Why am I insatiably hungry and losing weight?

Dear Hungry, 

It’s important to know that you’re not doing anything wrong. In fact, you’re doing a whole lot right! Home-cooking your meals, eating a well-balanced selection of foods, and paying attention to your body’s signals can all be great for your health and well-being. The good news is that these symptoms are typically treatable once their specific cause is identified. However, the underlying reasons for these symptoms can vary widely—from diabetes and thyroid conditions to absorption issues and sleep deprivation. Therefore, it’s recommended to meet with a health care provider to accurately diagnose and effectively manage what you’re experiencing. This may be a frustrating and exhausting experience, but you’re not alone. Read on to learn more about what might be going on behind the scenes of your midnight munchies and unexplained weight loss.

What’s it called when your hunger is more than a big appetite? 

If you eat often and still feeling hungry, your body might not be getting or keeping the nutrition it needs. This extreme, insatiable hunger is also known as polyphagia. When experienced alongside weight loss and exhaustion, polyphagia may be a sign of an underlying metabolic, hormonal, or other medical issue. The only way to learn more about what may be causing this is to talk with a health care provider.

What conditions can cause hunger and weight loss at the same time? 

A whole buffet of conditions can serve up the seemingly paradoxical combination of polyphagia and weight loss, as well as issues with your sleep. Some possible culprits include:  

• Type 1 diabetes: If your body isn’t producing enough insulin, it can’t use glucose for energy. Instead, your body may start breaking down fats and proteins, which can make you lose weight and feel ravenous. Extreme hunger is common with type 1 diabetes to the point that it’s referred to as one of the condition’s “three Ps”: polyphagia, polyuria (frequent urination), and polydipsia (extreme thirst). 
• Hyperthyroidism: You can think of your thyroid gland as acting like your body’s internal furnace. In overdrive (hyperthyroidism), your thyroid gland makes your body burn through fuel (the food you eat) too quickly. This can lead to extreme hunger, fatigue, and weight loss. There are various common causes of hyperthyroidism, including Graves’ disease and inflammation of the thyroid gland. 
• Malabsorption: You could be eating excellently from a nutrition standpoint, but if your digestive system isn’t absorbing the nutrients properly, your body may still end up running on empty. Conditions such as celiac disease, Crohn’s disease, and exocrine pancreatic insufficiency can all reduce nutrient absorption. Even bacteria can crash the dinner party; when there’s  too many in the gut (known as small intestinal bacterial overgrowth). In addition to hunger and weight loss, some signs of malabsorption might include bloating, diarrhea, and passing stools that float or appear greasy or pale in color.

List adapted from Cleveland Clinic 

Can your sleep affect hunger and weight? 

Sleeping plays a big role in appetite regulation, thanks to some important hormones. These include ghrelin (the “hunger hormone”), leptin (the “satiety hormone,” which makes you feel full), and orexin (which causes you to feel awake and hungry). When you’re sleep-deprived, especially night after night, the levels of these hormones can start to shift. Ghrelin and orexin may increase, boosting your hunger and wakefulness, while leptin may decrease, no longer telling you to stop eating because you feel full.  

Your description of waking up to eat every few hours and feeling exhausted during the day suggests your circadian rhythm might be thrown off. Disruption of your circadian rhythm can mess with your body’s use of food and may make your brain interpret low energy as hunger rather than fatigue.  

What can you do if you’re experiencing extreme hunger and weight loss? 

Feeling constantly hungry and losing weight without trying isn’t just exhausting—it can signal something important. The good news is that you’re paying attention to these signals. Some next steps you might consider taking include: 

• Tracking your symptoms: Consider keeping a log of the food you eat, how often you wake up hungry, how your energy levels feel, and any gastrointestinal issues you experience such as diarrhea or feeling bloated. Sharing this information with your health care provider may help them diagnose and treat your symptoms more easily. 
• Prioritizing your sleep: Part of treating your extreme hunger might involve treating your sleep. You might consider setting a consistent bedtime, cutting back on screen use before bed, and talking to your health care provider about your hungry nighttime wakeups. Restoring a more regular sleep cycle could help to calm your cravings. 

After gathering the relevant information, consider visiting a health care provider who might have you take some blood tests and can hopefully provide you with some answers and well-deserved relief. In the meantime, try to be gentle with yourself. Experiencing polyphagia with weight loss can be difficult, and it’s okay to be frustrated. 

Sending strength and snacks,