Anorexia is a medical term for a loss of appetite. While the term outside of the scientific literature is often used interchangeably with anorexia nervosa, many possible causes exist for a loss of appetite, some of which may be harmless, while others indicate a serious clinical condition or pose a significant risk.
Anorexia is a symptom, not a diagnosis.
The symptom also occurs in non-human animals, such as cats,[
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Etymology
The term is from (ἀν-, 'without' + όρεξις, spelled , meaning 'appetite').
Common manifestations
Anorexia simply manifests as a decreased or loss of appetite. This can present as not feeling hungry or lacking the desire to eat.
Physiology of anorexia
Appetite stimulation and suppression is a complex process involving many different parts of the brain and body by the use of various hormones and signals. Appetite is thought to be stimulated by interplay between peripheral signals to the brain (taste, smell, sight, gut hormones) as well as the balance of and in the hypothalamus.
Common causes
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Abdominal pain
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Acute radiation syndrome
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ADHD
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Addison's disease
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Alcoholism
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Alcohol withdrawal
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Anemia
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Anorexia nervosa
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Anxiety
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Appendicitis
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Babesiosis
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Benzodiazepine withdrawal
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Bipolar disorder
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Bronchitis
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Cancer
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Cannabinoid hyperemesis syndrome
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Cannabis Drug withdrawal
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Celiac disease
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Chronic kidney disease
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Chronic pain
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Common cold
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Constipation
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COPD
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COVID-19
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Crohn's disease
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Cystic fibrosis
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Dehydration
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Dementia
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Depression
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Diabetes
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Ebola
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Fatty liver disease
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Fever
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Food poisoning
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Gastroparesis
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Heart failure
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Hepatitis
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HIV/AIDS
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Hypercalcemia
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Hyperglycemia
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Hypervitaminosis D
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Hypothyroidism and sometimes hyperthyroidism
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Influenza
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Irritable bowel syndrome
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Ketoacidosis
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Kidney failure
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Hypotension
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Macroglossia
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Mania
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Metabolic disorders, particularly urea cycle disorders
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MELAS syndrome
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Nausea
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Old age
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Opioid use disorder
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Pancreatitis
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Pernicious anemia (vitamin B12 deficiency)
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Pneumonia
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Psychosis
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Salmonellosis
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Schizophrenia
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Side effect of
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Stimulant use disorder
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Stomach flu
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Stress
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Sickness behavior
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Superior mesenteric artery syndrome
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Syndrome of inappropriate antidiuretic hormone secretion
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Tobacco smoking
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Tuberculosis
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Thalassemia
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Ulcerative colitis
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Uremia
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Folate deficiency
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Zinc deficiency
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Infection: Anorexia of infection is part of the acute phase response (APR) to infection. The APR can be triggered by lipopolysaccharides and from bacterial cell walls, bacterial DNA, and double-stranded viral RNA, and viral , which can trigger production of a variety of proinflammatory cytokines. These can have an indirect effect on appetite by a number of means, including peripheral afferents from their sites of production in the body, by enhancing production of leptin from fat stores. Inflammatory cytokines can also signal to the central nervous system more directly by specialized transport mechanisms through the blood–brain barrier, via circumventricular organs (which are outside the barrier), or by triggering production of in the of the brain vasculature. Ultimately, the control of appetite by this mechanism is thought to be mediated by the same factors normally controlling appetite, such as neurotransmitters (serotonin, dopamine, histamine, norepinephrine, corticotropin releasing factor, neuropeptide Y, and α-melanocyte-stimulating hormone).
Drugs
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, such as ephedrine, amphetamine, methamphetamine, MDMA, cathinone, methylphenidate, cocaine, etc.
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Horomone which are produced by adrenal glands and used as medication such as adrenaline.
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, such as heroin, morphine, codeine, hydrocodone, oxycodone, etc.
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Antidepressants may have anorexia as a side effect, primarily selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine.
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Exenatide, a type II diabetes drug, will cause moderate nausea and loss of appetite.
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Abruptly stopping appetite-increasing drugs, such as cannabis and .
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Chemicals that are members of the phenethylamine group. (Individuals with anorexia nervosa may seek them to suppress appetite.)
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Topiramate may cause anorexia as a side effect.
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Other drugs may be used to intentionally cause anorexia in order to help a patient fasting prior to general anesthesia. It is important to avoid food before surgery to mitigate the risk of pulmonary aspiration, which can be fatal.
Other
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During the post-operative recovery period for a tonsillectomy or adenoidectomy, it is common for adult patients to experience a lack of appetite until their throat significantly heals (usually 10–14 days).
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Allergy
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Altitude sickness
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Airsickness
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Significant Broken heart caused by an event (rather than a mental disorder) can cause an individual to temporarily lose all interest in food.
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Several Twelve-step programs including Overeaters Anonymous tackle psychological issues members believe lead to forms of deprivation
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Psychological stress
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Toothache
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Experiencing grotesque, unpleasant or unappealing thoughts or conversations
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Being in the presence of unappealing things such as waste matter, dead organisms, or bad smells
Complications
Complications of anorexia may result due to poor food intake. Poor food intake can lead to dehydration, electrolyte imbalances, anemia and Malnutrition. These imbalances will worsen the longer that food is avoided.
Sudden cardiac death
Anorexia is a relatively common condition that can lead patients to have dangerous electrolyte imbalances, leading to acquired long QT syndrome which can result in sudden cardiac death. This can develop over a prolonged period of time, and the risk is further heightened when feeding resumes after a period of abstaining from consumption.
Refeeding syndrome
Care must be taken when a patient begins to eat after prolonged starvation to avoid the potentially fatal complications of refeeding syndrome. The initial signs of refeeding syndrome are minimal, but can rapidly progress to death. Thus, the reinitiation of food or oral intake is usually started slowly and requires close observation under supervision by trained healthcare professionals. This is usually done in a hospital or nutritional rehabilitation center.
Management
Anorexia can be treated with the help of orexigenic drugs.
