איוב, פרק ל״ג, פסוק כ׳

When a person sinks into severe illness, their body and spirit often lose the most basic drive for survival, leading to a complete rejection of nourishment. This profound loss of appetite is characterized by intense disgust and loathing [רלב״ג, אבן עזרא]. The primary approach among commentators is that the sick person feels a deep sense of foulness, viewing food as something contaminated and repulsive [מצודת ציון, רמב״ן, מלבי״ם].

The physical decline happens in stages. At first, the life force of the sick person rejects basic, everyday sustenance [רש״י, מצודת דוד, ביאור שטיינזלץ]. This is the simple food necessary for mere survival [מלבי״ם], yet the weakened spirit makes even this basic nourishment seem foul and unappealing [רמב״ן]. As the illness deepens, the condition worsens. While initially the person might still tolerate special meals prepared for the sick, eventually they reach a point where they refuse even the most appealing delicacies that any healthy person would naturally crave [אלשיך, רש״י, מצודת דוד, מלבי״ם].

A different perspective views this physical deterioration as a metaphor for spiritual distance from God. In this striking image, it is not the sick person who rejects food. Instead, the person's own body and soul become a desirable feast for the diseases and sufferings that slowly consume them [תקוות אנוש].