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Ep.51 – How to increase your appetite with IBS
19 Jun, 2024

Episode Intro

Do you need to increase your appetite? Maybe you know you need to eat more food because you are considered underweight, but you just don't feel like eating. It could be that you just don't get on well with eating much, and you find it hard to get excited about food. In this episode of the Inside Knowledge Podcast, You'll learn about how appetite works and how to stimulate your desire for food. You'll also learn how I suggest my gut reset clients measure their appetite, and you can download the tracker that I use with them to do this. So listen up for how to get a little bit more interested in food and hopefully start enjoying eating again.

Podcast transcript

Welcome to episode 51 of the Inside Knowledge podcast. I’m Anna Mapson. This episode is to follow on from the previous one, which was about how to gain weight. I realized when I got near the end of this episode, I had loads to say on actually how to increase your appetite because.

Appetite is an important part of gaining weight

Part of how to gain weight is feeling an urge to eat and being able to eat more.

You might know the specifics of what foods to increase and what calorie dense food you need to add in and how often to eat and all of that. But if you don’t feel hungry, it’s really hard to achieve all of that. In this episode, I’m going to talk a little bit about what can lower our appetite, so what might be one of the reasons that you don’t feel hungry.

And also how does hunger work and then quickly move on to some specific things that you can start working on in order to improve your appetite and hopefully start eating a little bit more. Some people like to differentiate between hunger and appetite and It’s more semantics, really, for most people.

Hunger is like your physical need for food, whereas appetite is more your desire for food. And sometimes it’s quite difficult to tell the difference. Is it a physical sensation that you’re feeling, or is it like a desire to eat certain foods? Craving, more like.

How appetite works

There’s a couple of ways that we physically get the sensation, the drive to go and eat. Mostly it’s when our stomach starts becoming empty. And a hormone is produced called ghrelin. This is our hunger hormone, and it’s released into the bloodstream, travels up to your brain, where it activates the hypothalamus, into a drive for food, drive for activity, that means you go and seek out food.

That process is triggered by not having any food in your stomach, so there are also things that indicate we need to get more food, which is a dip in our blood glucose, so that would be another trigger to go and seek food. So your body is responding to a lack of available glucose in the bloodstream, and that can be more like those sort of hangry feelings, like you feel irritable, maybe lightheaded and dizzy, headachy.

Those kind of hangry or hungry and angry feelings can often come through blood sugar dips. So those are the two basic ways that we are stimulated to go and look for food. One is a lack of actual content in our body, and the other one is a dip in some of the core nutrients that we need, specifically blood glucose, but also a lack of protein and a lack of healthy fats can also drive a need for food.

food and for appetite and that’s in healthy people, but we can also learn to override this and emotional factors can come into play. So the things that actually lower our appetite is often the gut brain connection driving it. So depression, or bereavement, like really significant grief, basically a real low mood.

A lack of appetite is commonly a sign of depression and that feeling of like heaviness in your digestion, just not wanting to eat. As well as high anxiety we know again, like when you’re feeling very, very nervous before a big party, presentation or something, then you don’t really want to eat a big meal.

Now, if you’ve got chronic anxiety, or you’re struggling with it on and off for a long time, that can also really affect your appetite. So mood and how you feel have definitely got a part to play in how your appetite works. Also, just thinking about You know, physically how those conditions will impact on your ability to get yourself food.

So when you are feeling very low, everything’s hard work, let alone preparing a good healthy meal and thinking of something to cook, really, really difficult. And so that also plays into it. So not only do you have a reduced appetite, but you also have a reduced drive to make that happen to make a nice mealtime.

And then the same with anxiety, you might just be all over the place, like, unable to think and focus on what a good meal can be, and almost paralysed by so many choices. And these, we know, are very common in people who have IBS. There is a big overlap of depression, anxiety, and other mood conditions. Other things that suppress your appetite can include pain medication, as well as chemotherapy., And also like when you’re ill and you’re struggling to fight off a virus your appetite generally goes down.

A lack of interest in food can be related to Some eating disorders.

You might have heard me talk about ARFID before, which is Avoidant Restrictive Food Intake Disorder. This is where people lose interest in food completely, and often it is associated with sensory processing issues around texture, around flavours, and often, for IBS people, around a fear of digestive consequences of eating.

Now, just because you’ve lost your appetite doesn’t necessarily mean that you’ve got an eating disorder. But it is something for you to consider, what part appetite plays in the overall picture of your relationship with food. The reason I’ve spent a few moments just going through some of the things that can lower appetite, is because I want to All of these tips I’m going to give you now, into context, if you are suffering from a recent bereavement, or you’ve got chronic depression, then some of these little tips are not necessarily going to make a big difference to your appetite, because it is driven by a bigger condition, something else that needs attention.

outside help. So where that is the case, yes, some of these might be worth a try, might be helpful, but don’t be disheartened if you try to put some of these things in place, but actually the reason that your appetite is low is that I don’t know, your medication that is suppressing your appetite.

The way that I work with appetite with my clients is using something developed by Dr. Helen McCarthy, who calls herself the Appetite Doctor. She’s a health psychologist, and she wrote a book called How to Retrain Your Appetite. It’s a very good book. It’s meant for the general public. It’s easy to understand and it’s full of lots of tips, but it’s actually focused on how to lose weight.

So it often talks about how to retrain your appetite in order to eat less, eat more mindfully, etc. I know that’s not the focus of this podcast, but I like the way that she describes appetite and she calls it an appetite pendulum. With this approach, she imagines that your hunger and your appetite go from minus five, and that is when you are absolutely starving.

You haven’t eaten for hours. You’re really, really hungry. And the pendulum can swing the other way, and it can swing up to plus five when you are Absolutely stuffed like imagine how some people feel after a full Christmas day of eating and you just couldn’t eat anything else. Now we want to ideally keep our appetite pendulum swinging between about minus two and plus two like you or two and a half to either way.

You don’t want to get absolutely starving, but nor do you want to feel absolutely stuffed. It’s just about keeping your body with enough energy without necessarily under or over eating The reason I like this model is because it’s quite easy to think about swinging backwards and forwards and what are the actual physical sensations that you notice when you get to these points.

When you’re very, very hungry, for example, if you have lost a lot of connection with your appetite, sometimes people don’t feel the gnawing hunger sensation that I mentioned at the beginning. That empty sensation that kickstarts our ghrelin, you might not feel that because you might have desensitized yourself from bad feelings in your digestion.

So you might have pushed those thoughts away to such an extent that you’ve lost a bit of connection to your appetite. So sometimes the signs of being hungry that you’re not recognizing are maybe having a headache or maybe feeling a little bit tired. I had a client a few years ago who said he never felt hungry and he was doing intermittent fasting, only eating two meals a day and he just assured me he just didn’t feel hungry.

But as I went through his case notes and took more and more information about how he felt during the day, he actually felt dizzy a lot of the time and he was getting recurrent headaches in the afternoon. And this for me was a sure sign that he wasn’t actually eating enough. But he didn’t notice the feelings of hunger as a symptom.

a rumbly tummy, he didn’t even notice them and associate them with being hungry because he had really lost this connection to his appetite. So, going back to the appetite pendulum, what I ask my clients to do at the beginning of working with me on my three month gut reset is I want them to tell me how hungry they are before and after each meal.

On a scale of minus five to plus five. The reason I want to know how hungry you are before the meal is I want to know how hungry you’ve let yourself become as in, was the last meal you ate before this enough to sustain you through to this point, maybe you never get hungry.

If you feel like you never eat to the point of being completely full, this is another thing that we want to look at to try and regulate your appetite, is you need to sometimes experience being full in If you want to put on weight, and I’m assuming that if you’re listening to this episode about how to increase your appetite, you have an understanding that your body size is too small or that you have nutritional insufficiencies or deficiencies even, but you’re just not eating enough and you need to encourage your body to eat more.

And so in order to do that, you may have to get to the point where you feel uncomfortably full. So this is why I want to measure on that appetite pendulum, when are you getting to plus five and how much are you eating to get to that sensation. If you are feeling massively stuffed and uncomfortably full, After a small amount of food, this could be a indication that you have consistently under eaten and your body is not used to eating a normal amount of food for the size of your body.

This can happen quite a lot in over restriction. Because what happens is our body slows down and in order to try and extract as much energy as possible and just the muscles become quite weak, your stomach will potentially take a long time to empty. So you could have food sitting in your stomach for a really long time and it leaves you feeling very full and uncomfortable.

And it’s because your digestion has slowed down due to a lack of consistent eating. I do also know from working with lots of people with IBS, that feeling full can be associated in your mind with very negative consequences. Like, last time you ate a really big meal, you got very bloated and had a lot of pain.

Or, you got diarrhoea. This can lead you to, , Also be really averse to the feelings of fullness. So it’s not just that you don’t have appetite that sometimes you just don’t like the feeling of full because it’s associated with negative consequences in your mind.

So that was a little meander through my thoughts about appetite and how You can better understand your own appetite, but now I’m going to move on to some sort of specific, more practical things, but I do think that the appetite tracking is one of the best ways for you to get a better sense. of the connection back to your body, like before and after meals, how hungry were you, what point did you eat to and looking at how that corresponds to the amount of food that you’ve actually eaten.

Other things you can do include looking at your flavours of food. Sometimes when you have a very low drive to eat, it can be helpful to eat things that you enjoy eating.

And I know that might sound a bit basic, but sometimes you’re so careful about thinking, Oh, I’ve got to eat some lean protein, some vegetables, some fruit. 

You kind of forget about what it all tastes like together, or whether you’re actually going to enjoy this sort of meal. So, going for some foods that suit you, and you may have preferences about temperature.

Some clients I work with just say, I don’t really like to eat anything cold, or for example, you don’t like anything with too strong a flavour.

But more often we go quite plain when we’re trying to eat safe foods and actually introducing some flavour can be helpful. You can use spices and you can use herbs to make your meals more interesting. These are all generally very well tolerated and good for your gut.

There’s a lot of polyphenols, these are like the good antioxidants in herbs and spices and actually even dried spices. Spices. They are condensed and have a good level of these antioxidants called polyphenols. So using things like dried oregano, cinnamon, cumin, these make your food much more interesting and can make it more desirable and can really help with your appetite, particularly the smells, which really helps to engage.

That first phase of digestion, like engaging your brain in experiencing the food. Also green leafy herbs like parsley, coriander, basil. These are all low FODMAP, easily well tolerated and don’t tend to cause irritation, but can really make the food a little bit more interesting. The next tip is about eating.

as a social experience. This might make your mealtimes a bit more enjoyable. If you eat with other people, it’s more of a event, you know, set the table, light a candle, make your mealtimes a little bit more special. That can sometimes really help you to just eat a bit more and if possible to eat with other people so that you’re chatting, you don’t really realize it and actually mealtimes is something that you look forward to because there is a sense of connection.

On the other hand, some people find that actually eating on your own may be better. And I always say I don’t want you to be too distracted when you’re eating because it helps with mindful eating like chewing. But, in this case where you have no appetite, no desire to eat, sometimes Eating in front of a good film or like your favourite series can actually help you eat a little bit more when you don’t actually feel like it.

The danger is for most people is that the food goes cold or you feel uncomfortable when you’re eating because you’re not sitting in a good upright position at the table. You’re maybe on the sofa or in your bed or whatever and It’s not necessarily good for digestion, but where your main focus is eat more, then sometimes distraction can be useful and can be of benefit.

So although I often say a lot of these things, like try not to be distracted at the table, sometimes it can be helpful to do that. You’ve got to think about what suits you and your ultimate goals at any one point. Sometimes it could change throughout your lifetime. Another tip for increasing your appetite and your desire to eat, which seems a bit counterintuitive, is actually to do some exercise.

When we move our body more and exercise, we tend to stimulate appetite. And this can be a real challenge for people who are trying to lose weight. So people who are going on a diet in order to lose body fat will often start to feel very hungry when they rapidly increase their exercise. And this can be Difficult for people when they’re trying to lose weight.

But for you, if you’re trying to gain weight and you’re trying to increase your appetite, then a bit more movement can be very helpful, particularly things like muscle building. So using some weights and it can be using your body weight at home. You don’t have to be going out to the gym, but anything where you’re stressing your muscles and just, you know, really engaging your heart rate can help you feel a bit more hungry.

We know that when we’re hungry, we tend to enjoy our food more. So the more that you can get that desire to eat, hopefully means you’ll be able to actually cope with more food at each meal. In order to increase your appetite, sometimes you need to eat more food, which means scheduling meal times. This can be quite difficult if you’re someone who, Really rails against having a routine.

You don’t like to feel boring or tied down eating at certain times, or maybe, you know, your life is just very busy and chaotic and you’ve got different routines every day. I would still suggest where possible trying to create some sort of mealtime routine where you are eating. on the clock. If you cannot feel hungry and you don’t naturally feel the desire to eat, then you are going to need to schedule in your mealtimes in order to make sure that you’re not losing any more weight.

In addition to these scheduled mealtimes, if you feel hungry outside of that time, then it’s also okay to eat, but you want to balance out increasing your hunger for the next meal, which is a good thing. So as you feel your appetite start to come back, sometimes you might feel a bit hungry and then you wonder whether you should have an extra small snack or should you wait until the mealtime is actually ready.

And that depends on how hungry you are and how long it is till the next meal. If you can get, you know, another hour in and wait till the next meal, but be properly hungry and actually really enjoy it and eat a bigger meal. Then that’s a good sign. But if it’s going to be another few hours and you just know you’re starting to feel some signs of hunger, like I mentioned, feeling dizzy or feeling very empty, then maybe it is okay to have an extra snack because you’re hungry and you’re honouring that hunger.

Nutrients associated with appetite

And then lastly, I wanted to just talk about a few nutrients that are implicated in appetite. One of them is Zinc.

Zinc

Zinc can be low in people who have lost their appetite. So, sometimes, Correcting a zinc deficiency can help you stimulate your appetite. It might be worth getting tested first before you start taking zinc, partly because taking zinc long term, if you don’t necessarily need it, is not good because it can interfere with the absorption of other minerals, such as iron and copper.

We don’t want to take zinc unnecessarily for a long time. In terms of foods, zinc is high in seafood, like white fish, prawns, and also meat as well.

Omega 3

The other nutrient it might be worth thinking about is an Omega 3 supplement. This has been shown in a meta analysis, that’s a study looking at all other different studies in this area. That showed that Omega 3 may help to regulate your desire to eat.

This is, again, something worth thinking about. Are you eating two to three portions of oily fish per week? That’s mackerel, sardines, herring, that sort of thing. If you’re not, maybe consider whether you need an omega 3 supplement. The other vitamins that are important for appetite is, vitamin B1, which is thiamine.

It’s quite hard to be low in this vitamin, to be fair, because B vitamins are quite frequent in all of our foods, but sometimes we have problems processing vitamins or absorbing them due to SIBO or IBS. Again, it can be worth considering whether this is an important nutrient for you.

I just wanted to mention those three as they’ve all been implicated in appetite and might be worth thinking about.

Each of you is individual

All of the things I’ve mentioned today may or may not be helpful for you. Obviously, it’s very individual as to what will help because it depends on what your problems are. So, as I said at the beginning, if you’ve got an issue with a recent bereavement. And you’re feeling very low and your appetite’s gone because of that. It’s probably not down to having a zinc deficiency.

So not all of these things will be relevant to all situations. I hope you have found something useful though, out of this 20 minute episode.

And if you have, I would love it if you would do a quick review or rate my podcast to help me reach a wider audience. But I’ll leave it there for this week.

Thank you for listening to the inside knowledge. Better digestion for everyone.

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