Undergoing cancer care can often suppress your appetite resulting in weight loss that can be stressful for you and your family. This loss of appetite or reduced ability to eat can be related to:  

• Treatment and other medications 

• Emotional stress  

• Fatigue 

• The disease itself 

• A combination of all the above 

When going through cancer treatment you may find yourself turned off by the sight, smell and taste of some foods – even those you typically enjoy.If food is unappealing, smells are bothersome, taste is off, or it’s painful to chew and swallow, it’s not surprising that you may eat smaller portions, or you may skip meals entirely. During treatment, your goal is to maintain a stable weight as much as possible to enhance quality of life and tolerance to treatment. This may require a change in eating strategy than what is typical for you and may be particularly challenging for you’re if you’re not in the habit of eating frequently during the day. 

1. Focus on calories first. Your body needs more protein during cancer treatment to fortify the “building blocks” for all the cells of our body. Even more important is calorie intake to fuel your vital functions (cardiac function, breathing, digestion), maintain our muscles, restore blood counts between treatments and support your immune system. Carbohydrates and fats in your meals and snacks can help prevent the protein you’re eating from being burned as calories to support these life-sustaining functions.  

2. Eat mini meals. If you’re unable to eat much at once without feeling sick, shift to a pattern of eating smaller“mini meals” more frequently during the day. This makes it possible for you to accrue enough calories to stabilize your weight. Set a goal of eating every two or three hours and set an alarm on your smartphone to remind you.  For more information about eating impactful mini meals, plus sample recipes, check out our article, Impactful snacks and mini meals to meet nutritional needs.

3. Use small plates. When food is unappealing, large plates of food can appear overwhelming. Serve mini-meals and snacks on small plates, and smoothies in smaller cups. This may feel more achievable and be less likely to trigger aversions. 

4. Try cold, odorless foods. Food odors can sometimes be a turn-off. Cold or room temperature foods typically don’t smell so may be better tolerated. Try cold cut sandwiches instead of cooked meat or poultry, sliced raw vegetables or vegetable salads in place of cooked vegetables, or cold pasta salads instead of cooked pasta dishes. 

5. Add something to soups. Soup can be a common go-to comfort food when you are not feeling well.  Pea and bean soups, chowders and cream soups can be good sources of calories and protein, but broth-based soups tend to be low in both calories and protein. To increase the nutritional value of a soup meal, add half a grilled cheese or other protein-containing sandwich (like sliced turkey or roast beef, tuna or egg salad, or peanut butter and jelly), a few crackers with cheese or nut butter, or a Greek yogurt to boost overall nutrition. 

6. Drink more between meals. Your stomach expands with eating and drinking, which contributes to the feeling of fullness. To mitigate this feeling drink most of your fluids between rather than with your meals. 

7. Supplement with small protein shakes. Protein shakes— either homemade or store-bought — can be helpful for boosting your calorie and protein intake. Protein shakes may be better tolerated in smaller portions, so serve them in 4 to 8-ounce cups, storing any remaining shake in the refrigerator for later in the day. It’s best to take protein shakes two hours before a meal to prevent them from affecting your mealtime appetite. 

8. Enrich foods with calories. The most efficient way to increase the calories in meals, snacks and shakes is to add fats. The following are ways to optimize calories in your food:   

   • Cook eggs and other pan-fried foods in oil. Drizzle oil into soups, pastas, and vegetable and rice dishes. You can also add neutral tasting oils like avocado and canola oil to smoothies. All oils add 40 calories per teaspoon (120 calories per tablespoon).   

   • Spread tub spreads or butter on toast, muffins, pancakes, French toast, potatoes, vegetables and anywhere else it may be appealing. Adds 30 – 40 calories per teaspoon. 

   • Add nut butters (peanut, almond, cashew, sunflower butter) to crackers, toast, muffins, sandwiches, smoothies, and fruit (like bananas or apples). Adds 95 – 100 calories per tablespoon. 

   • Sprinkle nuts on cereals, salads, fruit cups, ice cream, puddings, and yogurts, or snack on them between meals. On average adds 200 calories per ¼ cup.  

   • Use sliced or mashed avocado to add calories and creaminess to toast, eggs, sandwiches and salads, or with tortilla chips as guacamole. Adds 100 calories per 1/3 avocado, or 30 calories per 2 tablespoons of guacamole. 

   • Top bagels or toast with cream cheese (50 calories/tablespoon), and sour cream (30 calories/tablespoon) to potatoes, chili or eggs. 

9. Be consistent. Maintaining your weight often requires changing your mindset from food as enjoyment to eating as part of your treatment plan. Devising an eating plan you can stick to as consistently as possible is key to keeping your calorie intake up. A good goal to aim for is to eat 5-6 times per day. 

10. Maintain physical activity. Physical activity may increase your appetite and interest in eating. Whether it is indoors or outside, aim to move around as much as possible, even if it is just for a few minutes. 

11. Manage side effects that may be affecting your interest in eating. Nausea, constipation, diarrhea, taste changes and mouth sores can all affect your ability to eat so it’s important to follow your care team’s advice to proactively manage these issues. 

12. Consider medications and other therapies to improve appetite.Some appetite-stimulating medications may help increase your interest in eating. Speak to your clinical team to determine if they are safe and appropriate for you. Using medical cannabis as an appetite stimulant or for managing nausea may also be an option. Laws around the availability of medical cannabis vary from state to state. Speak to an Iris nurse to learn more about this option.