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Appetite stimulation towards fatty food items: case report A 42-year-old man developed appetite stimulation towards fatty food items during treatment with fenofibrate and simvastatin for high plasma lipids, total cholesterol and triglycerides [duration of treatments to reaction onset not stated]. The man, who was obese, presented to clinic due to tiredness and strong general headache. He reported inadequate sleep and had administered paracetamol to treat his headache episodes. He admitted himself for treatment of persisted headaches. On current admission, he had elevated BP and started receiving amlodipine initially, but the high BP persisted. Afterwards, furosemide was given along with continuous administration of low-ion water. After four hours, his BP and headache improved significantly. He was advised to continue his systematic medications with BP monitoring. His medical records revealed diagnosis of hypertension with similar headache episodes one year previously. On analysis at that time, he had high total cholesterol, plasma lipids and triglycerides. He had been receiving oral medications including simvastatin 20mg daily at night and fenofibrate 200mg daily in the morning along with amlodipine. Following the therapy, he had showed slight improvement. His medications were continued, but after six months from the first episode, he experienced similar onset of symptoms including headache, high BP and plasma lipids. His physician had instructed to continue the same doses of simvastatin and fenofibrate with modification in hypertension regimen to olmesartan medoxomil/amlodipine/hydrochlorothiazide. Thereafter, he reported improvement in BP over a period of six months. However, he experienced tiredness and another episode of strong general headache. Therefore, he admitted himself to current hospital. On admission, laboratory tests revealed elevated BP, triglycerides and total cholesterol and was found to be pre-diabetic. He was instructed to reduce the ingestion of carbohydrate-rich food items, desserts and reduce consumption of table sugar by replacement with natural low-calorie sweetener. On further investigation, he reported that his appetite toward fatty food items increased significantly since the initiation of fenofibrate and simvastatin. He had unbalanced dietary components which included excessive consumption of red meat, chicken meat, fried eggs and cow-milk butter. It was considered that high lipid diet following increased desire due to lipid medications and coffee consumption were the main contributing factors to repeated hypertension episodes. The man’s fenofibrate dose was reduced to 100mg daily (half a tablet in the morning) while maintaining the dose of simvastatin. He was instructed to avoid table salt and sweets, to reduce consumption of red meat, chicken meat, cow-milk butter, hydrogenated oils and eggs, to consume more vegetables and one multi-vitamin supplement daily with the main meal. During follow-up, it was noted that he strictly adhered to the instructions and lost about 7kg of weight