Ep 51 - How to increase your appetite when you have IBS or SIBO - IBS Nutrition, Digestion & Gut Health: Inside Knowledge for people with IBS

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Do you need to increase your appetite?

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Maybe you know you need to eat more food

because you are considered underweight,

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but you just don't feel like eating.

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It could be that you just don't get

on well with eating much, and you find

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it hard to get excited about food.

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In this episode of the Inside

Knowledge Podcast, You'll learn

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about how appetite works and how

to stimulate your desire for food.

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You'll also learn how I suggest my gut

reset clients measure their appetite,

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and you can download the tracker

that I use with them to do this.

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So listen up for how to get a little

bit more interested in food and

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hopefully start enjoying eating again.

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Welcome

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to episode 51 of the

Inside Knowledge podcast.

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I'm Anna Mapson.

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This episode is to follow on

from the previous one, which

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was about how to gain weight.

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I realized when I got near the end of this

episode, I had loads to say on actually

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how to increase your appetite because.

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Part of how to gain weight is feeling an

urge to eat and being able to eat more.

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You might know the specifics of what

foods to increase and what calorie

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dense food you need to add in and

how often to eat and all of that.

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But if you don't feel hungry, it's

really hard to achieve all of that.

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In this episode, I'm going to talk a

little bit about what can lower our

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appetite, so what might be one of the

reasons that you don't feel hungry.

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And also how does hunger work and

then quickly move on to some specific

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things that you can start working on

in order to improve your appetite and

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hopefully start eating a little bit more.

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Some people like to differentiate

between hunger and appetite and It's

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more semantics, really, for most people.

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Hunger is like your physical

need for food, whereas appetite

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is more your desire for food.

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And sometimes it's quite

difficult to tell the difference.

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Is it a physical sensation that

you're feeling, or is it like

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a desire to eat certain foods?

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Craving, more like.

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There's a couple of ways that

we physically Get the sensation,

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the drive to go and eat.

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Mostly it's when our stomach

starts becoming empty.

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And a hormone is produced called ghrelin.

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This is our hunger hormone, and

it's released into the bloodstream,

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travels up to your brain, where it

activates the hypothalamus, into a

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drive for food, drive for activity,

that means you go and seek out food.

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That process is triggered by not having

any food in your stomach, so there

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are also things that indicate we need

to get more food, which is a dip in

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our blood glucose, so that would be

another trigger to go and seek food.

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So your body is responding to a lack

of available glucose in the bloodstream,

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and that can be more like those sort of

hangry feelings, like you feel irritable,

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maybe lightheaded and dizzy, headachy.

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Those kind of hangry or hungry

and angry feelings can often

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come through blood sugar dips.

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So those are the two basic ways that we

are stimulated to go and look for food.

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One is a lack of actual content in our

body, and the other one is a dip in

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some of the core nutrients that we need,

specifically blood glucose, but also a

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lack of protein and a lack of healthy

fats can also drive a need for food.

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food and for appetite and that's

in healthy people, but we can

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also learn to override this and

emotional factors can come into play.

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So the things that actually lower

our appetite is often the gut

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brain connection driving it.

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So depression, or bereavement,

like really significant grief,

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basically a real low mood.

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A lack of appetite is commonly

a sign of depression and that

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feeling of like heaviness in your

digestion, just not wanting to eat.

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As well as high anxiety we know

again, like when you're feeling very,

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very nervous before a big party,

presentation or something, then you

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don't really want to eat a big meal.

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Now, if you've got chronic anxiety,

or you're struggling with it on

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and off for a long time, that can

also really affect your appetite.

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So mood and how you feel have

definitely got a part to play

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in how your appetite works.

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Also, just thinking about You

know, physically how those

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conditions will impact on your

ability to get yourself food.

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So when you are feeling very

low, everything's hard work, let

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alone preparing a good healthy

meal and thinking of something to

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cook, really, really difficult.

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And so that also plays into it.

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So not only do you have a reduced

appetite, but you also have

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a reduced drive to make that

happen to make a nice mealtime.

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And then the same with anxiety, you

might just be all over the place,

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like, unable to think and focus

on what a good meal can be, and

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almost paralysed by so many choices.

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And these, we know, are very

common in people who have IBS.

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There is a big overlap of depression,

anxiety, and other mood conditions.

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Other things that suppress your appetite

can include pain medication, as well as

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chemotherapy., And also like when you're

ill and you're struggling to fight off a

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virus your appetite generally goes down.

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A lack of interest in food can be

related to Some eating disorders.

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You might have heard me talk about

ARFID before, which is Avoidant

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Restrictive Food Intake Disorder.

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This is where people lose interest

in food completely, and often it is

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associated with sensory processing

issues around texture, around flavors,

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and often, for IBS people, around a fear

of digestive consequences of eating.

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Now, just because you've lost your

appetite doesn't necessarily mean

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that you've got an eating disorder.

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But it is something for you to consider,

what part appetite plays in the overall

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picture of your relationship with food.

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The reason I've spent a few moments just

going through some of the things that can

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lower appetite, is because I want to All

of these tips I'm going to give you now,

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into context, if you are suffering from a

recent bereavement, or you've got chronic

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depression, then some of these little

tips are not necessarily going to make a

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big difference to your appetite, because

it is driven by a bigger condition,

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something else that needs attention.

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outside help.

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So where that is the case, yes, some

of these might be worth a try, might

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be helpful, but don't be disheartened

if you try to put some of these

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things in place, but actually the

reason that your appetite is low is

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that I don't know, your medication

that is suppressing your appetite.

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The way that I work with

appetite with my clients is

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using something developed by Dr.

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Helen McCarthy, who calls

herself the Appetite Doctor.

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She's a health psychologist,

and she wrote a book called

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How to Retrain Your Appetite.

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It's a very good book.

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It's meant for the general public.

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It's easy to understand and it's full

of lots of tips, but it's actually

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focused on how to lose weight.

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So it often talks about how to

retrain your appetite in order to

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eat less, eat more mindfully, etc.

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I know that's not the focus of

this podcast, but I like the way

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that she describes appetite and

she calls it an appetite pendulum.

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With this approach, she imagines

that your hunger and your appetite

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go from minus five, and that is

when you are absolutely starving.

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You haven't eaten for hours.

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You're really, really hungry.

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And the pendulum can swing the other

way, and it can swing up to plus five

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when you are Absolutely stuffed like

imagine how some people feel after

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a full Christmas day of eating and

you just couldn't eat anything else.

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Now we want to ideally keep our

appetite pendulum swinging between

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about minus two and plus two like

you or two and a half to either way.

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You don't want to get absolutely

starving, but nor do you want

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to feel absolutely stuffed.

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It's just about keeping your body with

enough energy without necessarily under or

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over eating The reason I like this model

is because it's quite easy to think about

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swinging backwards and forwards and what

are the actual physical sensations that

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you notice when you get to these points.

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When you're very, very hungry, for

example, if you have lost a lot

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of connection with your appetite,

sometimes people don't feel the

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gnawing hunger sensation that

I mentioned at the beginning.

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That empty sensation that kickstarts our

ghrelin, you might not feel that because

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you might have desensitized yourself

from bad feelings in your digestion.

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So you might have pushed those thoughts

away to such an extent that you've lost

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a bit of connection to your appetite.

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So sometimes the signs of being

hungry that you're not recognizing

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are maybe having a headache or

maybe feeling a little bit tired.

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I had a client a few years ago who

said he never felt hungry and he

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was doing intermittent fasting, only

eating two meals a day and he just

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assured me he just didn't feel hungry.

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But as I went through his case notes and

took more and more information about how

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he felt during the day, he actually felt

dizzy a lot of the time and he was getting

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recurrent headaches in the afternoon.

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And this for me was a sure sign that

he wasn't actually eating enough.

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But he didn't notice the

feelings of hunger as a symptom.

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a rumbly tummy, he didn't even notice

them and associate them with being

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hungry because he had really lost

this connection to his appetite.

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So, going back to the appetite

pendulum, what I ask my clients to

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do at the beginning of working with

me on my three month gut reset is

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I want them to tell me how hungry

they are before and after each meal.

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On a scale of minus five to plus five.

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The reason I want to know how hungry you

are before the meal is I want to know

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how hungry you've let yourself become

as in, was the last meal you ate before

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this enough to sustain you through to

this point, maybe you never get hungry.

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If you feel like you never eat to the

point of being completely full, this

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is another thing that we want to look

at to try and regulate your appetite,

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is you need to sometimes experience

being full in If you want to put on

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weight, and I'm assuming that if you're

listening to this episode about how

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to increase your appetite, you have an

understanding that your body size is

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too small or that you have nutritional

insufficiencies or deficiencies even,

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but you're just not eating enough and you

need to encourage your body to eat more.

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And so in order to do that, you

may have to get to the point

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where you feel uncomfortably full.

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So this is why I want to measure on

that appetite pendulum, when are you

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getting to plus five and how much are

you eating to get to that sensation.

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If you are feeling massively stuffed and

uncomfortably full, After a small amount

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of food, this could be a indication that

you have consistently under eaten and

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your body is not used to eating a normal

amount of food for the size of your body.

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This can happen quite a

lot in over restriction.

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Because what happens is our body

slows down and in order to try and

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extract as much energy as possible

and just the muscles become quite

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weak, your stomach will potentially

take a long time to empty.

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So you could have food sitting

in your stomach for a really long

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time and it leaves you feeling

very full and uncomfortable.

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And it's because your digestion has slowed

down due to a lack of consistent eating.

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I do also know from working with

lots of people with IBS, that feeling

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full can be associated in your mind

with very negative consequences.

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Like, last time you ate a

really big meal, you got very

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bloated and had a lot of pain.

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Or, you got diarrhoea.

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This can lead you to, , Also be really

averse to the feelings of fullness.

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So it's not just that you don't

have appetite that sometimes you

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just don't like the feeling of

full because it's associated with

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negative consequences in your mind.

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So that was a little meander through

my thoughts about appetite and how

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You can better understand your own

appetite, but now I'm going to move

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on to some sort of specific, more

practical things, but I do think that

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the appetite tracking is one of the

best ways for you to get a better sense.

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of the connection back to your body,

like before and after meals, how hungry

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were you, what point did you eat to and

looking at how that corresponds to the

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amount of food that you've actually eaten.

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So, other things you can do, , include

looking at your flavours of food.

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foods.

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So, sometimes when you have a very

low drive to eat, it can be helpful

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to eat things that you enjoy eating.

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And I know that might sound a bit

basic, but sometimes you're so careful

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about thinking, Oh, I've got to eat.

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Some lean protein, some vegetables,

some fruit, you kind of forget

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about what it all tastes like

together, or whether you're actually

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going to enjoy this sort of meal.

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So, going for some foods that suit

you, and you may have preferences about

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temperature, but Some clients I work with

just say, I don't really like to eat

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anything cold, or for example, you don't

like anything with too strong a flavor.

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But more often we go quite plain

when we're trying to eat safe

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foods and actually introducing

some flavour can be helpful.

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You can use spices and you can use herbs

to make your meals more interesting.

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These are all generally very well

tolerated and good for your gut.

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There's a lot of polyphenols, these are

like the good antioxidants in herbs and

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spices and actually even dried spices.

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Spices.

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They are condensed and have a good level

of these antioxidants called polyphenols.

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So using things like dried oregano,

cinnamon, cumin, these make your food

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much more interesting and can make

it more desirable and can really help

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with your appetite, particularly the

smells, which really helps to engage.

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That first phase of digestion,

like engaging your brain

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in experiencing the food.

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Also green leafy herbs like

parsley, coriander, basil.

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These are all low FODMAP, easily well

tolerated and don't tend to cause

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irritation, but can really make the

food a little bit more interesting.

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The next tip is about eating.

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as a social experience.

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This might make your mealtimes

a bit more enjoyable.

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If you eat with other people, it's

more of a event, you know, set the

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table, light a candle, make your

mealtimes a little bit more special.

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That can sometimes really help you to

just eat a bit more and if possible

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to eat with other people so that

you're chatting, you don't really

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realize it and actually mealtimes is

something that you look forward to

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because there is a sense of connection.

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On the other hand, some people find that

actually eating on your own may be better.

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And I always say I don't want you to be

too distracted when you're eating because

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it helps with mindful eating like chewing.

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But, in this case where you have no

appetite, no desire to eat, sometimes

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Eating in front of a good film or

like your favorite series can actually

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help you eat a little bit more when

you don't actually feel like it.

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The danger is for most people is

that the food goes cold or you feel

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uncomfortable when you're eating

because you're not sitting in a

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good upright position at the table.

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You're maybe on the sofa or in your bed

or whatever and It's not necessarily good

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for digestion, but where your main focus

is eat more, then sometimes distraction

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can be useful and can be of benefit.

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So although I often say a lot of

these things, like try not to be

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distracted at the table, sometimes

it can be helpful to do that.

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You've got to think about what suits you

and your ultimate goals at any one point.

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Sometimes it could change

throughout your lifetime.

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Another tip for increasing your

appetite and your desire to eat,

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which seems a bit counterintuitive,

is actually to do some exercise.

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When we move our body more and

exercise, we tend to stimulate appetite.

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And this can be a real challenge for

people who are trying to lose weight.

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So people who are going on a diet

in order to lose body fat will often

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start to feel very hungry when they

rapidly increase their exercise.

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And this can be Difficult for people

when they're trying to lose weight.

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But for you, if you're trying to

gain weight and you're trying to

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00:16:40,568 --> 00:16:44,451

increase your appetite, then a bit

more movement can be very helpful,

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particularly things like muscle building.

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So using some weights and it can

be using your body weight at home.

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You don't have to be going out to

the gym, but anything where you're

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stressing your muscles and just, you

know, really engaging your heart rate

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can help you feel a bit more hungry.

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We know that when we're hungry,

we tend to enjoy our food more.

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So the more that you can get that desire

to eat, hopefully means you'll be able to

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actually cope with more food at each meal.

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In order to increase your appetite,

sometimes you need to eat more food,

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which means scheduling meal times.

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This can be quite difficult

if you're someone who, Really

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rails against having a routine.

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You don't like to feel boring or

tied down eating at certain times,

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or maybe, you know, your life is

just very busy and chaotic and you've

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got different routines every day.

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I would still suggest where possible

trying to create some sort of

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mealtime routine where you are eating.

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on the clock.

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If you cannot feel hungry and you don't

naturally feel the desire to eat, then

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you are going to need to schedule in

your mealtimes in order to make sure

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that you're not losing any more weight.

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In addition to these scheduled mealtimes,

if you feel hungry outside of that time,

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then it's also okay to eat, but you want

to balance out increasing your hunger

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for the next meal, which is a good thing.

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So as you feel your appetite start

to come back, sometimes you might

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feel a bit hungry and then you wonder

whether you should have an extra

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small snack or should you wait until

the mealtime is actually ready.

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And that depends on how hungry you are

and how long it is till the next meal.

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If you can get, you know, another

hour in and wait till the next meal,

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but be properly hungry and actually

really enjoy it and eat a bigger meal.

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Then that's a good sign.

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But if it's going to be another few

hours and you just know you're starting

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to feel some signs of hunger, like I

mentioned, feeling dizzy or feeling

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very empty, then maybe it is okay to

have an extra snack because you're

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hungry and you're honoring that hunger.

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And then lastly, I wanted to

just talk about a few nutrients

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that are implicated in appetite.

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One of them is Zinc, and Zinc can be low

in people who have lost their appetite.

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So, sometimes, Correcting

a zinc deficiency can help

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you stimulate your appetite.

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It might be worth getting tested

first before you start taking zinc,

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partly because taking zinc long

term, if you don't necessarily

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need it, is not good because it can

interfere with the absorption of other

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minerals, such as iron and copper.

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So we don't want to take zinc

unnecessarily for a long time.

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In terms of foods, zinc is high

in seafood, like white fish,

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prawns, and also meat as well.

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The other nutrient it might be worth

thinking about is an Omega 3 supplement.

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This has been shown in a meta

analysis, that's a study looking at

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all other different studies in this

area, that showed that Omega 3 may

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help to regulate your desire to eat.

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So This is, again, something

worth thinking about.

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Are you eating two to three

portions of oily fish per week?

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That's mackerel, sardines,

herring, that sort of thing.

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If you're not, maybe consider whether

you need an omega 3 supplement.

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The other vitamins that are

important for appetite is,

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vitamin B1, which is thiamine.

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It's quite hard to be low in this

vitamin, to be fair, because B

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00:20:13,784 --> 00:20:18,214

vitamins are quite frequent in all

of our foods, but sometimes we have

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problems processing vitamins or

absorbing them due to SIBO or IBS.

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So again, it can be worth

considering whether this is

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an important nutrient for you.

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I just wanted to mention those three as

they've all been implicated in appetite

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and might be worth thinking about.

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All of the things I've mentioned today

may or may not be helpful for you

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00:20:39,418 --> 00:20:43,813

you Obviously, it's very individual

as to what will help because it

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depends on what your problems are.

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So, as I said at the beginning, if

you've got an issue with, you know, a

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recent bereavement and you're feeling

very low and your appetite's gone

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because of that, it's probably not

down to having a zinc deficiency.

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So not all of these things will

be relevant to all situations.

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I hope you have found something useful

though, out of this 20 minute episode.

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And if you have, I would love it if

you would do a quick review or rate my

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00:21:11,333 --> 00:21:15,689

podcast to help me reach a wider audience,

but I'll leave it there for this week.

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So thank you for listening to the inside

knowledge, better digestion for everyone.

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