ketosis;
• decreased immune defense and the occurrence of infections;
• fever;
• growth retardation / weight loss (in children).

When to see a doctor

It is always recommended to consult a family doctor when the lack of appetite continues for a long time, voluntary desire or not, without connection with a clearly known cause and / or when it is associated with other symptoms such how:

• nausea;
• vomit;
• fever;
• diarrhea;
• dysentery (bloody diarrhea);
• changes in tastes;
• tachycardia;
• anxiety.

The doctor examines the general condition, paying particular attention to weight and the measurement of body weight obtained by calculating the BMI.

BMI (Body Mass Index) is a simple parameter that links a subject's height and weight, and is calculated using the following formula:

• BMI = body weight (kg) / height² (in meters).

The result allows us to classify a person's problem into the following categories:

• severe thinness <16.5;
• underweight 16-18.49 g;
• normal weight 18.5-24.99 g;
• and so on for overweight or obesity.

The doctor also collects the patient's medical history (anamnesis) by asking him questions, for example:

• How long have you been experiencing loss of appetite?
• Eat little or no food? Don't want to eat one type of food?
• Do you have stress, depression, nervous disorders, for some reason?
• Do you have other medical conditions such as nausea, pain, fever, fatigue, vomiting?
• Have you lost weight? If so, for how long and for how long?
• Are you on medication?
• What diseases do you suffer from?

Finally, useful for correct diagnosis are:

• blood tests:
  • platelet analysis;
  • AST and ALT transaminases;
  • direct, indirect and total bilirubin;
  • HIV test;
  • marker for large viral hepatitis (HAV, HBV, HCV);
  • tumor markers;
  • electrolyte analysis (sodium, potassium, magnesium, chlorine, calcium);
  • creatinine;
  • azotemia;
  • whey proteins;
  • toxicological tests;
• general urine analysis;
• food intolerance test (it is recommended to take only scientifically based approaches!);
• possible radiological examinations (X-rays, ultrasound, or, in some cases, CT or other more complex examinations).

Therapy

In the event of a loss of appetite, it is important to introduce a number of measures to increase nutrient stores and restore lost weight, for example:

• eat foods rich in calories and protein;
• Take any dietary supplement as directed by your doctor
• small frequent meals are preferable if there are 3 classic main meals (breakfast, lunch, dinner);
• keep a diary of what you eat and drink;
• carry out regular physical activity, even a simple 30-minute walk at a fast pace will help.

Correcting organic disease with an early onset of appetite loss is essential if identified and feasible.

If there is a lack of appetite in an adult caused by an emotional disorder, such as bereavement depression, recent diagnosis of cancer or other dramatic events, some measures may be helpful, along with supportive psychological therapy. Here are some things you can do to help your diet:

• eating with loved ones or friends;
• visiting some of your favorite restaurants;
• change your diet, cook what you like;
• allow yourself to relax (hot and relaxing baths, yoga classes, hobbies).

Any food that causes intolerance or malabsorption (malabsorption) should be excluded from the diet, and possible changes in medications or doses of drugs taken must be carefully assessed: all this must be done solely by a doctor and not the patient.

To eliminate loss of appetite in children, it is necessary to heed the advice of the pediatrician, the pediatrician, after studying the reasons, will give certain recommendations, in general, if the reason is not in the disease, they recommend:

• do not force the child to eat not of their own free will;
• do not force the child to eat foods that he does not like;
• eat at a specific time;
• Serve adequate portions, not too large or too small;
• have dinner with the whole family;
• serve food in a fun and tasty way.

If both the child and the adult are severely malnourished, hospitalization may be required for proper care.