Loss of Appetite: Causes and Treatment Options - Family Medicine

More Info

---

Loss of appetite can be a complex issue with various underlying causes, and it’s important to approach it holistically. Based on your description, it seems that your loss of appetite and associated symptoms may be linked to a combination of gastrointestinal issues, anxiety, and possibly depression.
Initially, you experienced vomiting after a stressful event, which led to a diagnosis of gastroesophageal reflux disease (GERD). GERD can indeed cause nausea and discomfort, which may contribute to a reduced desire to eat. However, the subsequent episodes of rapid heartbeat, cold sweats, and nausea when pressured to eat suggest that anxiety may be playing a significant role in your current symptoms. This is not uncommon; stress and anxiety can exacerbate gastrointestinal symptoms and lead to a vicious cycle of avoidance and further anxiety.

Your weight loss from 41 kg to 38 kg is concerning, especially if it is unintentional. Significant weight loss can lead to further health complications, including nutritional deficiencies, weakened immune function, and decreased muscle mass. It’s crucial to address both the physical and psychological aspects of your condition.

The medications prescribed to you, lorazepam and vortioxetine, are aimed at managing anxiety and depressive symptoms. Lorazepam is a benzodiazepine that can help with anxiety in the short term, but it is important to use it cautiously due to the potential for dependence and withdrawal symptoms. Vortioxetine, on the other hand, is an antidepressant that can help with both depression and anxiety, but it may cause gastrointestinal side effects, including nausea, especially when starting the medication.

Given your concerns about the side effects of vortioxetine, it’s understandable to feel apprehensive, especially since your symptoms began with nausea. It’s essential to communicate these concerns with your prescribing physician. They may consider adjusting the dosage or switching to a different medication that you might tolerate better.

In terms of treatment options, it would be beneficial to take a multidisciplinary approach. Here are some recommendations:
1. Gastroenterology Follow-Up: Since you have a history of GERD, a follow-up with a gastroenterologist may be warranted. They can assess whether your current symptoms are related to GERD or if there are other gastrointestinal issues at play.

2. Psychiatric Evaluation: Since anxiety and depression can significantly impact appetite and overall well-being, a thorough evaluation by a psychiatrist or psychologist could help. They can provide therapy options, such as cognitive-behavioral therapy (CBT), which has been shown to be effective for anxiety and can help you develop coping strategies.

3. Nutritional Support: Consulting with a registered dietitian may be beneficial. They can help create a meal plan that accommodates your current appetite and nutritional needs, ensuring you receive adequate nutrition even if your intake is limited.

4. Lifestyle Modifications: Incorporating stress-reducing techniques such as mindfulness, meditation, or gentle exercise can help manage anxiety and improve your overall mood. Regular sleep hygiene practices can also aid in improving your sleep quality.

5. Monitoring and Communication: Keep an open line of communication with your healthcare providers about your symptoms and any side effects from medications. Regular monitoring can help adjust treatment plans as needed.

In conclusion, your symptoms may stem from a combination of gastrointestinal issues and anxiety. A comprehensive approach involving gastroenterology, psychiatry, and nutritional support can help address the root causes of your loss of appetite and improve your overall health. It’s crucial to prioritize your well-being and seek support from healthcare professionals who can guide you through this process.