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Nutrition and daily life

Appetite on steroids: managing the hunger

Prednisolone and dexamethasone often cause intense hunger, especially in children and teenagers. Section “Weight gain: steroids, appetite and swelling” covered weight gain; this section gives practical ways to manage day-to-day hunger.

Last updated: ~1 min read
Vegetable and bean soup with yogurt.
Figure 1.A filling soup — Appetite on steroids: managing the hunger

01Short answer

The hunger is real, not a lack of willpower. Keep filling, lower-calorie foods ready: vegetable soup, cooked vegetables, legumes, yogurt, eggs, fruit (safely prepared). Eat at regular times and plan snacks. Swap sweet drinks for water. Salty snacks increase swelling. Prepare light options for night-time hunger. With children, offer choices rather than bans. Taking the steroid in the morning may help sleep; ask your team. Appetite usually returns to normal after the course.

02Simple explanation

The hunger is from the medicine.

Filling, light food.

Planned snacks.

No sweet drinks.

03Scientific explanation

MedlinePlus: corticosteroids increase appetite, cause fluid retention and raise blood sugar; effects usually pass as the dose comes down.

ESPEN: enough energy and protein matter for preventing weight and muscle loss in people with cancer, and nutritional status should be assessed regularly.

NCI: practical eating tips exist for treatment side effects such as nausea, taste changes and mouth sores.

04What happens in the body?

Children

On steroid courses children's mood and hunger swing; patience and planned snacks help.

Peeled oranges and baked apples.
Figure 2.Fruit — Appetite on steroids: managing the hunger

Blood sugar

If there is a diabetes risk, your team will monitor blood sugar.

A dim, tidy kitchen.
Figure 3.The kitchen at night.

Dietitian

If you are losing weight, have no appetite or need a special diet, ask to see the hospital dietitian.

Food safety

Food-safety rules for neutropenia (see “Handwashing: the simplest protection” and “Eggs and dairy: safe choices”) apply at every stage.

05Nutrition: four steps

Assess, swap the risky, cook safely, eat regularly.

Assess — Weight and appetite.1AssessWeight and appetite.
Swap — A safe choice.2SwapA safe choice.
Cook — Hot throughout.3CookHot throughout.
Eat regularly — Small portions.4Eat regularlySmall portions.
StrengthEnergy.
ProteinFor muscle.
SafetyFood rules.

06Key points at a glance

TopicIn brief
ChildrenOn steroid courses children's mood and hunger swing; patience and planned snacks help.
Blood sugarIf there is a diabetes risk, your team will monitor blood sugar.
DietitianIf you are losing weight, have no appetite or need a special diet, ask to see the hospital dietitian.
Food safetyFood-safety rules for neutropenia (see “Handwashing: the simplest protection” and “Eggs and dairy: safe choices”) apply at every stage.

07Key terms

Dexamethasone
A strong steroid medicine.
Hyperphagia
Excessive hunger.
Dietitian
A nutrition specialist.
Protein
A nutrient for repairing muscles and tissues.
Neutropenia
Low neutrophils.

08Key points

  • Plan ahead.
  • Filling choices.
  • Patience: it is temporary.
  • A diet is not a treatment.
  • Talk to a dietitian.

09Frequently asked questions

My child wants to eat every hour; what can I do?

Light, filling options and planned times.

Can I lower the dose?

No; changing it yourself is dangerous.

Can a special diet cure leukemia?

No. Good nutrition helps you cope with treatment, but it does not cure.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. My child wants to eat every hour; what can I do?

  2. Can I lower the dose?

  3. Can a special diet cure leukemia?

My questions

12Sources

  1. MedlinePlus. Prednisone
  2. National Cancer Institute. Eating Hints: Before, During, and After Cancer Treatment
  3. ESPEN. ESPEN practical guideline: Clinical Nutrition in cancer (2021)
  4. Leukemia & Lymphoma Society. Food and Nutrition
  5. World Health Organization. Healthy diet fact sheet
  6. NCCIH (U.S. NIH). Herbs at a Glance
  7. World Health Organization (WHO). World Hand Hygiene Day
  8. American Cancer Society. Preventing Infections in People with Cancer
  9. Centers for Disease Control and Prevention (CDC). Safer Food Choices for People With Weakened Immune Systems
  10. MedlinePlus (U.S. National Library of Medicine). Electrolyte Panel
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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