Eating enough when nothing appeals

What this guide is for

There is a phase on these medicines — sometimes a fortnight, sometimes months — where food simply stops making a case for itself. Not nausea exactly, though that may be there too. More that the whole category has gone flat. You open the fridge, everything in it is theoretically fine, and none of it is the answer.

This is one of the most commonly described experiences in our circles and one of the least written about, because most writing about these medicines treats reduced appetite as the point rather than as something you then have to live inside.

Two things we will not do on this page. We will not give you numbers, because numbers turn eating into scoring and this community does not do that. And we will not hand you a list of permitted foods, because prescriptive lists are how a lot of people’s difficulties with food started in the first place. What we can offer is the collected practice of people who have been through the flat weeks and out the other side.

Jonah reviews this guide, and asked for one thing at the top: eating enough is a kindness you are doing for your body, not a rule you are obeying or a test you can fail.

Why it matters, without a lecture

Undereating for a sustained period is not a shortcut. It makes the parts of this that are hardest, harder.

Fatigue deepens — it is the single most common thread when a member arrives in sleep-and-fatigue exhausted in month three. Headaches become routine. Cramps and dizziness turn up. Hair shedding is more likely, and the dermatology literature is clear that a substantial nutritional shift is one of the things that pushes it. And muscle is the tissue that suffers first when protein is scarce — Ren’s entire position in the strength circles is that muscle is the part worth protecting, and it cannot be protected without something coming in.

There is also a more human reason. People who are undereating are worse at everything, including deciding whether they are undereating. Judgement narrows. The flat weeks get flatter. Members describe realising, a fortnight later, that they had barely eaten and had also been miserable and had not connected the two.

None of that is a reason to force anything. It is a reason to make eating easier rather than more effortful, which is what the rest of this guide is about.

What has worked for members

From our nausea-and-eating circle, over two years. People contradict each other and we have left that in.

• Stop waiting for appetite to arrive. The commonest single realisation. Appetite was the prompt for most of us for decades, and on these medicines the prompt has gone quiet. Members who moved to eating at times rather than at signals found it much easier.
• Smaller and more often, without ceremony. A few mouthfuls, several times, beats a plate you look at and abandon.
• Drinkable food. Milk, soup, smoothies, kefir, a shake. When chewing feels like work, liquid does not. Members report this as the single most useful category.
• Cold and plain over hot and fragrant. Smell is the barrier for many people. Cold chicken, yoghurt, cottage cheese, a sandwich from the fridge.
• Anything, rather than the right thing. Toast at eleven at night counts. Kate in Belfast describes weeks where tea and toast was the whole plan and says so in circle without apology, which is exactly the register we want.
• Protein first while you still have interest. Not as a rule — as an ordering, because it is the thing hardest to make up later. Protein without a chore is deliberately low effort.
• Fluid alongside, sipped. Being dry makes food less appealing, which makes you drier. See hydration and electrolytes.
• Having something ready that requires nothing. The barrier is usually the standing up and the deciding, not the eating.

When food has gone strange rather than absent

A separate problem that gets muddled with this one. Plenty of members find particular things have become actively repellent — coffee, meat, eggs, anything fried, anything very sweet — while other things are fine.

Taste and smell change is reported constantly in our circles and barely at all in the published trial data, which is one of the odder gaps in the evidence. So we cannot tell you how common it is or why. What members report is that it moves: the thing that is impossible in month two is often fine by month six, and the sensible response is to let it be temporary rather than to conclude you no longer eat that food.

Practically: follow the aversions rather than fighting them. If meat has gone, dairy and pulses and fish have not. If hot food is unbearable, cold food is available. If sweetness has become cloying, savoury breakfasts exist. Members who worked around it did better than members who tried to reason with it.

And if everything is repellent for more than a few days, or you cannot keep fluids down, that is a symptom rather than a preference — contact your prescriber, and see the red-flag list.

The part we take most seriously

For some people in this community — a good number of us — appetite has never been a neutral subject, and a medicine that removes it lands in a life that already has a difficult history with food.

Jonah, who did eating-disorder peer support for years before he had heard of any of this, is clear that there is a real tension here and that pretending otherwise would be worse. Some members have found the quiet steadying. Some have found it dangerous. Both are true, and neither cancels the other.

Things members have told us they noticed, offered as recognition rather than diagnosis:

• Relief at not eating, in a way that felt like more than relief from nausea.
• Rules quietly hardening — times, places, categories, things that had become not-allowed.
• Using the medicine as a reason to skip meals that had already been getting skipped.
• A returning sense of achievement attached to eating less, which some members recognised from years ago.
• Avoiding eating in front of people.
• Watching what other people are eating, and how much, and comparing.

If any of that is familiar, please read disordered eating: warning signs and where to get help, and look at our support resources, which lists the kinds of services worth finding in a few regions. Telling your prescriber matters too, and it is a hard sentence to say — several members have said that writing it down and handing it over was the only way they managed it.

Jonah holds ed-recovery-aware. Nobody in that circle talks in numbers and nobody compares intakes, which is why it works.

What to raise with a clinician

Things worth bringing rather than absorbing.

• That you are struggling to eat, in those words, with how long it has been going on.
• Whether you are managing fluids at all, and whether you have had a day where you did not.
• Any spell of vomiting or diarrhoea, because that changes the picture and may need blood tests.
• Whether you would like a referral to a dietitian. Ask directly — many services have one and do not offer, and a dietitian is the right professional for this rather than a peer-support forum.
• Any history of an eating disorder, even one you consider long over. This changes how a good clinician watches.
• Dizziness, fainting, palpitations, or weakness rather than tiredness. Those get seen.

Talking to your GP when time is short has the practical framing, and members frequently find a pharmacist or nurse appointment is longer and more useful for this than a rushed doctor’s slot.

The gentler view

Most people’s flat phase passes. Appetite on these medicines is not a switch that has been thrown permanently; it moves with the dose, with the week, with how you have slept, and for a lot of members it becomes something ordinary again by the fourth or fifth month — not what it was, but present.

Meanwhile, being kind to yourself about it is not a soft option. Members who accepted that a fortnight of simple, dull, easy food was fine did better than members who tried to eat impressively and then ate nothing at all because the plan was too much. Nobody is grading this. There is no version of eating in a difficult week that this community would think less of.

And if you are reading this at the end of a day where you managed almost nothing: have something now, something easy, something that does not require a decision. Then come and say so in the check-ins, where somebody will have had exactly the same day and will say so back.