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The process of appetite regulation is complex, with an interplay between the brain and the body, being heavily influenced by psychological factors, as well as medications and medical conditions. In addressing reduced appetite, it is crucial that the underlying cause is attended to, as this will significantly impact the ability to achieve long-term and sustainable changes, and overall optimise dietary nutritional adequacy.

In this interesting presentation, Accredited Practising Dietitian Caity Smith-Gillis combines her passions of psychology and dietetics to provide an informative overview on the physiology of appetite, common conditions which can cause reduced appetite, as well as practical strategies to assist with increasing oral intake. She explains that hunger is based off physiological cues, while appetite, which more directly drives eating, is impacted by both physiological and environmental factors. With regards to direct hormonal driving factors, Caity explains that ghrelin, also known as the ‘hunger hormone’, is produced by the pancreas, being predominantly induced by hypoglycaemia and low body weight. On the other hand, leptin is known as the ‘satiety hormone’ which released from fat cells in adipose tissue and being induced by insulin and stress.

In improving oral intake, while an individualised approach is required, mindfulness practices to reduce cortisol and increase present-moment awareness, consuming small regular meals, eating by the clock/ setting reminders to eat, and maximising the sensory process of eating are all useful strategies to increase oral intake. Hence, focusing on the meal-time environment to increase interest in food and eating, building confidence around food, and including self-care and ‘feel good’ strategies can have a significant impact on the consistency of eating, helping to nourish our bodies and promote weight stability.

Summary:

• In addressing reduced appetite, it is crucial that the underlying causative factors are identified, and an individualised approach taken to prevent malnutrition and loss of weight. 
• Ghrelin and leptin undeniably have an impact on appetite, although psychosocial aspects and pre-existing medical conditions (such as diabetes, cancer, IBS or IBD), mental health conditions, and medications can further exacerbate appetite suppression.
• Overall focusing on the meal- time environment, stress management strategies and meal regularity can have a significant impact on increasing nutritional adequacy and promoting weight stability.

Caity Smith-Gillis is an APD and also has a Bachelor of Arts majoring in psychology. Using these skills she creates a dietetic practice which is both supportive and safe for her clients. Caity is committed to providing evidence-based dietetic care that is equitable, accessible, and culturally appropriate for her clients. She has several areas of interest including disordered eating, Non-Diet Approach and Health At Every Size®, oncology nutrition and women’s health and reproduction. Caity is passionate about evidence-based nutrition advice, having contributed to prostate and lung cancer nutrition research at Deakin University and Peter MacCallum Cancer Centre.

To register for the presentation and associated documents including the assessment quiz click here 

This presentation is useful for dietitians working across all sectors with individuals struggling with reduced appetite, seeking to better understand the signalling of hunger hormones and numerous driving factors impacting appetite, all of which influence nutritional intake.