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What is hyperphagia?

People with hyperphagia have an elevated, uncontrollable, and prolonged appetite for food, which usually results in increased food intake. Medical experts believe this may be due to a change in normal hunger cues and satiety signals that control food intake and satisfaction.1

It is essential to note that recovery is possible with timely support and professional treatment

Last updated on 
January 8, 2024
Hyperphagia
In this article

Hyperphagia is an eating behavior characterized by a pattern of:1

  1. Intense hunger
  2. Increased appetite for food
  3. Excessive hunger and eating

It is common for a person with hyperphagia to uncontrollably consume larger quantities of food than they normally would due to the lack of normal satiety (feeling full). This differs from extreme hunger after strenuous exercise or physical activity, which often resolves after eating.2

In hyperphagia, the desire to eat never stops—even after an episode of binge eating. In fact, eating may further stimulate an unending, intense, and persistent urge to consume more food rapidly.2

Hyperphagia is, by itself, not a disease or eating disorder per the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5). However, hyperphagia usually indicates more severe health issues, such as an underlying medical condition or eating disorder.2

The reality is that hyperphagia affects people across all age groups, races, genders, body types, sexualities, and populations.

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Hyperphagia symptoms

While hyperphagia starts gradually, the signs and symptoms can be challenging to identify. They may overlap with the characteristic features of some eating disorders. Also, hyperphagia can affect people differently as the indicative underlying condition evolves.3

For these reasons, every individual with hyperphagia is unique. For some, symptoms may manifest as a strong desire to always talk about food. Still, in others, it may show up as a lack of satiety, obsession with food, or the need for reassurance of meal time.4

Some common signs of hyperphagia can include:4

  • A strong desire or need to eat
  • Binge eating
  • Obsessing about food
  • Never feeling full or satisfied
  • Engaging in food-seeking behaviors
  • The uncontrollable desire to eat again after a few minutes of finishing a full meal
  • Eating a substantial amount of food in one sitting

What causes hyperphagia?

Hyperphagia is often caused by an underlying medical cause which may be due to several factors. These can include, but aren't limited to, blood glucose levels, hormonal imbalance, and rare diseases.1,2

Blood glucose causes of hyperphagia

Type 1 and type 2 diabetes

It's common for people with type 1 or type 2 diabetes to report feelings of extreme hunger and overeating behavior diagnostic of hyperphagia.6 In diabetes, a lack of insulin or insulin resistance causes the blood glucose level to build up. This is because the body needs insulin to convert the glucose from food into energy, and the available blood glucose is inaccessible to body cells.6

Hypoglycemia

On the other end of the spectrum, when you have low blood sugar, ghrelin—the hunger hormone - transmits signals to the brain to initiate food cravings. Episodes of hypoglycemia are most common at night and often lead to late-night hunger pangs.1

In fact, the higher your ghrelin level, the hungrier you'll get, and vice-versa. This is because the body releases ghrelin when it is starved of sugar. Apart from hyperphagia, other symptoms of hypoglycemia include rapid heartbeat, anxiety, irritability, and dizziness.1

Hormonal causes of hyperphagia

Hyperthyroidism

An overactive thyroid, which medical professionals call hyperthyroidism, can cause a build up of the thyroid hormone in the body. The thyroid hormone regulates the body’s metabolism, so elevated levels can lead to significant changes in the metabolism rate.7 As a result, people with hyperthyroidism use up calories faster than usual and feel hungry regularly.

Premenstrual syndrome (PMS)

PMS is a group of physical, emotional, and psychological symptoms people develop 1-2 weeks before their menstrual period. Hormonal imbalance in response to PMS alters the standard estrogen, progesterone, and serotonin levels.8

This can trigger the following symptoms:

  • Intense craving for carbs and sugary foods
  • Mood and emotional changes
  • Indigestion
Not everyone with PMS will have hyperphagia. Symptoms may appear mild for some, while others may experience severe symptoms.

Mental health causes of hyperphagia

Anxiety and depression

It's common for individuals with hyperphagia to have issues with other mental health conditions, including anxiety and depression. (9,10) While increased appetite is a significant symptom of depression, it can also be a coping mechanism to deal with the associated negative emotions.10

Stress

During chronic stress, you may notice an increased appetite or desire for a sugar, fat, or salt-rich diet. This happens because the brain interprets stress as a threat and signals the adrenal gland to release the stress hormone cortisol to fight it off.11 Scientific evidence shows that binging on such a high-carb diet can cause dopamine, the feel-good hormone, to flood the pleasure-reward centers of the brain and create a pleasant effect. This can stimulate the urge to keep eating even beyond satiety.12

Genetic causes of hyperphagia 

Prader-Willi syndrome (PWS)

A constant hunger drive at about two years of age is a cardinal diagnostic criterion for PWS. In people with this rare genetic condition, the part of the brain that controls appetite is affected. As such, it is not unusual for their food consumption to increase without feeling full.5

Kleine-Levin syndrome (KLS)

Individuals struggling with KLS may not complain of extreme hunger. But they'll usually experience episodes of compulsive hyperphagia that compel the consumption of available food, regardless of the condition, quality, or appeal to personal preferences.13

Understanding hyperphagia and eating disorders

Hyperphagia is typically not a standalone condition. It is a symptom of some eating disorders, which include binge eating disorder (BED) and bulimia nervosa (BN). Both conditions have a significant symptom in common—eating large volumes of food beyond satiety.1

While a restrictive mindset drives BED, compulsive eating may be due to several biological, genetic, or environmental factors in response to negative emotions.14,15 Having either of the two conditions can fuel the hyperphagic drive. 

If you or someone you love is struggling with symptoms of an eating disorder and would like professional treatment, help is available at Within.
Get help today >

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.

Resources

  1. Perello, M., Chuang, J. C., Scott, M. M., & Lutter, M. (2010). Translational neuroscience approaches to hyperphagia. The Journal of neuroscience: the official journal of the Society for Neuroscience, 30(35), 11549–11554. 
  2. Polyphagia (Hyperphagia): What It Is, Causes & Symptoms. (n.d.). Cleveland Clinic. (2023, January 23). Retrieved June 29, 2023.
  3. Crone, C., Fochtmann, L. J., Attia, E., Boland, R., Escobar, J., Fornari, V., Golden, N., Guarda, A., Jackson-Triche, M., Manzo, L., Mascolo, M., Pierce, K., Riddle, M., Seritan, A., Uniacke, B., Zucker, N., Yager, J., Craig, T. J., Hong, S.-H., & Medicus, J. (2023, February 1). The American Psychiatric Association Practice Guideline for the Treatment of Patients with Eating Disorders. The American Journal of Psychiatry, 180(2), 167–171. 
  4. Hyperphagia in prader-willi syndrome. (n.d.). Foundation for Prader-Willi Research. 
  5. Alam, S., Hasan, M. K., Neaz, S., Hussain, N., Hossain, M. F., & Rahman, T. (2021, April 16). Diabetes Mellitus: Insights from Epidemiology, Biochemistry, Risk Factors, Diagnosis, Complications and Comprehensive Management. Diabetology, 2(2), 36–50. 
  6. Li, J.-Y., Wu, X., Lee, A., Zhou, S.-Y., & Owyang, C. (2019, March 5). Altered R-Spondin 1/CART Neurocircuit in the Hypothalamus Contributes to Hyperphagia in Diabetes. Journal of Neurophysiology, 121(3), 928–939. 
  7. Amin, A., Dhillo, W. S., & Murphy, K. G. (2011, May 25). The Central Effects of Thyroid Hormones on Appetite. Journal of Thyroid Research, 2011
  8. Premenstrual syndrome (PMS). (n.d.). Premenstrual syndrome (PMS) | Office on Women’s Health. Retrieved June 29, 2023.
  9. Atypical Depression. (2023, February 02). Cleveland Clinic. 
  10. Konttinen, H., van Strien, T., Männistö, S., Jousilahti, P., & Haukkala, A. (2019, March 20). Depression, emotional eating and long-term weight changes: a population-based prospective study. International Journal of Behavioral Nutrition and Physical Activity, 16(1). 
  11. Kaiser, B., Gemesi, K., Holzmann, S. L., Wintergerst, M., Lurz, M., Hauner, H., Groh, G., Böhm, M., Krcmar, H., Holzapfel, C., & Gedrich, K. (2022, January 14). Stress-induced hyperphagia: empirical characterization of stress-overeaters. BMC Public Health, 22(1). 
  12. Thornley, S., Russell, B., & Kydd, R. (2011). Carbohydrate Reward and Psychosis: An Explanation for Neuroleptic Induced Weight Gain and Path to Improved Mental Health? Current Neuropharmacology, 9(2), 370–375. 
  13. Kleine-Levin Syndrome. (n.d.). NORD (National Organization for Rare Disorders). Retrieved June 29, 2023.
  14. Iqbal, A., & Rehman, A. (2022, October 31). Binge Eating Disorder. PubMed; StatPearls Publishing
  15. Moore, C. F., Sabino, V., Koob, G. F., & Cottone, P. (2017, August 24). Neuroscience of Compulsive Eating Behavior. Frontiers in Neuroscience.

FAQs

What causes hyperphagia?

Hyperphagia is caused by several underlying conditions, including diseases, like diabetes, or eating disorders, like binge eating disorder.1

Which condition is associated with hyperphagia?

Conditions that frequently coexist with hyperphagia may include mental health conditions like depression, glucose-related disorders such as diabetes, and eating disorders like compulsive eating disorder (CED).1

What is the difference between polyphagia and hyperphagia?

While people use hyperphagia and polyphagia interchangeably, they are slightly different conditions. Hyperphagia is usually associated with higher weight, while polyphagia can lead to either suppressed, neutral, or higher weight.2

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