Loss of appetite
Topics covered on this page:
What is cancer-related loss of appetite?
Loss of appetite is described as the loss of the desire to eat. Many people report losing their appetite during or after cancer treatment. This can be a side effect of the treatment, the cancer or you may lose your appetite because of how you are feeling about treatment (e.g., sad, anxious).
- How does it affect me? Eating less can result in poor nutrition, weight loss and loss of strength. It is normal to feel frustrated that you don’t want to eat even though you know that you need to keep up your strength during treatment. Everyone feels loss of appetite differently. You may simply feel that you don’t look forward to meals the way you used to or you may find you have little interest in food at all.
- Does it get better? Loss of appetite can be temporary and often your appetite returns to normal after treatment ends. When you have a loss of appetite, it is possible to use different self-management strategies to help you to take in the proteins and calories your body needs. Some of these strategies are described below (see the section What can I do to help manage my loss of appetite?).
What causes loss of appetite?
There are a number of possible causes for your loss of appetite with cancer
- Changes in the way food tastes or smells as a result of treatment
- Anxiety or depression related to the cancer diagnosis or treatment
- Fatigue that leaves you with little energy to prepare a meal
- Difficulty chewing or swallowing because of mouth sores caused by radiation therapy or chemotherapy
- Other treatment-related symptoms like constipation, diarrhea, or pain can discourage you from wanting to eat
What are the signs of loss of appetite?
Typical signs of loss of appetite can include:
- Not eating the same amount as usual
- Losing weight without trying
- Not feeling hungry
- Skipping meals
- Feeling full after eating a small amount of food
- Not liking food that once was a favourite
- Feeling fatigue after treatment – feeling too tired to eat
- Not getting pleasure from eating a meal with family or friends
When should I get help for my loss of appetite?
It would be a good idea to talk to your oncologist, your nurse, your pivot nurse, your dietitian or nutritionist at your next appointment if any of the following situations are true for you (For tips on talking with your healthcare team, see Talking to your healthcare team):
- You are losing weight without trying
- You feel full after not eating very much
- You are constipated or have nausea, diarrhea or pain from cancer or treatment that you think is affecting your desire to eat
- You are unable to enjoy eating a meal
- You are worried about your loss of appetite
Talk to someone in your healthcare team immediately if:
- You have pain when eating
- You have had nothing to eat or drink in the past 24 hours
- You lost weight in the last 2 weeks without trying
- A poor appetite interferes with your daily activities
What can I do to help manage my loss of appetite?
Below are some strategies to help you manage your loss of appetite and get the calories you need to keep up your strength. Eating well can help you maintain your energy to cope with cancer and any treatment side-effects.
A symptom diary can be very helpful to show to your healthcare team to help them understand your loss of appetite and to help them figure out how to manage it.
- Write down when you eat and what you eat.
- Keep track of what you like to eat and what you don’t like.
- Write down any physical problems you have related to your cancer or treatment that seems to affect your desire to eat, like constipation, nausea, diarrhea or pain.
- For more information see Symptom Diary.
A dietitian can help you plan meals to make sure you are getting the calories your body needs to stay strong. Find out if your cancer centre has a dietitian or ask for a referral from someone in your healthcare team. A dietitian or nutritionist can also suggest tips to help you:
- Learn about high protein and high calorie food and recipes to include more of this content in the food you are able to eat. You want to get the most you can out of what you can manage to eat.
- Learn if there are any foods to avoid because they can produce gas that makes it uncomfortable to eat.
- Learn about foods that are important for your overall physical and mental health, such as: fruits and vegetables, foods rich in omega 3 fatty acids and B vitamins.
- Learn what nutritional supplement could be good for you (Ensure©, Glucerna©, Boost©). These can be used alone or added to a coffee or hot cereal or smoothies.
- Clean your mouth before and after eating to keep your mouth fresh. You can also rinse with salted water or a baking soda and water solution, if you have no mouth sores.
- Eat whatever tastes good to you.
- Serve food cold or at room temperature to reduce strong smells.
- Experiment with different foods to discover what tastes or smells less strong to you at this time.
- Avoid food that is too spicy.
- Try adding new flavors like lemons, pickles, vinegar, nutmeg, or cinnamon. Be cautious of using vinegar or pickles if you have mouth sores.
- Use plastic utensils or chopsticks if food tastes bitter or metallic. This is often reported as a side effect of treatment.
- Avoid canned foods and if possible, don’t cook with metal pots.
- Bite into a marshmallow (without swallowing)—this can improve the taste of food that is eaten afterwards.
- Keep meal and snack times flexible.
- Try to eat 5 to 6 small meals a day instead of 3 large ones.
- Try eating small snacks even when you are not hungry — eat more when you do feel hungry.
- Try not to skip meals.
- Try and eat foods high in protein and calories (e.g. cheese, milk, yogurt, ice cream) to increase the nutritional value of your meals or snacks.
- Make soups with milk instead of water to increase the calorie content.
- You may feel like adding vitamins to your diet to make up for not eating a balanced diet. Check with your pharmacist or dietitian first to make sure they are safe for you during treatment.
- When you do not drink enough fluids, you can become dehydrated. Dehydration means the body does not have the amount of water it needs for all the organs to work properly.
- Signs of dehydration include fatigue, feeling thirsty or having a dry mouth most of the time, or passing very small amounts of urine.
- Try to sip fluids high in protein and calories during the day, such as milkshakes, smoothies and juice. If warm beverages are preferred, you can try Ovaltine.
- Limit drinks with caffeine (coffee, tea, cola) or alcohol. These beverages can result in dehydration.
- Drink beverages between meals instead of with meals. Drinking while you are eating may make you feel to full to finish your meal.
- If the grocery store is not easy to get to, consider ordering food from the grocery store, either online or by phone, and getting it delivered.
- Try convenience foods like frozen meals to make shopping and preparing food easier to do.
- How food looks and where you eat can help your appetite — explore ways to present food. Try smaller plates so the amount of food is not overwhelming. Try different combinations of food on a plate, use pretty or funny plates.
- Find ways to make meals relaxing and enjoyable. Play some music or put on soft lighting.
- Have meals with friends or family members when possible. Eating with other people can help you enjoy your meal time and distract you to eat more.
Regular physical activity can help improve your appetite. Light exercise and fresh air before a meal can also stimulate your appetite.
- It is generally fine to exercise during treatment, but check with your healthcare team before starting any exercise.
- Choose an activity or exercise that you enjoy doing or would like to try. If you can fit one into your schedule without too much difficulty, it will be easier to do it regularly.
- Pay attention to what your body tells you—only increase the amount and difficulty of your activity when you feel comfortable.
- Check with your healthcare team before starting any new exercise program.
- For more information see Get Moving.
- Don’t suffer in silence if your loss of appetite is too hard to manage on your own. Talk to your healthcare team, join a support group, or lean on your family and friends. Some wellness centres for cancer patients, such as Hope and Cope, give cooking classes.
- Ask family and friends for help buying groceries or preparing meals. It can be difficult to ask for help, particularly from family and friends. However the people in your life often want to know how they can help you.
- Remind friends and family not to make comments about what and when you eat. You are doing your best.
- For more information see Getting Support.
⚠ Important information about cannabis
Some patients do use cannabis to reduce pain, help with relaxation or as a sleeping aid. However, the research is still unclear about the use of cannabis to manage cancer-related symptoms, including loss of appetite. It is important to talk to your doctor before trying cannabis. For more information on what cancer patients should know about cannabis, go to: www.bccancer.ca/health-info/coping-with-cancer/medical-cannabis.
Resources
For more information on loss of appetite, self-management strategies and support organizations, check out the resources below.
Canadian Cancer Society – Eating Well When You Have Cancer
Canadian Cancer Society – Loss of appetite
Cancer Care Ontario – How to Manage Loss of Appetite
Acknowledgement of sources
The content of this document has been adapted from the following sources:
- Canadian Cancer Society. Eating Well When You Have Cancer. 2019.
- Canadian Cancer Society. Loss of Appetite.
- Cancer Care Ontario. How to Manage Loss of Appetite. 2016.
- COSTaRS. Loss of Appetite. 2020.
- Conserver l’appétit et la santé lors d’un traitement du cancer. 2016.
- Quebec Cancer Foundation. Bien Manger Pour Mieux Vivre. 2009.
- BC Cancer Agency. Loss of Appetite.
- COSTaRS. Appetite Loss. 2016.
- CHUM. Nutrition clinique – alimentation enrichie avec texture modifiée. 2018.
Healthcare professional endorsement
The content of this document has been reviewed and approved by a team of healthcare professionals and clinical experts.
Disclaimer
Please note that this fact sheet is not intended as a substitute for consultation with a healthcare professional. Rather, it was designed to complement interventions by your treating team. If you have questions about your health, or any medical issue, you should contact a healthcare professional right away. You should not delay seeking medical advice, or disregard professional medical advice, because of information in this fact sheet. Before beginning any health treatment, always consult your doctor. All care has been taken to ensure that the information contained in this document is accurate at the time of publication. e-IMPAQc is not responsible for any injury or damage to persons or property arising out of, or related to, any use of the fact sheet, or because of any errors or omissions.
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