If only eating was a simple process – you get hungry, you eat until you full, you stop eating but I see it time and time again where it is so hard to eat when you don’t have an appetite or you can’t stop eating

There is a difference between hunger and appetite. Hunger is the biological need to eat and appetite is the desire to eat. You can have an appetite and not be hungry.   Our appetite can also dictate what type of food we eat and how much we eat.  When we are hungry we will eat anything – with an appetite we might be a little more fussy. 

Lots of factors can affect appetite – either increasing or decreasing that desire to eat.

 

Diet: 

Carbohydrates, fats and proteins all affect appetite. A diet rich in protein should manage our appetite, keep us full for longer and help to stabilize our blood sugar. (1)

 A diet rich in carbohydrates can create a rollercoaster of feeling full and then feeling hungry and can increase our appetite. The anticipation, sight, smell or taste of yummy high-carbohydrate foods (I’m talking biscuits, cakes, chippies, bread, pasta here not veggies) can stimulate appetite. After we eat carbohydrates, we have an increase in glucose, an increase of insulin which gets the glucose into our cells and out of our bloodstream which then makes us hungry again…a vicious circle for some people. (2)  A 2017 study showed those who followed a Ketogenic diet had an increase in appetite at the start of the diet which then stabilised. (3) 

Mood:

Emotional eating can go hand in hand with appetite. When we are stressed or upset then our appetite can either increase or decrease. When my son was hospitalised as an 18 month old my appetite completely disappeared. I had to force myself to eat.  Our appetite might increase because food becomes our comfort. Certain mental health conditions can also affect our appetite especially depression, although it can affect people very differently either increasing or decreasing it. (4)

 

Medication

Certain medications are known to affect appetite and may also affect weight including blood pressure, diabetes and chemotherapy medications, antibiotics, steroids and some anti-depressants. It’s worth checking in with your doctor and asking about side effects when you are prescribed medications. 

 

Medical Conditions

It’s common to lose your appetite when you are unwell for a short time but there are some conditions where losing appetite can be a symptom. Thyroid conditions can influence appetite (increased or decreased)  and also how we burn that food and turn it into energy or fat. (5) 

Other conditions such as cancer, Parkinson’s and Kidney disease can all result in a lack of appetite and subsequent weight loss.  It is incredibly important that if you lose your appetite for more than a week or so and/or are starting to lose weight unintentionally that you see your GP. 

 

Age

As we get older our appetite may decrease due to hormones, social circumstances, bereavement, declining energy needs, changes in our taste and smell, problems with our teeth…something to look forward to. (6)

 

Hormones and our Cycle 

Hormones are responsible for appetite  – in particular Leptin and Ghrelin.  Leptin is made by our fat cells and is responsible for decreasing our appetite and making us feel full  and Ghrelin is responsible for making us hungry and increasing our appetite. Ghrelin is produced in the stomach and sends a message to the brain that you need to eat. Once you eat, Ghrelin levels drop substantially for about 3 hours after eating. Scientists have found that slimmer people have low amounts of leptin and obese people have more, sometimes they might build up a resistence to the appetite suppressing effects of this hormone. (7) 

Our reproductive hormones also make a difference, oestrogen inhibits food intake, whereas progesterone and testosterone may stimulate appetite. This is why we may have a low appetite around ovulation (8) but our appetite increases more in the 2nd half of our cycle. Cortisol also increases in the 2nd half of our cycle which means we need more nutrients to manage this. Interestingly, some studies have shown that androgens (such as testosterone) may be involved in abdominal obesity common in mid-life women (thank you Meno Belly) and others have shown that oestrogen based HRT can reduce that belly fat. 

Insulin (another hormone) has a relationship with oestrogen so it is common that as oestrogen drops during perimenopause, insulin increases and insulin resistance can become more common affecting appetite and weight gain. (9)

 

Gut Bacteria

Sadly sometimes you don’t have any control over your appetite or even weight.  There have been a number of studies that show that specific bacteria produce proteins that influence our food intake, change our taste buds, increase our appetite and cause cravings.

Different bacteria prefer different foods depending on the what gives them the energy to thrive.  Bacteroidetes prefer fats whereas our good friends Bifidobacteria prefers foods rich in fibre. Carbohydrates are the best source for Our beneficial Akkermansia muciniphila thrive on carbohydrates (not the chocolate cake kind, the fruit and veggie kind).  This means that you have the ability to improve your appetite and cravings by eating healthier foods (veggies and fruit) to ensure that it is the ‘good bacteria’ calling the shots. (10 – 12)

 

Why don’t I have an appetite in the morning? 

There can be lots of reasons for not having an appetite after you wake up – 

• You ate your dinner late or you ate a large dinner and therefore still feel full (especially when that ,meal was protein or fat rich). (13) 
• Your sleep has affected your appetite –  Ghrelin tends to be low first thing in the morning (14) and adrenaline (and cortisol) which are higher in the morning can suppress your appetite by encouraging our body to break down stored glucose to fuel us. Poor sleep is associated with an increase in ghrelin levels, appetite, and hunger.
• Pregnancy, mental health conditions or being unwell or run down will all affect appetite in the morning. 

 

Tips

1. Have protein and veggies as the foundation of your meal and then add any other carbs as a side – the less active you are the less carbs you need. Protein suppresses ghrelin more effectively so you don’t overeat. It also ensures that glucose from carbohydrates is slowly absorbed so you don’t get the high increase and quick crash. 
2. Get a good night’s sleep – 8-10 hours if possible.
3. Eat more in the 2nd half of your menstrual cycle – appetite and cravings naturally go up then – don’t fight this. Just make sure that what you eat is nutrient dense and not sugar or salt dense.
4. Make sure you are drinking enough water – 102 glasses on waking and then at least 2 water bottles sipped throughout the day – more if you are active. Dehydration can affect appetite. 
5. Mindful eating can improve appetite and also stop over eating too – spend time smelling and looking at food, make food visually appealing on your plate, use spices and herbs (they improve flavour AND are good for us), eat consistently at the same time every day (our body like routine)
6. Get moving – exercise can improve our appetite and can also help if stress or sleep is a cause behind the appetite problems. 
7. If you really struggle with your appetite then eat smaller meals more frequently or try soups, broths and stews.

 

References

1. https://www.sciencedirect.com/science/article/abs/pii/S0268005X1630340X
2. https://www.sciencedirect.com/science/article/abs/pii/S0195666382800172
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5550564/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818200/
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3112506/
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4589891/
7. https://www.webmd.com/diet/features/your-hunger-hormones
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964739/pdf/BMRI2014-757461.pdf
9. https://pubmed.ncbi.nlm.nih.gov/22281161/
10. https://www.gutxy.com/blog/understanding-the-role-of-gut-microbes-on-eating-behaviour
11. https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-021-01093-y
12. https://www.smithsonianmag.com/science-nature/gut-bacteria-may-be-controlling-your-appetite-180957389/
13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4960974/
14. https://pubmed.ncbi.nlm.nih.gov/30232416/

 

 

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