Expert: Dawn McNamara - 2/26/2011

Question
I lost my appetite like two years ago and went down to like 138 pounds.  Which for a 6 foot guy is pretty bad.  I used to be obese when I was a kid but I worked it off and stayed around 170, after that I was never really bothered about my weight so I don't think it's that.  I put myself on a strict feeding schedule for about a month but couldnt' keep it up.  It's like I had to force the food down.  Now back to square one drinking a lot of coffee and smoking a lot but the thought of food makes my stomach turn.  When i do eat it's a lot of breads and virtually no fresh veg/fruit which I've always loved.  I don't feel like the doctor takes my concerns seriously but for someone who's always had a passion for good food this is a major turnaround.  People are always asking if I'm ill, and I look half dead in photos etc..  What should I do?

Answer
Hi there Oliver,
To be quite honest I don't think what is going on is an eating disorder. I think you should seriously consider getting a second opinion and requesting some basic tests. First a CBC- complete  blood count, second a CMP -complete metabolic panel, enzyme, and B vitamin panel.
  Doctors don't always listen, and pushing for tests may be something you have to do. I think your B12 may be very low. Some of your symptoms suggest it. Some of your symptoms seem to be consistent with mono to. In the meantime cut down on the coffee, coffee suppress the appetite, and so does smoking. I wont tell you to stop smoking but I know, that you know, it reduces appetite too. Try however not to smoke 15 minutes before you are due to eat. A glass of wine also seems to help appetite (only 1) and only once a day before your largest meal. Have you tried yogurt and fresh fruit smoothies, its not a answer but It may help you keep your strength up until you get some real answers.
 I really think you need to get a second opinion asap. Get some tests run. Be aggressive (even if its not your nature) TELL your doctor what you want done. Remember Bread is empty calories so try to get a whole grain, increased protein bread, when you do eat it. Keep in mind too that certain meds will wreck havoc with appetite, research any your currently taking. Parasitic infections can do the same. You can get any number of these from every thing from undercooked meat, to gardening. so a stool sample would not be unreasonable either.
I hope you get answers, you need them. But in all honesty I think whats happening is not an ED, your outlook on food doesn't seem distorted to me.
I hope this helps
Dawn