Polyphagia: What Causes Excessive Hunger?

Polyphagia, also called hyperphagia, is the medical term for excessive hunger and increased appetite that may not be satisfied. 

Feeling hungry is a normal physiological function required for survival. It is regulated by hormones like leptin and ghrelin in the body. However, polyphagia is hunger that goes beyond this natural sensation of hunger. It is an extreme, insatiable hunger that is not satisfied by eating, with hypoglycemia (low blood sugar levels) being the exception.

The increased appetite and hunger may come and go or it may be present all the time. Polyphagia may or may not result in weight gain, depending on the underlying cause.

Common Misconceptions of Polyphagia

Myth: Polyphagia is not a real thing.

Fact: While it is rare, polyphagia is real. It can be a symptom of many medical conditions. The most common are uncontrolled diabetes and thyroid hormone disorders. Less common causes of polyphagia include a genetic disorder or mental health condition.

Myth: Excessive hunger (polyphagia) always has an emotional component.

Fact: An emotional component is not always present in polyphagia. For example, when polyphagia is a symptom of diabetes, it is not directly associated with the emotional component.

Myth: Polyphagia goes away after eating.

Fact: Unlike natural hunger, which typically subsides after eating, polyphagia is an insatiable hunger that may not go away even after eating. 

Recognizing Symptoms of Polyphagia  

The main symptoms of polyphagia are extreme, insatiable hunger and increased appetite, even when there is no reason to be hungry. For example, a person may feel constant hunger (feeling hungry all the time) or unexplained hunger (feeling hungry soon after a large meal). 

The intense hunger and excessive amounts of food consumption can lead to weight gain. But in some cases weight loss can happen with polyphagia, despite the increased hunger and appetite. 

For example, in type 1 diabetes, the immune system mistakenly attacks the insulin-producing cells in the pancreas. As a result, the pancreas cannot produce insulin. Without insulin, glucose begins to accumulate in the blood, and since the body is unable to convert glucose into energy, it starts using fat and muscle as alternative energy sources. This leads to weight loss due to the breakdown of muscle and fat. At the same time, polyphagia occurs because the body is unable to use glucose for energy.

Other common symptoms that can accompany polyphagia (excessive hunger) depend on the underlying cause.

Polyphagia is not a condition by itself. It is a symptom that something else is going on in the body. Polyphagia should always be evaluated by a healthcare professional. Polyphagia may be a symptom of conditions like diabetes, hyperthyroidism, premenstrual syndrome (PMS), or eating disorders. 

Other symptoms of diabetes include: 

• Polydipsia (increased thirst)

• Polyuria (increased urination)

• Nocturia (frequent nighttime urination)

• Fatigue

• Blurred vision

• Numbness and tingling in the hands and feet

• Delayed wound healing

• Weight loss, especially with type 1 diabetes

In addition to polyphagia, other symptoms of hyperthyroidism include:

• Rapid heartbeat (heart palpitations)

• Irritability, nervousness, anxiety

• Thinning skin

• Irregular menstrual periods

• Tremors

• Excessive sweating

• Sleep problems

• Heat intolerance

• Fatigue

• Hair loss

• Bulging eyes

• Goiter (enlarged thyroid)

In addition to polyphagia, other symptoms of premenstrual syndrome (PMS) include:

• Changes in bowel habits (diarrhea or constipation)

• Bloating

• Irritability and mood swings

• Fatigue

• Headache

• Fluid retention

• Low sex drive

• Breast tenderness

Learn the differences between PMS and PMDD.

In addition to polyphagia, other signs and habits of eating disorders include:

• Episodes of binge eating (eating large amounts of food in a short period of time)

• Restrictive eating (this is different from fasting due to health or religious purposes)

• Purging (forced vomiting) 

• Diuretic or laxative misuse

• Compulsive, excessive exercise, especially after meals

Notably, different types of eating disorders may present with different signs, symptoms, and habits. 

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Polyphagia Caused By Uncontrolled Diabetes

Undiagnosed, untreated, or uncontrolled diabetes (type 1 diabetes, type 2 diabetes, and gestational diabetes) is a common cause of polyphagia (increased appetite and insatiable hunger).

Malnutrition can also cause polyphagia. Decreased nutrition or undernutrition can be from an inadequate diet or due to the inability of the body to absorb nutrients from food.

Polyphagia and Hyperglycemia: What’s the Connection?

Insulin is a hormone made by the pancreas that regulates blood sugar levels in the body. In people with diabetes mellitus, the body cannot make insulin or does not use insulin properly (insulin resistance). This results in high blood sugar levels (hyperglycemia). Without enough insulin, the body cannot use sugar (glucose) for energy expenditure. The lack of energy in the body’s cells causes excessive hunger (polyphagia) in people with uncontrolled diabetes. 

Note: Polyphagia can also be a symptom during hypoglycemia episodes (low blood sugar) in people with diabetes.

Polydipsia, Polyuria, and Polyphagia

Doctors call polydipsia (excessive thirst), polyuria (frequent urination), and polyphagia (excessive hunger) the 3 P’s of diabetes. If you have these three symptoms, seek medical care as soon as possible. Undiagnosed and untreated diabetes can lead to damage to many organs in the body and serious health complications.

Hormonal Conditions  

Polyphagia can also be a symptom in people with a medical history of certain endocrine disorders due to changes in hormone levels:

• Hyperthyroidism and Graves’ disease: Thyroid hormone plays a key role in metabolism. High thyroid hormone levels in people with an overactive thyroid gland can speed up metabolism, causing constant hunger and weight loss despite eating excessively.

• Premenstrual syndrome (PMS): Elevated levels of estrogen and progesterone and decreased serotonin levels during the menstrual cycle can cause polyphagia 1-2 weeks before a menstrual period.

• Insulinoma: This is a rare tumor of the insulin-secreting cells in the pancreas. It leads to high insulin levels in the body, which causes hypoglycemia (low blood sugar levels) and excessive hunger (polyphagia).

Mental Health Conditions

Polyphagia can be a symptom of mental health disorders such as:

• Eating disorders like binge eating disorder.

• Atypical depression (symptoms are different from typical depression and include polyphagia and weight gain).

• Anxiety disorders (excessive eating as a coping mechanism for emotional issues).

• Stress (due to high levels of cortisol (stress hormone) in the body).

Rare Medical Conditions That Cause Polyphagia

• Prader-Willi syndrome (PWS): Prader-Willi syndrome is a rare genetic disorder that affects metabolism and causes polyphagia, increase in appetite, and weight gain.

• Kleine-Levin syndrome: Kleine-Levin syndrome is an extremely rare condition that mainly affects adolescent males. It causes sleeping for long periods (up to 20 hours a day) and other symptoms like overeating (polyphagia), child-like behavior, irritability, disorientation, and hallucinations.

Polyphagia Due To Medication Side Effects

Certain medications can cause polyphagia and an increase in appetite. For example:

• Corticosteroids such as prednisone.

• Cannabinoids (cannabis products).

• Antipsychotics such as clozapine, olanzapine, risperidone, haloperidol, quetiapine, and lithium.

• Antidepressants such as imipramine (Tofranil), amitriptyline, doxepin, phenelzine (Nardil), escitalopram (Lexapro), citalopram (Celexa), paroxetine (Paxil, Pexeva), and mirtazapine (Remeron).

• Anti-seizure medications such as gabapentin, pregabalin, carbamazepine, valproic acid, divalproex, vigabatrin.

• Hormonal birth control pills.

• Diabetes medicines such as insulin, thiazolidinones, and sulfonylureas.

• Beta-blockers (blood pressure medications) such as atenolol, propranolol, and metoprolol.

Treatment Options for Polyphagia  

Medical Treatments and Interventions  

Treatment of polyphagia depends on the underlying medical condition causing this symptom. For example:

• If you have prediabetes, your healthcare provider may recommend lifestyle changes such as diet and exercise.

• For diabetes type 2, you may need to take oral anti-diabetes medications, such as metformin.

• If you have diabetes type 1, you will need to take insulin injections lifelong. 

• For hyperthyroidism, your doctor may prescribe anti-thyroid medicine such as methimazole or propylthiouracil, radioactive iodine therapy, or surgery.

• If the cause of your increased appetite is a mental health condition such as an eating disorder, you will receive counseling and therapy.

• If a medication side effect is responsible for an abnormally strong appetite, your doctor may lower the dose or switch you to a different drug.

Lifestyle Changes and Dietary Adjustments

• Eat mindfully: Eat slowly and pay attention to what you're eating. This can help you recognize when you're full rather than mindlessly consuming a large amount of food. 

• Eat smaller, more frequent meals: Eating multiple small meals throughout the day can help curb appetite. 

• Eat protein and fiber: Protein and fiber-rich foods can help you feel full. 

• Drink water: Staying hydrated can help you feel less hungry. 

• Exercise: Exercise can not only help you lose weight but also help with hunger and appetite regulation.

• Get enough sleep: Aim for 7-9 hours of good quality sleep every day. This can help suppress appetite. 

• Manage stress: Stress can contribute to hunger, so try to manage it with practices such as meditation, mindfulness, deep breathing, muscle relaxation, yoga, and tai-chi. 

FAQ: Addressing Common Questions  

Why Do I Feel Hungry Even After Eating?  

Feeling hungry even after eating is called polyphagia. It can be a sign of diabetes (high blood glucose levels) and other medical conditions. Your healthcare provider can make a proper diagnosis and offer the appropriate treatment. 

How To Solve Polyphagia Effectively?  

The way to solve polyphagia effectively is to find out the underlying cause and treat it. 

Polyphagia vs Binge Eating: How To Tell the Difference?  

Binge eating disorder is a mental disorder in which a person eats a large amount of food in a short period of time and feels they can't control what or how much they eat. Polyphagia also involves excessive hunger and appetite. It can be due to eating disorders but can also have other medical causes. 

Is Polyphagia Rare?

Polyphagia is not all that rare. It is a common symptom of diabetes. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Centers for Disease Control and Prevention (CDC), about 38 million people, or 11% of the U.S. population, have diabetes.

When To Seek Professional Help  

Signs That Require Healthcare Provider Attention  

Polyphagia (extreme hunger that does not go away by eating food) is a sign of an underlying medical condition and should be diagnosed and treated. If you notice problems with appetite regulation, make an appointment to see a healthcare provider. Your doctor can find out the cause of polyphagia based on your other symptoms, medical history, physical exam, and tests.  

Preparing For Your Medical Consultation  

It may help to take the following to your medical consultation for polyphagia:

• A list of your symptoms.

• Known medical conditions.

• Current medications including prescription drugs, over-the-counter medications, herbal products, and dietary supplements.

• Food diary and eating habits.

Long-Term Health Implications of Unmanaged Polyphagia

It’s important to seek timely medical evaluation for polyphagia. Polyphagia or hyperphagia can cause you to overeat, and excessive food intake can lead to weight gain and obesity. Additionally, increased appetite and excessive hunger can be signs of many serious medical conditions, which, if left untreated, can lead to life-threatening complications.