Weight Changes, Appetite Loss, and Cancer

Whatever direction your weight goes, tell your team. A registered dietitian can help you and your family manage these changes with a plan that fits you.

Report appetite or weight problems to your doctor right away. This includes weight loss of more than 3 to 5 pounds in one week. Also tell your doctor about sudden weight gain, such as 5 pounds in a week, or weight gain that does not stop.

Cancer and cancer treatments can change your appetite and your weight. Appetite loss and weight loss are common, but some people gain weight instead. Weight loss can lead to malnutrition, when your body does not get enough nutrients.

Anyone with cancer might lose their appetite and lose weight. It is more likely with head and neck, lung, pancreatic, or liver cancer, or cancer in the upper digestive system. Appetite loss often leads to eating less than your body needs, which leads to weight loss.

Many side effects make eating harder, including nausea and vomiting, diarrhea, constipation, feeling full quickly, painful swallowing, mouth sores, dry mouth, and taste changes. Anxiety, pain, depression, and fatigue can also reduce appetite.

Ways to manage appetite loss:

• Eat foods high in protein and calories. Eat high-protein foods first, when your appetite is strongest.
• Eat small meals every 2 to 3 hours, about 5 or 6 meals a day. Set an alarm if you forget.
• Eat within an hour of waking, and have a bedtime snack.
• Drink milkshakes, smoothies, juices, or soups if you do not feel like eating solid foods. Use whole milk or yogurt to add calories.
• Sip nutrition supplement drinks like Ensure or Boost between meals.
• Add cheese, creamy sauces, beans, or leftover meat to boost calories and protein.
• Make eating pleasant. Candles, music, and eating with loved ones can help.

If you cannot keep your appetite up, ask your doctor about appetite stimulants. These are medicines that increase appetite.

Although many people lose weight, you may gain weight during treatment. This is more common with ovarian, breast, or prostate cancer. Small weight changes are normal, but tell your doctor about sudden gain or gain that does not stop.

Causes of weight gain include:

• Fluid retention, from the tumor or fluid buildup.
• Increased appetite, from the cancer, treatment, or medicines.
• Metabolic changes, since hormone therapy can slow your metabolism.
• Medications, especially steroids, which increase appetite and can cause the body to hold onto water.
• Decreased activity, when fatigue and pain make it hard to move.

To manage weight gain, choose high-fiber foods, lean proteins, and low-fat dairy. Limit fat, salt, sugary drinks, and alcohol. Eat slowly and use smaller plates, and stay as active as you can. If steroids cause swelling, limiting high-sodium foods can help.

Malnutrition is when your body does not get enough energy, protein, vitamins, and minerals. It can be caused by the cancer, the side effects of treatment, or both. Decreased appetite is a main cause in people with cancer. Problems with swallowing, digestion, and absorption can add to it.

Why it matters: malnutrition can make you weak and tired. It can make it harder to fight infection or finish treatment, lower your quality of life, and even become life-threatening.

Your team may use nutrition screenings to catch eating problems early. To help prevent malnutrition, eat high-calorie and high-protein foods, use supplement drinks, and eat small meals every 2 to 3 hours. If eating stays very hard, your doctor or dietitian may suggest tube feeding or IV nutrition.

Family and friends can help with meal planning, shopping, cooking, and cleaning. Give them a list of your favorite foods. Your doctor and registered dietitian are your nutrition experts. They can help before, during, and after treatment.

For caregivers: do not be surprised if your loved one's food preferences change day to day. Offer gentle support rather than pushing them to eat, and talk through eating problems together.

• Call 911 or go to an emergency department if you cannot be roused properly, become confused, or faint after a long stretch of drinking almost nothing. If you are on chemotherapy, do the same for a temperature of 100.4°F (38°C) or higher — CDC calls a fever during chemotherapy a medical emergency, and it should not wait for a callback.
• Call your care team the same day if you cannot keep any food or fluid down for a whole day, you are passing very little urine, or pain in your mouth or throat has made drinking impossible.
• Call your care team within a day or two if you lose more than 3 to 5 pounds in one week, gain about 5 pounds in a week, or the gain keeps going. Do the same for new puffiness in your ankles or a belly that suddenly feels tight and full.