Palliative Care: When Illness reduces your Appetite

Information and guidance for patients in palliative care, their families and carers

When you have a severe illness, you may lose weight and your appetite may become smaller than usual. This may be because you are feeling sick, have a sore mouth or feel constipated. Medication can help, but sometimes it is not possible to relieve these symptoms completely.

Often the illness itself can cause you to lose both your appetite and weight. This does not always improve or return to ‘normal’. Because of this, you may not be able to eat as much as you used to and you may prefer smaller meals.

You may also find that the amount you eat or drink changes from day to day, or from hour to hour, for no reason. You may also notice that you are becoming thinner.
If you notice a change in your appetite or weight, let your doctor, nurse or dietitian know. They will assess you to see if there is any treatment available to help you.

Why is my appetite smaller?

Severe illnesses such as cancer make the body produce chemicals which break down muscle and fat. These chemicals also ‘trick’ the part of the brain that controls appetite. The brain starts to think that you are full after only a few mouthfuls, or even after no food at all. Because of this, your appetite becomes smaller.

Will I starve if I don’t eat?

No. Changes that can occur in your body during serious illness are very different to those that happen when you are in good health and do not have enough to eat.

When you are seriously ill, your body may not be able to use food to build itself up. Because the body recognises that it can no longer use as much food as before, your appetite becomes smaller.

Things that may help you to eat more

Choose foods that you enjoy

Choose foods that you enjoy and that you are able to manage.

Try to eat the foods that you prefer, little and often.

Try small meals

Try to take a small meal at breakfast, lunch and dinner. If you do not feel like a cooked meal, have a small snack or a drink instead.

Tell people what you would like

If you have family or friends around to help, chat to them about the types of meals that you would like.

Eat at least some of a meal

If you do not feel like eating a full meal, have part of the meal instead. For example, try to eat the meat, or the potato and vegetables.

If meals on a large dinner plate put you off, try having smaller portions on a small plate.

Eat snacks

Keep a variety of snacks in the house so that if you do not feel like a meal, you can try something else instead.

Eat regularly

If you cannot manage large meals, have a snack or small meal every 2-3 hours instead. Try foods like cereal, soup, milky pudding, trifle, mousse, stewed fruit and custard, soft cake, milk or yogurt, toast, cheese on crackers, or biscuits and milk.

If eating makes you tired

If you find that eating makes you tired, you might find it easier to eat softer food like porridge, soup, stew, poached fish, soft cooked eggs, or rice dishes.

Try drinks instead of solid food

You may find it easier to drink instead of eating. Try nourishing drinks like milk, milkshakes, yogurt drinks, or smoothies.

The role of oral nutritional supplements

Oral nutritional supplements are unlikely to help you gain weight at this time. But talk to your doctor, nurse or dietitian if you are upset by your lack of appetite and wish to try a supplement.

Get help if you cough while eating

If you find that you cough when eating or have difficulty swallowing, discuss this with your doctor or nurse. They might refer you to a speech and language therapist who can help you.

Try to eat the foods that you prefer, little and often.

Adapted by a team of dietitians working in palliative care in Ireland, with kind permission from Why won’t they eat?
Harris Hospice Care with St Christopher’s (St Christopher’s Hospice December 2010).

Palliative Care: When Illness reduces your Appetite217.63 KB

Any Questions please contact...

Marie Hannon I Dietitian Manager I MINDI I CORU No: DI 015776
Our Lady’s Hospice & Care Services I Harold’s Cross I Dublin 6W
Tel: 01 4068720. Internal extension 8720
Email: mhannon@olh.ie

Specialist Palliative Care Dietetic Services are also available in Milford Care Centre Limerick, Marymount University Hospital and Hospice Cork, Waterford Hospice and Regional Specialist Palliative Care Service HSE DNE