How to Manage Appetite Changes with Cancer

It’s normal to experience appetite changes when you’re going through cancer treatment. These changes can have many causes, including the cancer itself and side effects of medication or other treatments. It’s important to talk about your appetite and eating habits with your healthcare team so they can support you in getting the nutrition you need and maintaining a healthy body weight.

Here’s what you need to know about appetite changes and cancer.

Reduced appetite

Reduced appetite is very common in people with cancer. You might hear this referred to as anorexia. In the context of cancer treatment, anorexia just means appetite loss. It is different from the psychiatric condition anorexia nervosa.

Here are the common causes of low appetite in people with cancer.

Cancer can make you feel full. This can happen if you have cancer in your abdomen, or if inflammation of abdominal organs (like your liver or spleen) or fluid buildup causes pressure on your stomach. Fluid buildup around your organs is called ascites. This condition can happen with several types of cancer (ovarian, breast, colon, pancreatic, liver, and stomach cancer).
Cancer can impact metabolism. Cancer can cause changes in how your body breaks down food and turns it into energy. This condition, called cachexia, involves significant weight loss in addition to low appetite. It is rare in people with early-stage cancer but very common in people with advanced cancer.
Cancer treatments can cause side effects that impact your appetite. Chemotherapy, immunotherapy, radiation, and medications often used in cancer treatment, like opioids or antibiotics, can cause a low appetite as well as a variety of other side effects that can make eating and drinking seem unpleasant. These can include changes to the way foods taste or smell, pain, nausea and vomiting, fatigue, mouth sores, difficulty swallowing, dry mouth, and diarrhea or constipation. Surgery that impacts your digestive system can slow down the digestive process and make you feel full even when you need to eat. These side effects can make foods you used to enjoy less appealing, or make you less interested in eating in general.
Emotional impacts of cancer and treatment can lower your appetite. Reduced appetite is common in people who are feeling depressed or anxious.
Less physical activity can make you less hungry. Feeling unwell and exhausted, physically, emotionally or both, means you may not be as active as you used to be. This can impact your appetite.

The best way to improve low appetite is usually to address its root cause, if that is possible. If your cancer treatment is the cause, your appetite should return in the weeks and months after treatment ends. Cachexia related to advanced cancer is usually long-term. Either way, your healthcare team can help you find ways to get the best nutrition possible even when your appetite is small or you have trouble eating and drinking.

Some medications can help increase your appetite in the short term. These include steroids, progesterone hormones, cannabinoids, and metoclopramide, which stimulates stomach emptying. These medications can all have significant side effects so it’s important to weigh the benefits and risks with your treatment team.

Tips for managing low appetite

If you have a reduced appetite, it’s best to work with your body to try to make eating easier and more appealing, rather than forcing food down when it seems very unpleasant. (This can actually make a low appetite worse and make eating more difficult over time).

Here are some strategies to try:

Even modest physical activity before a meal can help increase your appetite. Try 10 or 20 minutes of walking, stretching, or yoga.
Keep a stash of prepared and frozen foods and snacks that don’t take much work or time to prepare, so you can easily have food ready whenever you do feel hungry.
Take snacks with you whenever you leave home.
Focus on foods that do seem appealing and eat them any time of day (leftover take-out for breakfast or pancakes for dinner, for example). Be kind to yourself and flexible about eating whatever does seem appetizing, whenever it seems appetizing.
Try to eat small portions of food more often, rather than relying on three large meals each day.
Maximize the nutritional impact when you do feel like eating by choosing high-protein and high-calorie foods, like yogurt, ice cream, eggs, nuts, cheeses, cereal, and granola or protein bars.
Try to add calories to meals with condiments like cheese, gravy, peanut butter, butter, sour cream, whipped cream, and half and half.
Drinks can sometimes be more palatable, so opt for nutrient-dense, protein-rich drinks like smoothies, nutritional shakes, milk, and milkshakes.
Try drinking fluids between meals instead of with them. It’s important to stay hydrated, but drinks can make you feel full, so avoiding them at mealtime can help you eat more.
If you have problems with changes to taste or smell that make food less appetizing, try cold or room temperature dishes or snacks. Hot food tends to have stronger smells and flavors.
If your sense of taste is affected by a metallic flavor, sucking on a hard candy before eating can sometimes help.
If your sense of taste is reduced, try adding strong flavors to foods with hot sauce, soy sauce, spices or other condiments (caution: if you are suffering from heartburn or reflux, strong spices or flavors can sometimes aggravate those conditions).

Causes of increased appetite in people with cancer

Some people see their appetite increase during cancer treatment. Here are the most common causes:

Chemotherapy can trigger food cravings. Many people who undergo chemotherapy experience intense cravings for carbohydrates, starchy foods like cookies, crackers, and bread. These cravings may be related to nausea caused by the chemotherapy. Carb-rich foods can reduce nausea.
Steroid medications can increase appetite. Steroids are commonly used in cancer treatment. They boost appetite and are sometimes used for this purpose in people whose appetites are very low. However, a higher appetite can also be an unwanted side effect when these medications are used for other reasons.
Emotions can play a role. While emotions like stress, depression, and anxiety can lower appetite in some people, they can have the reverse effect in others.

An increased appetite can play a role in leading to weight gain during cancer treatment for some people. Small weight changes are usually not a major concern. But maintaining a healthy weight long-term is very important to support the best chance of recovery and avoid other health problems, especially for women with breast cancer. If you notice your appetite has increased, talk to your healthcare team about how to manage it. Rapid weight gain may be from a cause other than overeating and should be reported to your healthcare team as soon as you notice it. Working with a dietician may be helpful.

There are also some strategies you can try yourself to reduce cravings and help you feel full.

Tips for managing increased appetite:

Opt for whole grains to satisfy carbohydrate cravings. These can help you feel full longer and are more nutritious than simple carbs like white bread, pasta, and most crackers and chips.
Include protein with carbohydrates to help satisfy cravings and keep you feeling full and energetic longer. Adding peanut butter to bread or crackers is an example.
Keep chopped fresh vegetables available to snack on.
Drink plenty of water, which can help you feel full. Herbal tea is another good option.
Avoid sugary and high-calorie drinks, which are often easier to consume than high-calorie solid foods.
Eating smaller meals more often throughout the day can reduce intense hunger and cravings.
Eat fresh fruit to satisfy sugar cravings. Fruit is a healthier choice than other sweets (your body can more easily process fruit’s sugar), and the fiber in fresh fruits can help you feel full.
Modest physical activity, like going for a walk, may help boost your energy, improve your mood and reduce food cravings.

Get help with appetite and eating challenges

Cancer and cancer treatments impact your body, mind, and habits in a variety of ways, and all of these can easily lead to changes in your appetite. Because appetite changes can affect your eating habits, they can lead to shifts in your nutrition and body weight. This can affect your treatment, recovery, and other aspects of your health, so it’s important to talk to your treatment team early if you notice any changes to your appetite. They will be familiar with any challenges and should be able to support you.

Here are a few additional resources to get you started:

Pearl Point

Cancer.gov

Cancer Dietitian

The content on this website is intended to provide the best possible information for you, but should not be considered—or used as a substitute for—medical advice. If you have questions about your diagnosis or treatment, please contact your health care provider(s). For questions or comments about this content, please email us at [email protected].