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excessive hunger

Alternative Names
excessive appetite, polyphagia

Definition
Excessive hunger describes an abnormally strong desire or need to eat. This can be normal or related to an underlying medical condition.

What is going on in the body?
Increased hunger is not considered excessive when related to a recent lack of eating. People who have always had a large appetite are not considered to have excessive hunger either. There are many potential causes of an unexpectedly large appetite.

What are the signs and symptoms of the condition?
When a person complains of an excessive amount of hunger, the doctor will want to know:
  • when the problem started
  • whether the hunger is constant or occurs only at certain times
  • how much the person eats daily
  • whether the person has increased or decreased the amount of food he or she eats each day
  • whether the person's weight has changed
  • how much the person exercises
  • whether the person has had any change of mood or emotional problems
  • whether the person any excessive guilt related to eating
  • whether the person is engaging in purging types of behaviour such as intentionally throwing up after eating
  • what other medical conditions the person may have
  • what medications, drugs, or herbs a person may be taking
  • whether the person is having any other symptoms
Other questions may also be asked.

What are the causes and risks of the condition?
There are many possible causes for excessive hunger. These include:
  • increased exercise, which can increase the body's food requirements
  • growth spurt. Just before or during a period of rapid growth, a person's appetite increases to ensure that the body has enough food to support this growth. This is common in infants and adolescents.
  • hormone imbalances. A high level of thyroid hormone, called hyperthyroidism or a high level of adrenal hormones, called hyperadrenalism, can cause excess hunger. Some women may have this condition due to hormone changes that occur during pregnancy or at certain times during the menstrual cycle.
  • uncontrolled diabetes. This is a condition that causes increased blood sugar levels which trigger increased appetite.
  • depression. This condition often causes a decrease in appetite. However, it can cause excessive hunger in some cases.
  • bulimia nervosa, an eating disorder that most commonly affects young women. This disorder causes short, intense periods of hunger that usually result in eating binges.
  • certain drugs or medications. The use of antihistamines, steroids, marijuana, or large amounts of alcohol can cause excess hunger. Withdrawal from cocaine or amphetamine can also cause this condition.
  • damage to an area of the brain called the hypothalamus. This is a rare condition.
Other causes are also possible. Sometimes, no cause can be found.

What can be done to prevent the condition?
Prevention is often not possible. Avoiding the drug can prevent cases due to drug abuse. Taking medications as prescribed and checking blood sugars regularly can prevent some cases due to diabetes.

How is the condition diagnosed?
The doctor will first take a medical history and perform a physical examination. This may be all that is needed to determine the cause. In other cases, further testing is needed.

The tests used will depend on the suspected cause. Blood tests are commonly done. For example, a blood glucose level can be used to detect diabetes. A series of blood tests called thyroid function tests can detect hyperthyroidism. A toxicology screen of the blood or urine can detect illegal drug use. An x-ray test called a cranial CT may be done if brain damage is suspected.

What are the long-term effects of the condition?
Some people with excessive hunger may gain weight. Others may lose weight in spite of eating more. This is the case for people with hyperthyroidism. Other long-term effects are related to the cause of the problem. Growth spurts in children and normal and have no long-term effects. depression may result in an inability to work or interact with others. It sometimes leads people to commit suicide. Uncontrolled diabetes can cause damage to many bodily organs and even death.

What are the risks to others?
Excessive hunger is not contagious and poses no risks to others.

What are the treatments for the condition?
Treatment is directed at the cause. For example, an individual with diabetes may use insulin injections or other medications to control blood sugar levels. A person with hyperthyroidism may be treated with medications, surgery, or radioactive therapy. Someone who abuses drugs may need drug rehabilitation. A person with bulimia or Depression may be treated with psychotherapy. Medications such as fluoxetine and sertraline may be used as well.

What are the side effects of the treatments?
Side effects depend on the treatments used. For example, medications can cause allergic reactions, stomach upset or headaches. Specific side effects depend on the medications used. Surgery carries a risk of bleeding and infection.

What happens after treatment for the condition?
Someone experiencing increased hunger due to pregnancy or a growth spurt needs no further treatment. An individual with diabetes needs lifelong monitoring and treatment. Someone who stops abusing drugs may no longer experience excessive hunger.

How is the condition monitored?
Any changes or response to treatment can be reported to the doctor. Other monitoring is related to the cause. For example, someone with diabetes needs to check blood sugars levels every day.

Author: Adam Brochert, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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