May 8, 2023 • 10 min read

Loss of Appetite During Pregnancy: What Causes Food Aversions

Medically Reviewed by Kim Langdon, MD on 05.31.23
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In popular culture, pregnancy is often associated with food cravings and increased consumption, or “eating for two.” The reality is that 60% of women say they had nausea and poor appetite in the first trimester of pregnancy, and half say it continued throughout their pregnancy.

Regardless of where you are in your own pregnancy, the idea of eating may seem unappealing to you. You may be nauseous or simply less hungry.

There is also the problem of food aversions which means you can eat certain foods but simply can’t tolerate others—including foods you have eaten without difficulty before. 

Food aversions often happen because foods smell wrong to you or because you have a heightened sense of smell compared to before you got pregnant. Research shows that certain foods are listed among those that pregnant women often avoid, including eggs, coffee, meat, fish, dairy, and onions.  

Between nausea, changes in appetite, and food aversions, it can seem impossible to get enough food to feed both you and your baby. What causes these pregnancy-related food issues and what can you do to make sure you’re getting enough to eat throughout your pregnancy?

This guide goes over what causes loss of appetite during pregnancy, strategies you can use to help overcome it, and more.

What causes loss of appetite during pregnancy?

Loss of appetite during pregnancy has many causes. Appetite is a blend of what’s going on in your brain’s appetite center, the way food tastes and smells, and other factors that indicate your threshold for tasting salt, sugar, sour, and bitter substances.

You may feel hungry for most foods you encounter yet struggle to drink your morning coffee or eat a cheeseburger.

Let’s look at what is behind the loss of appetite seen so often in pregnancy:

1) Nausea

Nausea in pregnancy is believed to be due to rising pregnancy hormones, particularly human chorionic gonadotropin (hCG), although other hormones also play a role.

The levels of hCG increase exponentially as soon as you become pregnant but then decrease after the first trimester.

When you are nauseous, it can be difficult to eat or drink anything—even the fluids you need to prevent dehydration.

2) Food aversions

Many food aversions are due to a heightened sense of smell during pregnancy, which explains why strong-smelling foods top the list of food aversions.

Fried foods like fried fish, fried onions, and bacon commonly give off odors that many pregnant women cannot tolerate.

When food aversions lead to nausea or a poor appetite, you are less likely be able to gain weight.

3) Stress, anxiety, and/or depression

Mood and appetite are highly linked. When you are overly stressed or experience a low mood for any reason, your ability to eat enough is challenged. Pregnancy is stressful as it is; if it leads to mood changes or anxiety, you are more likely to feel uninterested in eating.

4) Medication

Many medications affect appetite in complex ways, even if you aren’t nauseated.

Selective serotonin reuptake inhibitors (SSRIs) taken for depression, OCD, and anxiety can reduce appetite. Both Prozac and Zoloft are called Pregnancy Class B (generally considered safe), and both can reduce appetite.

Buprenorphine used for opioid withdrawal can also reduce appetite or lead to nausea. Other medications that cause nausea (of which there are many) can contribute to poor food intake while pregnant.

5) Pregnancy hormones

Pregnancy causes many hormonal changes inside your body. These changes can affect your appetite in several ways.

Rising estrogen levels early in pregnancy contribute to the tendency to favor sweet foods but reduce overall appetite. Progesterone later in pregnancy leads to favoring salty foods and enhances overall appetite.

Research on pregnant women throughout the world has found that appetite generally increases during pregnancy, but that most women in developed countries don’t eat more than 10% more than they did before pregnancy.

6) Other hormones

Pregnancy is a state of hormonal upheaval beyond the traditional “pregnancy-related” hormones.

In normal women, leptin in fat cells suppresses appetite; however, during pregnancy, there is greater resistance to this signal (meaning you’ll eat more).

Pregnancy also causes a reduced tolerance for bitter foods, which is felt to be an adaptation to prevent pregnant women from consuming potentially toxic, often bitter-tasting substances.

7) Other bodily changes

Your pregnant body is changing in ways that can lead to a poor appetite. Increased levels of heartburn and acid reflux (GERD) from pregnancy hormones and your expanding belly can lead to nausea and food aversions at any time during your pregnancy.

You can learn about the best foods to eat with GERD and which to avoid here.

8) A more serious underlying issue

There are a few more serious issues that cause poor appetite during pregnancy. One of these is hyperemesis gravidarum, which is extreme nausea during pregnancy.

Many cases of this disorder are due to elevated pregnancy hormones like hCG and are not serious; however, because of the risk of weight loss and dehydration, you should seek medical advice if you think you have this problem.

Another potentially serious problem in pregnancy is disordered eating from things like anorexia or bulimia. Either of these disorders needs medical attention to make sure you gain enough weight while pregnant.

>> Read more: Hungry but no appetite? Possible reasons why

When loss of appetite during pregnancy is most common

Nausea after eating early in pregnancy is very common. The first trimester is the peak time for both food aversions and nausea/vomiting of pregnancy. However, some women have them throughout pregnancy.

As the first trimester gives way to the second and third trimesters, your pregnancy hormones shift toward reduced hCG and heightened progesterone.

While some women experience third-trimester nausea and morning sickness, most find that this change in hormones increases appetite, and they are able to eat more to support their growing baby.

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How to make sure you’re eating enough for your baby even if you’re dealing with food aversions

When you are pregnant, it’s important to know how many calories you should eat at each stage of pregnancy. That’s because not eating enough during pregnancy can lead to uncomfortable symptoms and fetal complications.

With food aversions being so universal in the first trimester of pregnancy and beyond, it might help to learn ways to overcome this problem.

Here are some ways you can begin to eat better despite having this problem:

  • Eat smaller, more frequent meals. Large meals expand your stomach more than small meals and are more likely to cause acid reflux. This is because acid reflux is worse when the pressure builds up inside your GI tract. Small meals reduce nausea and excess salivation which make eating less attractive. Eating more often will also help you keep up your calorie intake, even if you don’t eat a lot in one sitting.
  • Try bland foods. Bland foods tend to be better tolerated when you have food aversions. Spices contribute to strong smells that make food taste better under normal circumstances but can backfire during pregnancy. Try reducing the number and quantity of spices in your food to see if it helps you tolerate them better.
  • Switch up your cooking methods. Fried foods give off stronger odors than foods that are baked, boiled, microwaved, or broiled. Deep-fried foods are greasier, too. The excess grease contributes to more GERD symptoms because your stomach doesn’t empty as quickly.
  • Avoid foods with strong smells. Some foods are naturally likely to be intolerable during pregnancy, no matter how they are prepared. Coffee, bacon, and eggs have strong smells that can be hard to tolerate. Change your breakfast routine to include things like baked muffins, toast, or bagels so you can get calories with less smell. Your morning coffee can be switched with teas that help reduce nausea, such as ginger tea.
  • Try different temperature foods. Because hot foods often have stronger odors than cold ones, choosing cool foods might be a better option. Foods that are generally served hot may be better tolerated if you instead cool them before eating.
  • Have others cook your meals. Try eating out or having others in the family do the cooking. If you are exposed to the hot kitchen and need to taste or smell everything as you cook, your ability to tolerate those foods are less than if you sit down to foods that are far from where they were prepared. Having cooked food delivered can also allow you to eat good food without having to prepare it yourself.
  • Make easy-to-eat meals. Foods that don’t require lengthy preparation and that can be popped into the microwave in individual serving sizes can help you eat small meals with a wide variety of nutrients. Some easy meals include frozen diet meals that often have low-fat content. Other easy meals to consume are energy bars and other healthy snacks; these are often easily tolerated, even if you’re nauseated or have food intolerances.
  • Stay hydrated. Hydration matters throughout pregnancy. Even if you can’t eat much, try drinking fluids. Keep fluids nearby and sip them often or carry a water bottle that can help you measure your fluid intake throughout the day. Cold beverages are often better tolerated than hot ones; however, judge for yourself and choose those you more easily tolerate.
  • Take prenatal vitamins. Talk to your provider about the best kinds of prenatal vitamins to take if you’re nauseated. You may get by with taking smaller pills more often to avoid stomach upset from your prenatal vitamins.

>> Find a prenatal nutritionist that can help with a loss of appetite

Making sure you’re consuming enough vital nutrients

You probably know that you and your baby need nutrients even when you don’t feel like eating. Rather than becoming overly stressed out by this knowledge, look at the nutrients you need the most and see which foods you can eat to help you gain these valuable substances in your diet.

  • Folic acid. Folic acid is needed even before pregnancy to avoid neural tube defects in your baby. It is most important in the first trimester. Foods you can eat include spinach, broccoli, and peas. Cereals and orange juice are also fortified with it.
  • Omega-3 fatty acids. Omega-3 fatty acids are important for the nervous system and brain development. They are good for your mental health as well. Fish, nuts, and seeds are great sources of these fatty acids.
  • Iron. Iron is used to prevent maternal and fetal anemia. Anemia means you aren’t carrying enough oxygen to active or developing tissues. Red meat and spinach have iron in them naturally but so do eggs, fruits, and poultry. Many breads are fortified with iron.
  • Iodine. Iodine is essential for thyroid health and to optimize metabolic processes. It is found naturally in seafood, but you can get it in any food that you make at home using iodized salt.
  • Vitamin B12. Vitamin B12 is also essential for nervous system development. The best sources of vitamin B12 are meats, poultry, and dairy products; however, soybeans can be fortified with this vitamin, too.
  • Fat-soluble vitamins (A, D, E, and K). These vitamins have multiple essential uses. Spinach is the richest in A, E, and K, while vitamin D is supplemented in dairy products. Remember that spinach leaves are a great substitute for lettuce in salads.
  • Calcium. Calcium is needed along with vitamin D for the development of your baby’s bones and teeth. Drink milk or consume other dairy products, cheese, and leafy greens to get enough.
  • Vitamin C. Vitamin C is important for immunity and as an enzyme cofactor in cellular reactions. It also makes collagen and helps in iron absorption. Eat peppers, broccoli, spinach, potatoes, and citrus to get enough.

Select a variety of foods to eat each day so you can get enough of the various essential nutrients while pregnant.

How working with a prenatal nutritionist can help with food aversions

You may become anxious if you begin having a poor appetite during pregnancy and don’t know where to turn. A prenatal nutritionist can help determine if you’re getting enough to eat and can tell you what to do if you’re not getting what you and your baby need.

Prenatal nutritionists have special training in pregnancy-related issues that affect a woman’s nutritional status. Your nutritionist can evaluate you at any time during your pregnancy and can guide you until your weight gain and food intake are optimized. They can even help with issues such as eating disorders during pregnancy.

Your nutritionist can evaluate your dietary needs and will work with you to determine which foods are better tolerated given your eating habits and current struggles. You can learn from them how best to prepare your meals to maximize your nutrition throughout pregnancy.

If you’re interested in finding help, we can match you with a prenatal nutritionist that accepts your insurance and offers your preferred visit type (online, phone, in-person, etc.). Simply browse through options and book online!

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Healthy mom, healthy baby: Get support from a prenatal dietitian

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Complications of not eating enough during pregnancy

Some complications of not eating enough during pregnancy include:

  • Poor fetal growth. Poor fetal growth due to unsatisfactory nutrition can have harmful effects on the health and development of the baby. Inadequate nutrition can increase the risk of low birth weight, preterm birth, and adverse effects on the newborn.
  • Low birth weight. Infants born to mothers who do not eat enough during pregnancy may have a low birth weight, which can increase the risk of health problems for the baby. Low birth weight is a weight of fewer than 2500 grams or approximately 5.5 pounds at birth.
  • Preterm birth. Women who do not eat enough during pregnancy may have a higher risk of preterm labor, which can be dangerous for the baby. Preterm labor is defined as labor that occurs before 37 weeks of gestation and can increase the likelihood of respiratory distress syndrome, infections, and other health problems.
  • Anemia. Pregnant women who do not get enough to eat may develop anemia, a lack of sufficient red blood cells to transport oxygen to the body’s tissues.
  • Maternal weight loss. Undereating during pregnancy can also lead to improper weight gain or even weight loss. Weight loss can affect the long-term health of both mother and baby.
  • Miscarriage. Inadequate prenatal nutrition can affect fetal development and, in some cases, increase the risk of miscarriage.

When medication or supplementation may be necessary for loss of appetite during pregnancy

Lack of appetite can mean you are at risk for dehydration and miss key nutrients like folate, vitamin B12, iron, and others your baby needs for adequate development of critical organs.

A baby born after a pregnancy in which appetite and weight gain were poor is more likely to have a low birth weight or to be born prematurely. If you face pregnancy complications because of poor weight gain, your provider may recommend that you take medications or consume supplements.

If you’re struggling with food or fluid intake, you can do some simple home remedies first, such as vitamin B6 and B12 supplementation or taking ginger to reduce nausea. You can work with your doctor to sort out the doses of each supplement.

Your doctor may also prescribe or recommend antihistamines like hydroxyzine, doxylamine, or meclizine to reduce nausea. While some SSRIs cause poor appetite, other drugs called serotonin receptor antagonists like Zofran can be used to reduce nausea and vomiting because they act on the nausea centers in the brain.

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Healthy mom, healthy baby: Get support from a prenatal dietitian

90% of Zaya Care patients pay $0 for one-on-one counseling with a Registered Dietitan

Christine Traxler MD is a family physician, lifelong writer, and author with a special interest in mental health, women’s healthcare, and the physical after-effects of psychological trauma. As a contributing writer and editor for numerous organizations, she brings a holistic focus to her work that emphasizes healing and wellness through daily self-care, connecting with others, and setting stepwise goals toward achieving more balanced and authentic lives.