Appetite changes during pregnancy is often expected to lean towards an increase in appetite. However, there are many reasons why a pregnant women may experience a decrease in appetite during pregnancy. These reasons can even vary among the different trimesters. Any appetite loss in pregnancy tends to be a cause for concern as the general thinking is that expectant mothers should be ‘eating for two’. However, a reduction in appetite may not necessarily be a cause for concern in many instances.
Why does appetite change during pregnancy?
A change in appetite during pregnancy is normal, whether it is an increase or even a decrease. Most of the time there is an increase in appetite because the body needs more resources to sustain the fetus and for to facilitate fetal growth. In terms of the former, the fetus is dependent on the mother’s body to acquire and process nutrients, oxygen and wastes. With regards to the latter, it is mainly in the second half of pregnancy when fetal growth accelerates. During this time an approximately 10 ounce fetus at week 20 of pregnancy grows into a 7 to 8 pound baby by the time of delivery.
Since appetite is related to the body’s needs, it is understandable that this rise in appetite will occur. However, it is not as simple when it comes to a loss of appetite. Often the reduction is a result of the hormonal changes associated with pregnancy, the digestive disturbances due to the growing uterus and sometimes it may even be psychogenic in origin. According to the American Pregnancy Association a loss of appetite affects about half of all pregnant. It tends to start around the middle of the first trimester and gradually eases around the first week or two of the second trimester.
Causes of Appetite Loss In Pregnancy
These are some of the common causes of appetite loss during pregnancy. There may be other reasons at play as well and a loss of appetite that is persisting should be investigated by a medical professional. It is usually not serious but due to the delicate state of pregnancy, it is advisable to have it assessed. Expectant mothers need to be aware that insufficient nutrition could have an adverse effect on the baby such as low birth weight, development abnormalities, premature birth, respiratory problems and even feeding difficulties.
Nausea and Vomiting
Pregnancy-associated nausea, often termed ‘morning sickness‘, is one of the most common causes of appetite loss. It usually ends in the first trimester but in some women it may extend into the second trimester and beyond. The nausea is believed to be due to the rising HCG (human chorionic gonadotropin) levels, a hormone associated with pregnancy. Other hormones also rise during pregnancy and may also be contributing factors to the nausea.
While the nausea may not always be accompanied by vomiting and will diminish with time, some women suffer with a severe form of morning sickness. This is known as hyperemesis gravidarum where there is severe nausea and repeated vomiting. Understandably there is a loss of appetite. It is also possible for nausea to continue well into the second trimester and beyond. This does pose some risk to the mother and baby’s health if there is insufficient nutrition during this time.
Indigestion and Acid Reflux
Two common digestive tract conditions in pregnancy are indigestion and acid reflux.
Indigestion is a collection of digestive symptoms like nausea, bloating, abdominal discomfort and early fullness when eating. Since the symptoms correlate with eating, there is often a loss of appetite. The cause is not always known but indigestion often occurs with overeating, greasy meals, spicy foods, chocolate and even with iron supplements. Sometimes indigestion is due to other gastrointestinal conditions like gastritis, peptic ulcer disease, gallstones and constipation, among other conditions.
Acid reflux, or gastroesophageal reflux disease (GERD), is a very common condition in pregnancy and affects most expectant mothers at some point during pregnancy. It occurs when the lower esophageal sphincter (LES) cannot stop the backward flow of stomach acid into the esophagus. One of the main symptoms of acid reflux is heartburn. However, there are times when there are no symptoms present and this is referred to as silent acid reflux. A loss of appetite may be the only symptom.
Growing Pregnant Uterus
The uterus is about the size of a medium-sized pear at the start of pregnancy. It grows to the size of a grapefruit by week 12 of pregnancy and by full term, it is about the size of a watermelon. The pregnant uterus is no longer able to ‘fit’ in the pelvis by the second trimester. It extends into the abdominal cavity apart from protruding outwards as the abdominal muscles stretch. Eventually the uterus may extend as high up as the bottom of the ribcage.
There is consequences of this degree of growth of the uterus. It presses against many abdominal organs and this can cause appetite changes. The compression on the stomach for example means that the stomach cannot expand as much as it normally would with eating. There is early satiety after eating and the pressure may even contribute to acid reflux. There may not always be a loss of appetite but rather a slight reduction in appetite when most expectant mothers feel that their appetite should be increasing.
Stress and Depression
While motherhood is an exciting and joyous life experience, pregnancy can be stressful and may even contribute to depression in some women. It may not always be the pregnancy itself that is the cause but rather a combination of personal, social and financial factors along with the physiological impact of pregnancy. A loss of appetite is a common symptom during periods of psychological stress and with depression. It may continue after childbirth due to the stress of life with a newborn and postpartum depression.
Many people are surprised to find that eating disorders can occur in pregnancy. Some types of eating disorders may have started before pregnancy while the combination of physical and emotional stress of pregnancy could trigger eating disorders in people who are prone. A loss of appetite is a characteristic feature in eating disorders like anorexia nervosa. The weight gain and change in body shape associated with pregnancy can further exacerbate the behavioral symptoms seen in anorexia nervosa, such as avoiding eating and exercising excessively.