Changes in appetite are not uncommon as we age.
But when a once-healthy appetite begins to fade, it can be both concerning and confusing.
Whether it’s a gradual decline or a sudden shift, loss of appetite later in life can signal a range of underlying issues, from physical health problems to emotional wellbeing. Left unaddressed, reduced food intake can lead to malnutrition, weight loss and a decline in overall vitality.
We got in touch with Dr Nick Thompson, consultant gastroenterologist and president of the British Association for Parenteral and Enteral Nutrition (BAPEN), who has outlined seven common reasons why appetite may decrease – from medication side effects to mobility issues – and he has offered some practical strategies for managing these factors.
1. Mobility
“As you get older you might struggle to get to a supermarket because you don’t drive, or have a disability or eyesight problems,” recognises Thompson. “You may only have access to a corner shop, and although walking there is good exercise, it may not offer any fresh fruit or vegetables. So, if you are relying on that, then you may become deficient in certain minerals or vitamins, like vitamin D or selenium, which can then impact your appetite.”
2. Poor dentition
Poor dentition, which includes issues like misalignment of teeth, missing teeth and oral pain, can significantly impact appetite and food intake.
“Dentition is often worse in older adults can feed into a reduced appetite,” explains Thompson. “For example, some people find it more uncomfortable or difficult to eat certain foods, so they’ll avoid them altogether.”
3. Depression and mental health
“One of the cardinal features of depression is a change of appetite,” highlights Thompson.
4. Medication
“The older you are, the more likely you are to be on medication, and polypharmacy [taking multiple medications concurrently] can have an impact on appetite,” says Thompson. “Many antidepressants and analgesics in particular can have an effect on appetite.”
5. Loneliness and isolation
“With some older people who live on their own, when you ask them about what they eat, they’ll often say I can’t be bothered,” says Thompson. “Often it’s an older person whose partner has died, and now they tend to eat more snacks and easy things like sandwiches, and don’t cook in the way that they used to. So, isolation and loneliness can have a significant influence on appetite.”
6. Illness
“Lots of illnesses have an impact on appetite, and the likelihood of getting ill tends to increase as you get older,” says Thompson. “There are some gut issues, such as small intestinal bacterial overgrowth (SIBO), which become more common as you get older and can impact appetite.”
7. Constipation
As people age, their digestive system processes tend to slow down, and they may also be more prone to certain medical conditions and medications that can contribute to constipation.
“There are some illnesses which are more common in the elderly and can impact constipation,” says Thompson. “If you’re less mobile and have to go on bed rest, for example, you often become more constipated. When you are bunged up, you often just don’t feel so hungry.”
Ways to counteract these effects:
As lots of different factors can impact appetite later in life, it’s important to recognise what might be the cause in your case, so you can begin to think about ways to resolve this.
Make eating social
“The factors contributing to a reduced appetite and the balance of reasons for this will be different for everyone, so it’s important to ask yourself why is it that I eat a bit less?” says Thompson. “Is it because of the sociability? Is there a way in which I can address that? Is there a way of maybe eating with the family? If we eat with others, that will often help things.”
Review your medications
“Don’t stop any medication without discussing with your GP first, but it might be worth thinking about if any of your medications might be impacting your appetite, if you are worried about your appetite and are losing weight,” says Thompson. “Then it might be a conversation with the GP or the prescriber about if you need the medication – or if you can have a lower dose or switch to an alternative that doesn’t have the same effect.
“Or they might say you need to carry on taking a specific medication but they will help you find another way to increase your food intake.”
Exercise
Regular physical activity can play a role in regulating appetite and promoting overall wellbeing.
“If you have more muscle, you’ll have greater function and will be able to do more – it’s a direct relationship,” says Thompson. “So, any exercise that you can do to preserve mobility and strength with help.”
Think about your diet
“Vitamin deficiencies, particularly in vitamin D, is very common in the elderly,” says Thompson. “Think about your diet – what are you missing? Is there a way in which you can get some fresh fruit and vegetables back into your diet?”
