Food Aversions

What a food aversion feels like

A food aversion is more than not liking a food. It often involves:

• nausea or gagging at the sight, smell or thought of the food
• a sudden switch from loving a food to being repelled by it
• heightened sensitivity to smells, such as cooking meat, coffee or garbage

Aversions are the opposite of cravings, but they often occur together, especially in pregnancy.

Food aversions in pregnancy

Food aversions affect more than half of pregnant women, often starting around 5 to 6 weeks, alongside morning sickness. They usually peak in the first trimester and ease by 14 to 16 weeks, although some last the whole pregnancy.

Common pregnancy aversions:

• meat, poultry and fish, especially cooked smells
• eggs
• coffee and tea
• spicy, fried or fatty foods
• garlic and onions
• alcohol and cigarette smoke

The cause is not fully known. Rising hormones (hCG and estrogen) and a heightened sense of smell are thought to play a role. One theory holds that aversions protect the developing baby from foods more likely to carry harmful bacteria or toxins.

Food aversions are not a reliable sign of pregnancy, of the baby's sex or of any problem with the pregnancy. If your period is late and you have new aversions with nausea, a pregnancy test will answer the question.

Other causes of food aversions

Learned taste aversion

If you get sick after eating a food, your brain links the two, even if the food was not the cause. One episode of vomiting can create an aversion lasting years. This is a strong, fast form of learning.

Cancer treatment

Chemotherapy and radiation cause nausea, taste changes and mouth sores, so patients may develop aversions to foods eaten around treatment. Many develop a dislike of red meat or a metallic taste. The cancer itself can also reduce appetite.

Migraine and illness

Nausea during migraine, colds, flu and COVID-19 can create aversions. Loss or distortion of smell after viral infections (parosmia) can make previously liked foods smell rotten or chemical.

Medicines

Antibiotics, metformin, GLP-1 medicines for diabetes and weight loss, some antidepressants and opioids can cause nausea and taste changes.

Medical conditions

• Gastroparesis, ulcers and reflux, which make eating uncomfortable
• Stomach cancer, where aversion to meat with early fullness and weight loss in an older adult needs investigation
• Zinc deficiency and some thyroid and kidney conditions, which affect taste
• Liver disease

Avoidant/restrictive food intake disorder (ARFID)

ARFID is an eating disorder in which a person eats a very limited range of foods because of sensory sensitivity to taste, texture or smell, fear of choking or vomiting, or lack of interest in food. Unlike anorexia, it does not involve body image concerns. It often starts in childhood and can cause poor growth, nutrient deficiencies and weight loss. See eating disorders.

Sensory differences

Children with autism or sensory processing differences may strongly reject certain textures or mixed foods.

How doctors assess food aversions

A doctor will ask when the aversions began, which foods are affected, whether there is nausea, vomiting or weight loss, and about medicines, pregnancy and mood. They will check weight, hydration and, in children, growth. Tests depend on the clues: a pregnancy test, blood tests for anemia, zinc, thyroid and kidney function, or an endoscopy if stomach disease is suspected. Suspected ARFID is assessed by an eating disorder specialist.

How to cope with food aversions

In pregnancy

• Eat small, frequent meals and snacks, and avoid an empty stomach.
• Swap in alternative protein sources if meat repels you: beans, lentils, dairy, nuts, tofu or eggs if tolerated.
• Choose cold or room-temperature foods, which smell less.
• Ask someone else to cook, open windows and use an exhaust fan.
• Keep taking a prenatal vitamin with folic acid. If the pill itself triggers nausea, take it with food or at bedtime, or ask about a chewable form.
• Ginger and vitamin B6 can help nausea. Ask your doctor before starting supplements. Medicines are available for severe nausea.

During cancer treatment

• Avoid favorite foods right before chemotherapy so they do not become linked to nausea.
• Use plastic cutlery if food tastes metallic.
• Try marinades, herbs and tart flavors to improve taste.
• Ask about anti-nausea medicines and a dietitian referral.

For children

• Offer disliked foods alongside accepted ones without pressure.
• Expect many exposures, often 10 to 15, before a new food is accepted.
• Seek help if the child accepts fewer than about 20 foods, is losing weight or meals cause severe distress.

Frequently asked questions

When do food aversions start in pregnancy?

They usually begin around 5 to 6 weeks of pregnancy, often at the same time as nausea, and are strongest in the first trimester. Most improve by 14 to 16 weeks, although some women have aversions throughout pregnancy.

Are food aversions an early sign of pregnancy?

They can be one of the early signs, along with a missed period, nausea, breast tenderness and tiredness. They are not reliable on their own because illness, stress and medicines can also cause them. A home pregnancy test is the best way to check.

Why do I suddenly hate a food I used to love?

Sudden aversions often follow pregnancy, an episode of nausea or food poisoning linked to that food, a virus that changed your sense of smell, a new medicine, or cancer treatment. If the aversion comes with weight loss or other symptoms, see a doctor.

Can food aversions be a sign of something serious?

Usually not, but persistent aversions with weight loss, early fullness, vomiting or abdominal pain can point to stomach problems, including cancer in older adults. A very restricted diet with poor growth or weight loss can also be ARFID, which needs treatment.

How long do food aversions last?

In pregnancy, most fade after the first trimester. Aversions after an illness may last weeks to months, while a learned aversion after food poisoning can persist for years. Gradual, low-pressure exposure can help reduce long-standing aversions.