DEAR DOCTOR,

I got malaria a few weeks back and lost my appetite. I got better and still can’t bring myself to eat anything more than soup. What can I do to get my appetite back? I have lost a lot of weight and it doesn’t look good. SAMANTHA

DEAR  SAMANTHA,

Usually after any acute or chronic illness, one does lose appetite, a condition called anorexia. At times reduced appetite is the only symptom of the sickness. The disease process, indigestion, medicines taken, all contribute to anorexia. After cure, appetite reverts to normal. But severity of the anorexia and time of recovery depends on multiple factors. These are age of the person, severity of illness, associated comorbidities, use of alcohol, physical and or mental stress.

If appetite does not build up spontaneously after the sickness, one should put in some efforts to regain it, as appetite is the desire, which stimulates one to eat and food is what builds up energy stores of the body, making it capable to work and enjoy.

If an individual does not feel like eating much, it is advised to take four to five small frequent meals. Food should be preferably freshly cooked and warm. Because such food becomes more palatable and appetising. Unless there are restrictions on some kind of food (as sugary food for diabetic patients), a person should take food items of their choice, as that makes one eat better. Hot soups taken before meals also help in stimulating appetite. 

Foods rich in zinc, vitamin B1 and omega 3 fatty acids are helpful in improving appetite. Nuts, whole grains, seeds, beans, lentils, fish, fruits like mango, avocado, musk melon are very good in this regard. The supplements of these are usually not needed, unless there is a proven deficiency.

It is also important to avoid dyspepsia and clear bowels regularly. Because if one does not clean bowels regularly or has dyspeptic symptoms, like retrosternal burning pain, bloating sensation of abdomen, nausea, vomiting, etc., one will not be able to eat adequately. High fibre food, drinking adequate amount of water, taking meals in time, avoiding heavy meals at night, will help to improve digestion. Alcohol and excess tea, coffee should be avoided.  Regular physical exercise also helps in stimulating appetite. As per a person’s capability, light exercise can be done before meal times.

A word of caution here; as far as possible, the appetite stimulating drugs available in market should be avoided. They are not needed as appetite reverts with simple dietary and life style measures, after illness is cured. These medicines cause drowsiness and weight gain.

Dr. Rachna Pande,Specialist internal medicine rachna212002@yahoo.co.uk