by Mike Arnold
In Part #1 of this article we talked a lot about digestive health-efficiency and the importance of dietary fine-tuning when it comes to optimizing appetite. While there is no doubt that our individuality plays a big role in determining which type of diet is ideal, there are many who fail to achieve an appetite sufficient for meeting their daily caloric needs even after years of dietary fine-tuning. In these cases there are many steps one can take to help rectify the problem, including both mechanical and chemical manipulation. Which approach is best will depend on the individual’s circumstances, but since I am addressing a wide range of readers, I will cover both.
In terms of mechanical manipulation, I have frequently found colon cleansing to be of great value. This is especially true for bodybuilders, as the typical meat and refined grain-based diet makes it virtually impossible to keep the colon free and clear of debris. This has a direct, negative effect on one’s appetite and in many cases can even make the individual feel ill. Colon cleansing, which can be done either at home or by a professional (at a colon cleansing clinic) can rapidly assist in the removal of this rotting fecal matter, thereby eliminating/minimizing many of the ailments associated with this pre-disease state. While professional cleansing is ideal, home procedures are still a viable option. If you choose to do this at home, I recommend employing a stimulant-based laxative—particularly the Senna-based variety. There are many such products on the market, with one of my favorites being “Smooth Move” tea, by Traditional Medicinals. Unlike powdered products, which require you to consume the whole herb, teas can be just as effective…and are MUCH better tasting. In my opinion, the product above actually tastes pretty good, which is a huge departure from the absolutely disgusting whole-herb powders that you have to mix in water and choke (literally) down.
Lest you think that a Senna-based laxative is going to have you running to the toilet like a scene out of American Pie, you can rest easy knowing this is not the case. You may have to take a few visits to the bathroom over the course of a day, but you will not have to endure the watery explosion attributed to other types of laxatives. Stimulant laxatives work by stimulating the bowels to contract and move uneliminated digestive matter out of the body, rather flooding the bowels with fluids and causing diarrhea-like symptoms. Using these products is easy. I recommend taking them once per week before bed, on a day when you don’t have to work the following morning. It’s not that you couldn’t work, but unless you don’t mind visiting the restroom 3-4 times over the course of your work day, make sure you have the next day off. It may take a few weeks (3-4 applications) before maximum results are achieved, but with long-term, consistent use this simple practice will go a long way toward not only improving bowel health, but will make you feel better and likely lead to an improved appetite.
Before moving onto the various types of drugs/supplements we can use to improve digestion/simulate appetite, let’s first look at one of the major ways in which bodybuilding pharmacology can negatively impact our appetite. Fortunately, the majority of bodybuilding drugs in use today have either a neutral or positive effect on appetite, but one class of drugs in particular is known to cause severe appetite suppression in a large percentage of users. These are oral AAS, or more specifically, methylated steroids. As much as I like my orals—and I really like my orals—there is no denying that many bodybuilders experience anywhere from mild to severe appetite suppression from this class of drugs. While some orals are more likely than others to cause this side effect, personal response can vary greatly among individuals, with some people having no problems and others reacting negatively even to the mildest drugs. The only way to really know how you will respond is to use them and see how things go.
Still, most people will experience at least some degree of appetite suppression from the harsher orals. Some will attempt to fight through it by way of sheer willpower, while others will succumb to their appetite suppressing effects. But rather than viewing this as a test of mental fortitude, the truth is that if this side effect is severe enough, not only will it make your bodybuilding journey miserable, but the chances of achieving long-term success dwindle exponentially. For this reason many find that they can only use these drugs at certain times, such as pre-contest, before photo shoots, or at any other time their cosmetic effects are desired. The point here is that it doesn’t matter how powerful a certain drug might be for adding mass and strength if it prevents you from eating, because if you can’t eat you can’t grow.
When it comes to drugs/supplements, there are many options available. Some of these compounds are used purely for appetite stimulation, while others have additional benefits. Furthermore, not all of these compounds affect everyone in the same way, so some trial and error may be required in order to find what works best for you. Side effects can also vary significantly, with some compounds being considered quite safe and others possessing a comparatively horrendous side effect profile. We also have to consider legality, route of administration (injectable vs. oral), and the manner in which these compounds have been produced (peptide-research company vs. GMP approved facility, etc). Fortunately, there are enough products available to meet just about everyone’s needs and preferences.
Let’s explore some OTC options first. One of the most commonly used and effective OTC preparations is prunus domestica, otherwise known as plum extract. Working through the same mechanism as many other appetite boosters, plum extract stimulates the release of ghrelin, a 28 amino acid peptide produced in the gastrointestinal tract that works in unison with leptin to manage energy balance through appetite control. Unlike leptin, which suppresses appetite, ghrelin has the opposite function, working to increase caloric intake through an increase in appetite. Anecdotal reports are favorable, with many claiming that plum extract has notable and significant effects in this area. 1-2 grams before meals is a normal dosage for this product (note: if you are already using other ghrelin mimetics/releasers, this product may not provide additional benefit).
Another OTC product many find effective, but which often provides contradictory effects is ginger. Oddly, ginger has been shown to both increase and decrease appetite in different individuals, so this really is a product that requires personal experimentation before coming to any conclusions. Although it is most frequently administered for its anti-nausea benefits (it can also cause nausea in higher dosages), it may be useful for stimulating the appetite through increasing the secretion of gastric acids, eliminating gas/bloating, and inducing gastric expansion. Overall, it seems to enhance the digestive process, which is always a plus for those putting away large volumes of food. You should know within a short time whether or not this stuff works for you, and with it being sold at a very affordable price there is little financial risk in trying it out.
This next one isn’t normally classified an appetite stimulant, but it can help improve appetite by eliminating a number of digestive ailments and enhancing overall digestion. I am referring to digestive enzymes. Produced naturally in the body, these enzymes help catalyze the breakdown of proteins, carbohydrates, and fat. Without them proper digestion is impossible, preventing us from fully absorbing all the nutrients we need to maximize recovery and growth. Although the body releases these enzymes in response to the food we eat, production is often inadequate, leaving us susceptible to all sorts of food intolerances and sub-optimal digestion. There are a few reasons for this, one of which is the destruction of naturally occurring enzymes in the food supply. Further compounding the problem is the unnaturally large quantities of food found in the typical bodybuilding diet, which makes it difficult for the body to keep up. By supplementing with exogenous sources of these enzymes we take some of the burden off our digestive system and make it much easier for the body to extract nutrients form the food we eat. Clinically, digestive enzymes have been shown to help provide relief from constipation, boating, gas, heartburn, nausea, food allergies, and also speed up the rate of digestion, all of which can help improve appetite through both direct and indirect mechanisms.
Rarely are minerals thought of as an appetite stimulant, but there is promising evidence to show that zinc may stimulate appetite in those with a zinc deficiency. Several studies on humans have demonstrated its effectiveness in this regard, while rat studies have shown that zinc stimulates food intake through the affernet vagus nerve and by altering the function of peptides associated with food intake regulation. Being that humans possess this same nerve and naturally produce the same peptides, it stands to reason that zinc’s mechanism of action may be the same/similar in humans. Oddly, zinc has also been shown to lead to appetite suppression in some cases. This difference in response is likely attributable to varying levels of zinc throughout the population. A simple blood test can tell you whether or not you are zinc deficient. If you are, supplementing with this mineral is a good idea, as its benefits extend far beyond appetite stimulation alone.
There are a handful of other OTC supplements that may prove useful for appetite stimulation, but for those who need a bit more help than what these products can offer, there are several prescription/ grey-market drugs that work extremely well. Although results can vary, experience has shown that the majority of users respond positively and often to a more profound degree than what is possible with OTC products. Of all the different classes of drugs that are used for this purpose, the GHRP’s (growth hormone releasing peptides) are probably the most well known of the bunch. Although most people use them primarily for their GH and IGF-1 elevating effects, they can just as easily be employed on an as needed basis anytime an increase in appetite is desired. Essentially, these drugs function as ghrelin mimetics, increasing appetite through the same mechanism as ghrelin itself. However, not all of them are effective in this regard, so just randomly choosing one of the GHRP’s is not a good idea. I recommend using either GHRP-6 or GHRP-2, although some of the secretagogues, such as MK-677 and Anamorelin (very hard to obtain), provide similar benefits. Of these, GHRP-6 is generally considered to be the strongest, followed by GHRP-2. However, not everyone will be able to tell a difference between GHRP-6 and GHRP-2, in which case you are better off using GHRP-2, as it is more effective at increasing GH levels.
One of the downsides of these drugs is that they must be injected (subcutaneously with an insulin syringe) and kept refrigerated when not in use. They are also sold only by peptide-research companies, so there are no regulatory bodies in place to monitor the conditions under which they are produced. This can and does lead to quality control issues, but for the most part it is pretty easy to obtain legitimate GHRP’s, as they are both inexpensive and easy to manufacture. This allows them to be sold at a low cost of around $10-$20 a vial (5 mg), which provides anywhere from 25-50 doses on average. Personally, I believe they are the single best class of drugs (in general) for appetite stimulation. Why? They work extremely well for most users and don’t cause any serious side effects. This is a big plus in my book, as most of the prescription options are loaded with negative sides. Furthermore, the GHRP’s have a fairly short duration of action, stimulating the appetite for only a few hours at best. This is usually an advantage, as it allows the individual to more closely manage their appetite, rather than having to deal with ravenous hunger for long periods of time when it may not be wanted. Combined with their low cost and wide availability, this is usually my first recommendation for those dealing with appetite suppression.
I want to take a second to talk about insulin. As many of you know, I am a big proponent of responsible insulin use. It can accelerate recovery, increase muscle fullness, provide superior muscle pumps and accelerate your bodybuilding progress in a number of other ways. However, I have recently seen more and more people advocating insulin as an appetite stimulant—something I do NOT recommend. Although it is certainly effective in this regard, the indiscriminate use of insulin, especially when administered chronically, causes more problems than it is worth. In my mind, it makes little sense to expose oneself to such risks when there are safer, equally effective alternatives available. The bottom line is that insulin shouldn’t be used purely for its appetite stimulating effects.
Over the years I have been approached by many clients asking what I think about prescription appetite stimulants. I can almost hear the excitement in their voice as they ask me what to take and how to take it, but their excitement quickly turns to disappoint when I tell them that I don’t believe that ANY of these drugs are suitable for bodybuilders. Understandably, the next question out of their mouth is “why”? Having appetite issues myself, this is an area of research I have spent a considerable amount of time investigating. Therefore, I can tell you that my reservations do not stem from a lack of effectiveness, but from their unacceptable side effect profile. Most of these drugs were originally prescribed for another purpose, but after pharm companies became aware of their appetite stimulating effects they were re-submitted to the FDA for approval as an appetite stimulant.
Some of these drugs include Remeron (mirtazapine), Megace (megestrol), Marinol (dronabinol), Periactin (cyproheptadine), and even the anabolic steroid Oxandrin (oxandrolone). I am not going to spend too much time on these as I don’t believe they are worthwhile, but I will provide a brief description of each. Mirtazapine (brand name Remeron) was originally used (and still is) as an anti-depressant. For those of you who are at least semi-educated on this class of drugs, I shouldn’t need to tell you why anti-depressants are a horrible choice for those seeking to improve their appetite. Not only do all of them cause a multitude of unwanted side effects, but this stuff is particularly nasty. Involved in a class-action lawsuit, Remeron has been linked to suicidal ideation/suicide attempts, liver damage, bone marrow damage, violent behavior, depression, seizures, loss of coordination, and birth defects. In addition to all that, it can make you so sleepy that you literally won’t want to get out of bed. I have yet to see a single bodybuilder use this stuff for more than a day or two before saying “never again”. Internal side effects aside, common sense dictates that any drug which places someone in a comatose state is not compatible with the bodybuilding lifestyle. If you’ve ever heard the term “drugged-up”, it applies readily to mirtazapine. This is bad stuff all the way around.
Less severe in the side effect department, but also less effective, is cyproheptadine (brand name Periactin). An antihistamine similar to Benadryl, cyproheptadine is usually given to help relieve symptoms associated with colds, allergies, and hay fever, but is also prescribed to for insect bites, poison ivy, and poison oak. Unfortunately, it can cause drowsiness just like mirtazapine—maybe not to the same degree, but still significant enough to adversely affect day to day functioning. Furthermore, it appears to be more effective in treating appetite loss in children and adolescents than it does in adults.
Dronabinol (brand name Marinol) is a synthetic version of tetrahydrocannabinol (THC), the principle mood and mind-altering substance found in marijuana. You will find a wide range of opinions regarding the use of marijuana in bodybuilding, but I am not going to debate the ethics or morality of its use. Rather, I will say that as someone who has extensive experience with the drug (it has now been almost 20 years since I’ve used it), and having reviewed much of the recent literature surrounding it, I do not believe that appetite stimulation alone (in the majority of cases) is justification for its use. The logic supporting my position is simple and can be summed up as follows. There are other options available which can do the job just as well, but with a greatly reduced side effect profile. I understand that most users view appetite stimulation as only one of the many potential benefits this drug provides, but when evaluating it strictly within the context of appetite stimulation, its risk to benefit ratio is far from ideal.
Megestrol (brand name Megace) is completely unsuitable for use in bodybuilders, and most other people for that matter. As a synthetic progesterone derivative, those who use megestrol are susceptible to all the side effects normally associated with elevated progesterone levels. This includes sexual dysfunction, reduced testosterone levels and sperm production, fat gain, decreased insulin sensitivity, and many more. I see zero use for this drug as an appetite stimulant, regardless of the circumstances. Better options are available.
I am not going to get into the other FDA approved therapies for appetite stimulation, such as AAS use (i.e. oxandrolone), fish oil consumption, etc, as they are marginally effective at best. Many users experiencing no benefits at all and in the case of oxandrolone, some experience the exact opposite effect. One might think that with all the money and resources available to pharmaceutical companies that they would have come up with something better by now, but regardless of the reasons for their failure our best options still come from grey-market and OTC companies. Before I go I want to mention one more thing that many have found to be helpful for increasing their appetite. This is not a drug or a supplement, but can be done almost anywhere without having to spend a single penny and it comes with a multitude of health benefits. I am talking about good old cardio. While excessive cardiovascular activity can be detrimental to recovery and growth, low-moderate intensity cardio performed 3-4 times per week (20-30 minutes per session) can often provide a significant boost in appetite.
For those of you whose appetite does not match your caloric needs, it is my hope that the information presented here will help close the gap, while allowing you to avoid many of the mistakes made by those without direction. There is no easy way to bodybuilding success, but by employing what you learned here you may find that it becomes just a little easier.