Can Anxiety Affect Your Appetite?

Why Are More People Eating Less?

Though the COVID-19 pandemic is, hopefully, winding down, the impact that pandemic anxiety has been having worldwide has been especially apparent with young people. This may explain why clinics for patients with eating disorders have seen skyrocketing rise in hospitalizations for children and adolescents who are not eating correctly.

In a recent media interview, Dr. Herbert Orlik, a psychiatrist for children and adolescents at a major pediatric hospital in Halifax, Canada, noted more than two hundred admissions for eating disorders, more than double of the expected number in a typical year.

"It's been a massive increase for us to see and assess those young people," he said. "There may have been already something going on before the pandemic became an issue because we saw an uptick in the numbers of referrals already in January 2020, but then it increased — and it has not slowed down."

Other eating disorder specialists also report sharp rises in new cases of anorexia nervosa and bulimia. But they are also reporting a sharp rise in what is now known as avoidant restrictive food intake disorder (ARFID). Formerly referred to as a "selective eating disorder," young people with ARFID typically show little interest in eating but are not motivated by fear of getting fat such as with other eating disorders. Instead, they may simply avoid eating though it can be hard to say why.

Is Pandemic Anxiety To Blame?

So why are young people eating so much less than usual? One clue for this eating disorder epidemic may be the sharp rise in anxiety disorder cases that clinics also report. "Young people with eating disorders seem to be suffering from anxiety a great deal," said Dr. Orlik. "One way in which sometimes young people express anxiety is that when they can't control anything else in their lives, they can control maybe what they eat."

Throughout the pandemic, people of all ages have become more isolated due to lockdown restrictions and the loss of regular contact with friends and family we all once took for granted. Inevitably, this means a sharp rise in anxiety due to the uncertainty of pandemic life, school shutdowns, social distancing, and, for young people in particular, worrying about body image and weight gain, especially for people hoping to return to post-pandemic life. Even though the pandemic seems to be winding down, people are still afraid of what the future might bring.

We have certainly been seeing more videos and social media posts than ever focusing on "lockdown weight gain" and "fat-shaming", all of which help reinforce personal fears about physical unattractiveness, particularly in young women. As a result, it hardly seems surprising that pandemic fears also seem to be leading to a rise in eating disorders

Why Would Stress and Anxiety Make Us Eat Less?

To understand more about how stress and anxiety might affect appetite, it is important to understand what triggers hunger in the human body. We all experience "hunger pangs" which can strike at any time when our energy reserves get too low and we feel the need to eat to restore the natural balance. Much of the latest research into hunger has focused on a "hunger hormone" known as ghrelin which regulates the amount of food we want to consume. Mainly produced in the gastrointestinal tract, ghrelin plays a key role in food consumption, including preparing the stomach for food intake by increasing stomach acid levels as well as triggering specific regions of the brain controlling hunger.

Studies looking at ghrelin levels in people suffering from anorexia and other eating disorders suggests that it plays an active role in suppressing appetite but does not seem to be as important in people who are overweight. But ghrelin levels in the bloodstream are also linked to acute stress, particularly the "fight or flight" mechanism regulated by the sympathetic nervous system. Since higher stress results in increased ghrelin levels, at least temporarily, followed by a gradual return to normal. 

But people dealing with chronic stress may not be so lucky. If the body stays in a constant state of agitation (such as people dealing with pandemic anxiety), the ghrelin levels may stay high which can lead to a corresponding loss of appetite. This is particularly true for people who are already overweight or who are experiencing eating disorders since worrying about weight loss can be stressful as well.

And there are other hormones that can also play a role in how stress affects the appetite including cortisol, the "stress hormone," which acts as the body's alarm system. Elevated levels of cortisol in the bloodstream can lead to increased stomach acid production and elevating levels of secondary hormones to suppress hunger. Prolonged stress can also lead to more serious stomach issues, including ulcers.

How Can I Deal With Stress and Regain My Appetite?

Though we normally depend on the body's regular circadian (daily) rhythms to tell us when to eat, chronic stress can often throw these rhythms out of whack. This means that we may often not get the daily nutrients we need to stay healthy, even if we are not hungry. The best ways of getting back on track include:

• Listen to other people when they tell you they are worried about your health. All too often, you will be the last person to realize that you are not eating properly. Friends and family will usually be better at noticing that you are overstressed and not eating as much as you should. Do not dismiss such warnings but consider that they might be right.
• Follow a regular schedule for eating and sleeping. Loss of sleep often goes with loss of appetite, especially when it comes to chronic stress. Make sure you stick to a regular sleep schedule and do the same when it comes to eating. Never skip a meal because you "aren't hungry" or will "grab a sandwich later."
• Try to get your stress under control. Identify what might be causing the stress you are experiencing and consider ways to deal with this stress. Take regular breaks and get your mind off whatever is bothering you. Focus more on recreation and exercise to stay physically fit.
• Learn to relax more. Look into online resources for learning mindfulness and relaxation exercises. Take a yoga class (even virtually). Recognize the stress-busting virtues of regular exercise. These can all help curb stress and anxiety in important ways.
• Make long-term changes to manage your stress and develop a healthier lifestyle. While there may be limits to what you can change in the short run, especially if you are in a stressful job, you can start making plans for a healthier future by searching for another job or adopting a less-stressful life. Educate yourself more on healthier options to follow and start making plans for the future. You'll be glad you did.

Ultimately, you are the one responsible for managing your health, and you cannot afford to neglect this responsibility for long. Controlling stress and following a healthy lifestyle is the key to a long and productive life. But you need to get started today.