Loss of Appetite in the Elderly: Why It Happens and How to Get It Back

Aging brings many physiological and lifestyle changes that can cause a loss of appetite in the elderly. According to the National Institutes of Health, one in four seniors suffer from appetite loss, which can lead to malnutrition and other health problems.^[01]

Typical reasons for appetite loss in older adults include the following:

• A lower metabolic rate and less physical activity mean seniors need fewer calories.
• Changes in the senses of smell and taste can make food less desirable. We also lose taste buds as we get older.
• Hormone changes can alter the hunger signals to the brain. Older adults typically don’t feel hungry as often as they once did.
• Dental problems or gastrointestinal changes, such as lactose intolerance, can accompany aging and make eating uncomfortable.
• An inability to prepare meals particularly affects seniors who live independently and experience difficulty cooking or using kitchen utensils and appliances.
• A lack of or changes in a daily routine can cause discomfort or confusion around meal times.
• Loneliness or isolation can lead to decreased appetite, especially if a person recently lost a loved one or moved to a new environment.

Because loss of appetite among seniors is common, we asked dietitian and nutrition specialist Heather Garza to share advice for caregivers worried about an older adult not eating.

“I remind my clients often that a loss of appetite and thirst is a normal part of aging and doesn’t always mean something is wrong,” said Garza.

Yet, sometimes a sudden loss of appetite in elderly adults can be more severe and require treatment. If you notice unexplained weight loss or weight gain, general lethargy, or changes in your loved one’s eating habits that persist for more than one week, the first step is to consult their doctor.

Sometimes what causes a loss of appetite in the elderly isn’t aging — it could be a medical condition. Here’s a list of common health problems that may cause a loss of appetite in seniors:

• Depression
• Dementia symptoms
• Side effects from medications
• Insomnia or other sleep problems can mean less energy to cook

Less common, albeit serious, underlying causes when a senior stops eating may also be the culprit. These could include:

• Parkinson’s disease
• Head and neck cancers
• Mouth and throat infections
• Periodontal disease
• Salivary gland dysfunction
• Thyroid disorders

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Whether your aging loved one’s lack of appetite is standard or related to a medical condition, you can do a few practical things to help them get adequate nutrition.

Medication side effects

Elderly appetite loss could signal a problem with the medicines a person is taking. Medication side effects such as dry mouth may occur in seniors. Dry mouth occurs when the salivary glands don’t produce enough saliva, causing food to taste different and swallowing to be difficult.

“Chewing sugarless gum, brushing often, or using an oral rinse before meals can improve taste sensation and, ultimately, nutrient intake,” Garza said.

Another reason why older adults stop eating could be changes in the taste of their food. Certain medications can make foods taste different than normal, giving off bitter or metallic notes.^[02] These can include the following medications:

• Antibiotics, including ampicillin, sulfamethoxazole, metronidazole, and others
• Neurologic medications like those used to treat Parkinson’s or migraines and many muscle relaxants
• Heart medications, including some blood pressure medicines, diuretics, statins for cholesterol, and medicines for heart arrhythmias
• Endocrines that are often used in thyroid medications
• Psychiatric medications, including some antidepressants and mood stabilizers
• Other medications, including chemotherapy drugs, prescriptions for smoking cessation, and bronchodilators

If your loved one says their food tastes “off” or metallic, try switching to other protein sources such as dairy or beans. If water doesn’t taste right to them, add herbs like mint or basil. Or try sliced fruits or vegetables, such as lemon and cucumber, as water infusions can help prevent dehydration in seniors. Make healthy recipes with senior-friendly ingredients.

Encourage social meals

For people of all ages, the idea of eating alone may seem unappealing. But seniors may be unable to have meals with others due to mobility problems, lack of transportation, or losing a spouse.

“Senior centers, temples or churches, and community centers may have weekly dinners and other mealtime events for seniors,” said Garza. Encourage meal “dates” with friends, family, or caregivers.

Increase nutrient density, not portion size

It may be tempting to offer large plates of food, but huge helpings of food can be intimidating. Instead, focus on providing calorie-rich options.

“I ask caregivers not to increase the volume of food they serve to seniors with low appetites,” Garza explained. “Rather, increase the nutrient density of the foods they serve.”

Avocados, olive oil, and peanut butter are examples of nutrient-dense foods packed with “healthy fats.”

Set a regular eating schedule

“Our bodies tend to thrive off regularity, as do our hunger and thirst signals, so when we stray from our usual patterns, so does our appetite,” Garza said.

If your loved one isn’t used to a mealtime routine, start slowly by introducing a small beverage or snack during a regular mealtime. This process can help stimulate the body’s hunger signals.

Consider appetite stimulants for the elderly

Some seniors stop eating because they’re not interested in food. Ghrelin, known as the “hunger hormone,” regulates appetite. Studies suggest that ghrelin production slows down as we age.^[03] Unfortunately, weight loss, malnutrition, and frailty often occur when seniors don’t eat enough.

One way to counter this natural part of aging is through prescription appetite stimulants. Talk to your doctor to determine if this is a good option for your loved one. They can review the pros and cons, including side effects and suitability, in light of a senior’s overall health.

Though it might be normal when an older adult seems to be eating less, you should still seek medical advice if your loved one refuses to eat. A doctor can give valuable advice on encouraging a healthy diet so that you can help them get the vitamins and minerals they need.

The following lifestyle and dietary changes may help some people increase their appetite naturally.

Exercise

Getting regular exercise increases the amount of energy a person burns. In turn, this can increase the body’s need for fuel, which boosts hunger levels.

Plan and prepare meals

Proper planning can help people consume enough calories each day.^[04] To help your loved one reach their goals, try these practical tips:

• Consider eating six to eight little meals instead of three big meals daily.
• Figure out the time of day when their appetite is strongest, and eat at that time.
• Even if they’re not hungry, try to encourage meals and snacks at the same times every day.
• Place healthful items around the house to promote regular snacking.

If your parent is living alone, consider hiring an in-home caregiver who can help with meal planning and preparation. Home care aides can even handle grocery shopping to further reduce stress.

Choose foods wisely

Sometimes the quality of the food a person takes in is more important than the quantity, but it can be tough for them to think of meal options when they don’t feel like eating. Follow these food selection tips to encourage a senior’s appetite and boost their calorie intake:

• Avoid loading up on high-fiber, low-calorie foods like raw fruits and vegetables at meals. Consult your doctor about the advantages of a low-fiber diet.
• Add sweet fruit or full-fat ice cream to increase the flavor and nutritional value of milkshakes and desserts.
• Try drinking the calories instead. Encourage at least one smoothie, protein shake, or high-calorie nutritional supplement drink.
• Serve proteins one hour or more after removing them from the refrigerator; some enjoy the taste of these foods at room temperature.

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Make mealtimes more enjoyable

When your loved one looks forward to mealtime, they may be inclined to eat more. Encourage seniors to implement one or more of these suggestions to make mealtime more enjoyable:

• Choose tasty and enjoyable foods.
• Add extra flavor with herbs, spices, sauces, or marinades.
• Use garnishes and colorful foods to make meals more appealing.
• Change the menu regularly to avoid getting bored with a particular food.
• Watch a favorite television show or movie while cooking or eating.
• Play music while preparing food or eating.
• Set the table using your favorite place settings.
• Try different-sized plates to see what works best.
• Make mealtimes a social event; research suggests eating with others increases food intake.^[05]

Advice for older or less mobile adults

Older adults or people with limited mobility can face challenges when it comes to appetite and weight loss. The following tips may help address some of these challenges:

• Use grocery or meal delivery services if going out to get food is difficult.
• Set an alarm for mealtimes if forgetting to eat is an issue.
• Ensure that dentures fit correctly to avoid pain or discomfort while eating.
• Invest in adaptive utensils if joint pain or dexterity is a problem.
• Try to visit an occupational therapist or dietitian for assistance.

Loss of appetite in the elderly can occur due to aging, medical conditions, or the side effects of medications. It’s important to address this issue in your senior loved one, as it can increase their risk of illness or other complications.

Regular exercise, socializing more during meals, certain medications, and other lifestyle changes are all safe and effective ways to increase your loved one’s appetite. However, if you notice that this change in appetite persists for more than a few days, it’s essential to seek help. Your doctor can determine any underlying causes and recommend a course of action.

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