No Appetite

[tips from 20 reliable sources]

No appetite? We’ve collected tips from reputable websites such as National Cancer Institute, Canadian Cancer Society, Lung Cancer Alliance, Cancer Council Victoria, etc. to improve your appetite during chemo.

Treatment day


You might not feel hungry when you’re having chemotherapy, but it’s important you keep eating well. Nutritious food keeps up your strength, fights fatigue, nausea, helps your body heal and to avoid malnutrition and weight loss. Poor nutrition can slow recovery and lead to breaks in treatment.

  • Talk with your doctor or nurse about what may be causing your poor appetite.
  • Address the underlying cause – talk with your doctor or nurse about what may be causing your poor appetite and ways to relieve gastrointestinal symptoms, such as nausea, vomiting, diarrhea, constipation or other conditions such as mouth sores, dry mouth, swallowing difficulty, pain, or depression may help improve appetite.
  • Mouth Sores– If you are not eating because you have sores in your mouth, check with your doctor if it is okay to use acetaminophen (Tylenol®) or ibuprofen for the discomfort.
  • Dry Mouth– you aren’t eating much because your mouth is dry Avoid toothpaste and mouthwashes that contain alcohol as this can cause further drying of your mouth. To stimulate saliva, or to make your mouth moist, try sucking on ice cubes, candies, or gum.
  • Don’t wait until you feel weak, have lost too much weight, or are dehydrated. Tell your doctor or nurse if you are not hungry or if you find it difficult to eat.
  • Eat lightly and several hours before you receive a treatment.This helps prevent food aversions caused by nausea or vomiting after chemotherapy, targeted therapy, or radiation.
  • Your doctor may prescribe drugs to stimulate your appetite. These drugs may include: Steroids such as Decadron (dexamethasone), Megace (megestrol), Reglan (metoclopramide) and Cannabinoids (medical marijuana)
  • Some people claim that marijuana helps increase their appetite.
  • Meet with a registered dietitian for eating plan, suggest vitamins and supplements and help you deal with side effects and symptom management. People with a weakened immune system or low white blood cell counts may have to take some basic food safety precautions, as suggested by their dietitian.

Eating


  • Try having 6-8 small meals a day rather than 3 big ones. Many people who get chemo find they have more of an appetite when they eat every few hours.
  • Schedule mealtimes and use the clock to tell you when to eat.  Determine which times of day you are hungry and eat at those times. If you never seem to feel hungry, it’s often helpful to eat according to a schedule rather than to rely on appetite.
  • Eat more when you’re hungry.Take advantage of the times when you feel your best to eat more. Don’t limit how much you eat. Eat whatever you want, whenever you want it, but don’t force yourself to eat.
  • Start the day with large breakfast.Some people may have a better appetite in the morning, so eat a large breakfast.
  • Eat your favorite foods.Your appetite and the foods that appeal to you can change from day to day. For now, eat what sounds good, when it sounds good.
  • Try not to skip meals.Make an effort to eat regularly even if it is only a few bites. Eat even though you have no appetite.
  • Pay attention to protein. It helps repair body tissue and keeps your immune system healthy. High protein foods include dairy products like milk, Greek yogurt, pudding, cheese, Meat, poultry, fish, seafood, Tofu, soy beverages, nuts, seeds, peanut butter, Dried peas, beans and lentils, and Eggs.
  • When having a meal, try to eat protein foods first.
  • Add extra calories to make your foods more calorie rich. Eat puddings and desserts – foods with fat or sugar are good sources of calories. Use “instant breakfast” mixes for extra calories. (Olive oil, butter or margarine, Gravy or sauces, Cream, honey, maple syrup or jams, Mayonnaise, Whipping cream, Avocado, Nuts and nut butter, Full fat cheese, Sour cream)
  • Consider a multivitamin If your loss of appetite is keeping you from eating well for more than a few days, you might consider taking a multivitamin to help you get the vitamins and minerals you need.
  • Plan an enjoyable meal– Appetite is very much affected by how food looks and by the eating environment. Prepare food that is colorful and appealing to the eye. Make mealtimes an event. You tend to eat more when you’re distracted. Eat while you watch TV or listen to music. Or invite a friend over to keep you company during meals. The social support can help you feel better, too.
  • Take nausea medication a half-hour before meals, or as instructed.
  • Try to eat your meals in a room where you feel relaxed and where there are no distractions.
  • Try tart foods, such as oranges or lemonade that may have more taste. If you have a sore mouth or throat, tart or citrus foods might cause pain or discomfort.
  • If the smell or taste of food makes your nauseous, eat food that is cold or at room temperature. This will decrease its odor and reduce its taste.
  • Avoid smells that make you sick.Pay attention to smells, as certain scents may decrease your appetite or bring on nausea. Avoid smells that have this effect on you.
  • Try placing food on smaller plates rather than larger plates and don’t expect to eat regular size meals.
  • Choose foods that appeal to your sense of smell and eat cold or slightly warm food if the smell of cooking puts you off eating.
  • Avoid heavy meals, greasy or fried foods, and foods that cause gas such as cabbage, broccoli, and beans.

Snack time


  • Keep your favorite snacks close at hand during cancer treatment in order to take advantage of the moments when you feel like eating. Such as cheese, ice cream, canned fruit in heavy syrup, dried fruit, nuts, peanut butter with crackers, cheese with crackers, muffins, cottage cheese and chocolate milk are examples of high-calorie snacks requiring little or no preparation. Don’t be too concerned that some of these options are high in cholesterol or fat. Once you regain your appetite, you can focus on lower calorie snacking options.
  • Get in the habit of having a bedtime snack.Bedtime may be a good time to snack because your appetite for the next meal won’t be affected.
  • When you go out– Don’t forget to take a snack you can carry with you whenever you go out, such as peanut butter crackers or small boxes of raisins.
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Taste changes


  • Keep an open mind – Don’t be afraid to try out new foods and tastes, you’ve never eaten before, so you won’t notice if they taste “off” and You may be surprised at what you like. Recognize that what is appealing one day may not be appealing the next day.
  • Spice up your life – If you are having trouble tasting food, try adding spices such as basil, nutmeg, cinnamon, parsley, curry, coriander, mint, oregano or rosemary, and condiments to make the foods more appealing. Spices make the mouth water and change the taste of food.
  • Add new flavors by using lemon, pickles, salad dressings, vinegar, mayonnaise, relish or fruit juices.
  • Add sauces and gravies to meats and cut meats into small pieces to make them easy to swallow. Marinate meat in liquids to change the flavor and make it more appealing. Try marinades made with fruit juices, salad dressings, sweet and sour sauce, soy sauce or barbecue sauce.
  • Beef is particularly prone to tasting metallic, so you may want to replace it with other forms of protein like chicken, eggs or dairy products.
  • Keep your mouth clean by brushing at least two times per day and rinsing your mouth out with water between meals/snacks.
  • Rinse your mouth with tea, ginger ale, salted water, or baking soda dissolved in water before you eat to help clear your taste buds. Some people say that sucking on ice chips in between bites of food helps numb their taste buds so they can eat.
  • If you have no appetite because you have lost your sense of taste from chemo treatment,try sucking on hard candy such as mints or lemon drops before eating a meal to solve metallic taste and strange tastes in your mouth.
  • Use plastic forks and spoons rather than metal to help prevent a bitter or metallic taste. Cooking in glass pots and pans can also help.
  • Avoid cigarette or cigar smoking, as this can make taste changes worse.

Convenience foods


  • Consider buying precooked meals.Buy frozen foods that are easy to put in the oven. Try mini-quiche, pot-pies, chicken fingers, frozen pasta and any other foods that appeal to you. Buy pre-cut vegetables, fruits, cheese and other quick snacks and use the deli counter at your local grocery store for pre-prepared meats, salads, and other foods.
  • Keep your pantry stocked with easy-to-prepare foods, so there is always something to eat when you feel hungry. Have a stock of convenience foods in the cupboard, such as tinned soups and puddings.
  • Store your favorite food ahead of time.On days you feel well enough to cook, make extra portions and freeze them for later.
  • Cooking your own food can sometimes put you off eating. Ask friends and family to help you shop and prepare meals and don’t be shy about telling them what you’d like to eat. People often want to help you during your treatment and this is an easy thing that they can do.
  • Consider getting your meals delivered.If you live alone, you might want to arrange for ‘Meals on Wheels’ (US) to bring food to you.

Fluids


  • Sip liquids throughout the day – Drinking too much at once can make you too full to eat.Avoid filling your stomach with a large amount of liquid before eating. Drink fluids after your meal.
  • Drink plenty of liquids. Drinking plenty of liquids is important, especially if you have less of an appetite. Losing fluid can lead to dehydration, a dangerous condition. You may become weak or dizzy and have dark yellow urine if you are not drinking enough liquids.
  • Try liquid or powdered meal replacements, such as “instant breakfast,” for extra calories, protein, or when it is hard for you to eat food.
  • Drink high-calorie beveragesIf you’re losing weight, you may want to drink high-calorie liquids, such as juices, fruit nectars, milk, cocoa, malted milk, shakes, smoothies, Ovaltine®, Carnation Instant Breakfast®, and commercial nutritional beverages such as Ensure® and Boost®, or cream soups.
  • Choose nourishing fluids.Drinks that are dairy based (milkshakes or smoothies) have more energy and protein than many other drinks such as water, tea, coffee, and squash.
  • Happy hour– With your doctor’s permission, small amounts of your favorite alcoholic drink might boost your appetite. a small sherry or brandy half an hour before you eat. A glass of wine with meals may also help digestion.
  • Drink lemonade or orange juice if your mouth isn’t sore, drink lemonade or orange juice. Juices that contain acid can stimulate the appetite.

Be active


  • Get moving. Any physical activity in fresh air (if possible), an hour before meals, even if it’s just a short walk (20 minutes) around the block, can fuel and stimulate your appetite. (Consult your health care team before starting an exercise program). Also a light housekeeping task, or playing with a pet can help you develop an appetite.

Emotional


Your emotional state and how you cope with your cancer may also cause a loss of appetite.
  • Don’t give yourself a hard time if you really don’t feel like eating for a few days after treatment. It is important to drink, but you can make up for lost calories between treatments.
  • Worrying about not eating can further affect the appetite. Try to accept that you may find only a few kinds of food appealing. Do your best to include variety and choice in your diet.
  • Tell family and friends that talking too much about your appetite can make you feel worse.
  • Sometimes loss of appetite during cancer therapy is a symptom of depression, anxiety, fear, and stress. If you think you may have problems with your mood and emotions, speak to your doctor about your concerns. Support groups are another resource that may help in processing these emotions.
  • Think of food as a necessary part of treatment.
  • Avoid getting overtired. You will find everything more difficult to cope with if you are exhausted.

Caregivers


  • Don’t blame yourself if the patient refuses food or can’t eat.
  • Be encouraging, but try not to nag or fight about eating.
  • If the patient can’t eat, you might want to offer just your company. Or offer to read to them or give them a massage.
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References


1. Appetite Loss. CancerNet. 2018. Available at: cancer.net. Accessed May 5, 2018.

2. Loss of appetite – Canadian Cancer Society. wwwcancerca. 2018. Available at: cancer.ca. Accessed May 5, 2018.

3. Poor Appetite. Cancerorg. 2018. Available at: cancer.org. Accessed May 5, 2018.

4. Cancer C. Cancer and Chemo-Based Lack of Appetite and Early Satiety – Managing Side Effects – Chemocare. Chemocarecom. 2018. Available at: chemocare.com. Accessed May 5, 2018.

5. No appetite? How to get nutrition during cancer treatment. Mayo Clinic. 2018. Available at: mayoclinic.org. Accessed May 5, 2018.

6. Appetite loss. Stanfordhealthcareorg. 2018. Available at: stanfordhealthcare.org. Accessed May 5, 2018.

7. Appetite Loss. National Cancer Institute. 2018. Available at: cancer.gov. Accessed May 5, 2018.

8. Managing Your Loss of Appetite: Chemotherapy and Prostate Cancer – UCLA Urology. Urologyuclaedu. 2018. Available at: urology.ucla.edu. Accessed May 5, 2018.

9. Loss of appetite | Advanced cancer | Cancer Council NSW. Cancer Council NSW. 2018. Available at: cancercouncil.com.au. Accessed May 5, 2018.

10. Cold F, Health E, Disease H et al. How to Eat When Chemo Kills Your Appetite. WebMD. 2018. Available at: webmd.com. Accessed May 5, 2018.

11. Loss of Appetite – Lung Cancer Alliance. Lung Cancer Alliance. 2018. Available at: lungcanceralliance.org. Accessed May 5, 2018.

12. Appetite Changes: A Side Effect of Treatment. Breastcancerorg. 2018. Available at: breastcancer.org. Accessed May 5, 2018.

13. Nutritional Management of Loss of Appetite During Cancer Treatment – Health Encyclopedia – University of Rochester Medical Center. Urmcrochesteredu. 2018. Available at: urmc.rochester.edu. Accessed May 5, 2018.

14. 8 Tips for Managing Weight during and after Cancer Treatment | Memorial Sloan Kettering Cancer Center. Mskccorg. 2018. Available at: mskcc.org. Accessed May 5, 2018.

15. Appetite Changes. MD Anderson Cancer Center. 2018. Available at: mdanderson.org. Accessed May 5, 2018.

16. Treatment side effects and nutrition – Cancer Council Victoria. Cancervicorgau. 2018. Available at: cancervic.org.au. Accessed May 5, 2018.

17. Tips for diet problems | Coping with cancer | Cancer Research UK. Cancerresearchukorg. 2018. Available at: cancerresearchuk.org. Accessed May 5, 2018.

18. Nutrition During Cancer Treatment | OncoLink. Oncolinkorg. 2018. Available at: oncolink.org. Accessed May 5, 2018.

19. If you have changes in appetite – Information and support – Macmillan Cancer Support. Macmillanorguk. 2018. Available at: macmillan.org.uk. Accessed May 5, 2018.

20.Loss of appetite after cancer treatment. Cancerie. 2018. Available at: cancer.ie. Accessed May 5, 2018.