The appetite is controlled by several factors in the body. It is a complex interplay of hormones, signals from the gut and brain centers which also involves the sense of taste, smell and even sight. A healthy appetite is where a person desires food but is satisfied (satiety) once enough food is consumed to maintain the blood sugar levels and provide energy for a period of time thereafter. A common problem among seniors is a loss of appetite (anorexia). It is usually a gradual decline in the appetite and the development of poor eating habits but in some instances it can arise in the short term.

Age and Appetite Loss

As a person gets older, the body’s ability to regulate many functions becomes impaired. The metabolism is one of these systems and the appetite is affected accordingly. This often leads to problems with energy levels and is one of the reasons why the elderly tend to feel fatigued more easily. However, appetite is controlled and determined by a number of factors.

1. Dulling of the senses with age may also hamper the sensory component (taste, smell and sight) which usually increases one’s appetite.
2. The elderly are often less active that younger adults, whether due to choice, a lack of energy or inability to move with ease. Less activity means lower energy needs and subsequently a decrease in appetite.
3. Sometimes the condition is not associated specifically with appetite – the desire still exists but the ability to chew and digest food is impaired which detracts a person from eating.

Although none of these factors should be considered normal, the reality is that it occurs in almost every elderly person to some degree or the other. It is therefore accepted as a part of aging.

Abnormal Loss of Appetite

Sometimes a loss of appetite is associated with specific diseases or medication and is not just a sign of age related changes in the body. It can arise as the first symptom when no other symptoms are present. A loss of appetite is often considered to be non-specific meaning that it does not clearly indicate a cause. It occurs in many diseases, not only those affecting the gut, metabolism, hormones or brain.

Causes of Appetite Loss in the Elderly

Although many diseases may cause a loss of appetite, the elderly need to be cautious of certain conditions which are more likely with advancing age. This includes :

• Heart failure
• Kidney failure
• Chronic liver disease
• Cancer
• Chronic obstructive pulmonary disease (COPD) – chronic bronchitis or emphysema

Not all of these conditions which cause loss of appetite are physical ailments. Emotional states such as grief, depression and dementia can als0 compromise the appetite. Furthermore the elderly, who are often on various medication for a host of chronic diseases, may experience a loss of appetite as a result of side effects.

Treating Loss of Appetite

There is no specific treatment for loss of appetite in the elderly. Any treatment should be directed at the causative condition and the appetite may subsequently improve. However, in cases where the loss of appetite is not associated with any disease and just appears to be another change in the body’s physiology with age, a few simple measures can help improve appetite or at the very least avoid problems associated with poor nutrition.

• Keep regular meal times and eat even if not hungry. Small meals are sufficient.
• Combine favorite foods with other less desirable items to ensure a balanced diet.
• Avoid excessive amounts of sweet and high fiber foods as it can make one full for long periods. Rather eat these foods in moderation.
• Speak to a dietitian for a suitable eating plan combining desired foods while taking one’s medical history into consideration. This may help to avoid an upset stomach or other effects that may be hampering the appetite.
• Understand the impact of skipping meals or consuming small meals that lack nutrition, like the tea and toast diet. Awareness may compel a change in eating habits despite the lack of appetite.
• Have a brisk walk about an hour before meal time to stimulate the appetite.
• Avoid sipping beverages such as coffee, tea or soft drinks all day as this can upset the appetite.