It is because of our appetite that we eat food, feel satiated and energetic to carry on our daily work. But when a person loses appetite and interest to eat anything, it becomes worrisome as he/she begins to feel weak. Loss of appetite or anorexia is a distressing condition for any individual. Loss of appetite may be for a short duration, say about two or three days. This could be due to some stress, overwork, acute sickness like flu or tonsillitis. But it usually recovers spontaneously when the problem is corrected. The loss of appetite can be of longer duration when it is more worrying. It can be due to chronic infections like tuberculosis, HIV. Disorders of the liver, gall bladder and kidneys also result in anorexia. In fact, a person saying he has no appetite and refusing food may be the first indicator of a chronic illness. Malignancy in any part of the body induces anorexia along with other problems. Chronic cardiac failure leads to impaired perfusion of the gut as of other organs. This impairs digestion as well as appetite. Chronic digestive problems like constipation, dyspepsia, state of hyperacidity, and etcetera, also impair the appetite of a person. One can have anorexia due to chronic smoking and or alcohol use. Some drugs like Metformin (anti-diabetic drug), anti-migraine, anti-depressant drugs, and etcetera, suppress appetite. Anorexia nervosa is a neurotic condition where an individual, mostly a young woman, starves herself to remain slim. Similarly anorexia mirabilis is a neurotic condition where a middle aged woman stops taking food for sake of piety. Whatever the cause for loss of appetite, if long standing, it impairs the nutritional status of a person. Being deprived of essential calories, an individual becomes weak and looks emaciated. He develops multiple deficiencies due to inadequate intake of essential nutrients like iron, calcium, and vitamins, along with calories. This makes him feel weak. He suffers from vague body pain and is unable to carry on his work efficiently. In advanced cases, small activities like walking around in a room, or dressing up, also become difficult for the affected person. Therefore, it is imperative to treat the cause of anorexia and help a person regain his normal strength, thereby improving his quality of life. Diagnosis of the underlying cause of anorexia is based on the duration of the anorexia and associated symptoms. It is confirmed by means of specific tests. In case of specific causes like tuberculosis causing anorexia, the appetite improves spontaneously after specific treatment. If anorexia is due to eating disorders like anorexia nervosa, counselling and regular supervision of the individual is needed to see that he/she starts eating properly. Drugs are available to improve appetite. But it is not desirable to use them indiscriminately. They cause side effects like drowsiness, instability in walking, dryness of mouth and even obesity. Thus, instead of improving the overall well-being of a person, it tends to make him feel sicker. Attention to the nutritional status of the person is vital till the appetite improves. He/she should be fed with small quantities of food three to four times every day. This helps in maintaining the energy levels and is suitable for the normal physiology of the digestive system. It also provides the essential nutrients necessary for normal healthy functioning of the body. Supplements of vitamins and essential nutrient substances aid in regaining good health of a person suffering from anorexia. Quitting alcohol and smoking are useful in improving the overall health of an individual. Some obese people feel happy if they develop anorexia for whatever reason thinking that this will help them lose weight. But they should realise that losing weight due to sickness is not healthy and they should get it treated. Dr Rachna Pande, Specialist, internal medicine rachna212002@yahoo.co.uk
