This topic is about a person with Crohn’s disease, an ileostomy/BCIR, and rheumatoid arthritis who is experiencing changes in appetite and weight after stopping tramadol, a medication they were taking. They noticed that while on a small dose of tramadol, they could eat well, stay hydrated, and maintain their weight. However, after stopping the medication, they lost weight, rarely feel hungry, drink less, and sometimes vomit when trying to eat more. They don't feel dependent on tramadol and actually have lower energy and migraines when taking it. Their doctors haven't been able to explain the connection between tramadol and appetite changes, nor have they suggested an effective alternative. Here are some insights and advice shared by others:

1. Opioid-type drugs like tramadol can cause rebound migraines, and many neurologists avoid them for long-term use.
2. Eating 5–6 small snack-sized meals throughout the day instead of three large meals might help reduce nausea and vomiting.
3. Discuss prescription appetite stimulants with your doctor, as there are several options available.
4. Consider therapies based on opioid antagonists, which might be helpful.
5. Some people have found that cannabis products improve appetite:
- Hemp-derived Delta-9 THC helped one person during chemotherapy.
- Smoking or ingesting regular cannabis increased appetite when CBD oil alone did not.
- Be aware that the legal status of these products varies by location.
6. Tramadol can have side effects like low blood pressure, nausea, fatigue, insomnia, and brain fog, and its effects on appetite can vary widely.
7. For digestive support, prescription pancreatic enzymes like Zenpep or Creon have helped some people keep food down and avoid vomiting.
8. It's important to monitor for dehydration and weight loss. If oral intake remains inadequate, discuss options like Total Parenteral Nutrition (TPN) with your healthcare team.