How to Manage Loss of Appetite
This guide is for people who have a loss of appetite before, during or after cancer treatment. It can be used by patients, family, friends or caregivers. It does not replace advice from your health-care team.
What is cancer-related loss of appetite?
Loss of appetite is when you do not have feelings of hunger or interest in food. If you are not able to eat, you may lose weight and not be strong enough for your treatments.
What causes cancer-related loss of appetite?
Some things that can make you not want to eat include:
- Side effects from cancer treatments, like nausea and vomiting
- Depression or anxiety
- Being put off by the smells of cooking and food
- Medications
- Constipation and diarrhea
- Pain
- Fatigue
- Cancer itself
What can I do when I do not feel like eating?
Ask for a referral to a registered dietitian
A dietitian can help you make a plan to eat and drink when you have no appetite.
Treat symptoms that might be affecting your appetite. If pain, nausea or any other symptoms are making you not want to eat, talk to your health-care team. Many symptoms can be treated, which may help to bring your appetite back. You can also visit unlockfood.ca or call 1-866-797-0000 to connect with a registered dietitian for free.
Make every bite count
You need to get enough calories, protein and liquids in your diet to keep up your strength and keep going with your treatments.
Eat and drink often. Eat small meals more often instead of two or three big ones. Try to have a few mouthfuls of food every one to two hours, even if you do not feel hungry. Have easy-to-eat, nutritious snacks with you, like cheese and crackers, pudding cups, hummus and vegetables, and yogurt.
Choose higher-calorie foods. These simple changes give you more calories without having to eat more food.
| Switch from | To |
|---|---|
| Skim milk | 2% or whole milk |
| Tea or coffee | Hot chocolate made with whole milk |
| Broth soup | Cream soup made with milk |
| Water | Juice (or diluted juice) |
| Low-fat dairy | Full-fat dairy (sour cream, yogurt, cottage cheese) |
| Frozen yogurt or sorbet | Ice cream |
| Oatmeal | Granola (soaked in whole milk or full-fat yougrt) |
Choose food and drinks that are high in protein
Protein helps your body heal when you are going through cancer treatment. These foods are high in protein:
- Dairy products like milk, Greek yogurt, pudding and cheese
- Meat, poultry, fish and seafood
- Tofu, soy beverages, nuts, seeds, peanut butter
- Dried peas, beans and lentils
- Eggs
Make high-protein milk by adding one cup of skim milk powder to four cups of whole milk. Use the high-protein milk in cream, soups, stews, gravies and sauces.
Add protein powder to liquid foods or baking. The amount of protein in each brand of powder may be different, so read the label or ask your dietitian to help you.
Add more fat to your food
Here are some simple ways to make your foods more calorie-rich.
| Add | To |
|---|---|
| Olive oil, butter or margarine | Noodles, rice and bread |
| Gravy or sauces | Mashed potatoes and meats |
| Cream, honey, maple syrup and jams | Fruits, yogurts and desserts |
| Mayonnaise | Salad dressings, sandwiches, tuna and egg salad |
| Whipping cream | Soups, custards, fresh fruit, smoothies or pasta sauces |
| Avocado | Sandwiches, quesadillas or mash it and use a dip or spread |
| Nuts and nut butters | Toast, smoothies and snacks |
| Full-fat cheese | Sandwiches, melted on vegetables, in sauces or as a snack |
| Sour cream | Potatoes, dips |
Drink at least six to eight cups of liquids each day
Use these tips to help you get enough liquids:
- Drink often throughout the day
- Choose liquids with calories like juice, milk, soup and fruit smoothies
- Keep a water bottle with you, filled with your favourite drink
- Limit drinks with caffeine (cola, coffee, tea) and alcohol
If you need to get more calories, try these high-calorie drinks:
- Breakfast drink mixes
- Commercial nutrition supplements or ask at your local health food or grocery store
- Whole milk or chocolate milk
- Milkshakes or homemade smoothies
- Yogurt drinks
- Malted milk powders and other malted drinks
Tip: Ask your health-care team if you can take your medication with milkshakes or other high-calorie drinks.
Eat whatever foods appeal to you
Eat whatever tastes good to you, whenever you feel up to it. Do not worry about sticking to your usual schedule for meals. Eat your biggest meal of the day when you feel your best. If you feel best in the morning, eat more then. You can eat breakfast foods for dinner or dinner foods for breakfast. Eat your favourite foods at any time of the day. Try using smaller plates or bowls.
Eat convenience foods if you have trouble preparing meals
Try these tips to make preparing meals easier:
- Contact your local community meal service program (like Meals on Wheels)
- Buy frozen foods that are easy to put in the oven
- Try mini-quiches, pot pies, chicken fingers, frozen pastas and any other foods that appeal to you
- Buy pre-cut vegetables, fruits, cheese and other quick snacks
- Use the deli counter at your local grocery store for pre-prepared meats, salads and other foods
Be active and exercise
Exercise can help boost your appetite when you do not feel like eating. Even small amounts of exercise can help. Try to get up and do something every day. Choose an activity you like. Start slowly with something like gentle stretching and a short walk. Go at your own pace.
Be safe. Talk to your health-care team if you have questions about how to exercise safely. You can exercise at any time during or after treatment. Stop and rest if you feel sore, stiff or out of breath.
Get help from family and friends
Family and friends may be upset by how little you want to eat. Share this list with them so they know how to help you in the best way.
You should not be forced to eat. Family and friends should encourage you to eat what you want, when you want to eat it. This is not the time to judge or try to change your loved one’s choice of foods. Tell family and friends that talking too much about your appetite can make you feel worse. Accept help from family and friends who offer to cook and shop for you – they may be looking for ways to help. Tell them which foods you like and are able to eat. Invite people over so you can eat together. This might help you eat more.
Medications might help your appetite
Even after improving all the things that can be treated, you may still not have much of an appetite. Sometimes appetite stimulation medications might help. Speak with your physician and health-care team for more information.
When should I talk to my health-care team?
Tell your health-care team right away if you:
- Have nausea and/or vomiting that does not get better
- Cannot eat for a day or more
- Have pain when eating
- Cannot pee for an entire day
- Have not had a bowel movement (gone poo) for more than two days
What is symptom screening?
Doing your symptom screening helps you and your health-care team to manage symptoms. In Ontario, patients with cancer fill out a symptom screening tool. The screen tells your health-care team about your symptoms and how you are feeling. The tool is called the Edmonton System Assessment System (ESAS).
You may need help with your loss of appetite if:
- You do not feel hungry, even if you have not eaten in several hours or even days
- You are losing weight and notice a loss of muscle and strength
- Your loss of appetite is causing you worry or stress
- You need help making a plan to eat more
Where to get more information
Visit the websites below for more information and support.
Websites
Support services
Books
- Goes Down Easy: Recipes to help you cope with the challenge of eating during cancer treatment – Elise Mecklinger, 2006
- The Essential Cancer Treatment Nutrition Guide & Cookbook – Jean LaMantia and Neil Bernstein, 2012
- Eating Well When You Have Cancer – Canadian Cancer Society
For more information on this symptom, or for guides to help manage other symptoms, visit Managing Symptoms, Side Effects & Well-Being.
If you need this information in an accessible format, contact 1-855-460-2647, TTY: 416-217-1815 or [email protected].
The recommendations in this guide are based on published evidence and expert consensus. The information in this guide was adapted from the following patient tools:
- Food ideas to help with decreased appetite, Healthy eating using high-energy, high-protein foods (BC Cancer Agency)
- What to eat when you don’t feel like eating (University Health Network)
- Appetite (Sunnybrook Health Sciences Centre)
This patient guide was created by Cancer Care Ontario to provide patients with information about loss of appetite. It should be used for information only and does not replace medical advice. This guide does not include all information available about managing loss of appetite. Always ask your health-care team if you have questions or concerns. The information in this guide does not create a physician-patient relationship between Cancer Care Ontario and you.