Indications of assessment .
- Following are the indication for assessment of weight loss . When the patient has
- 5% weight loss in one month
- 10% weight loss in six months
- Body mass index < 21
- Change in fit of clothing
- Change in appetite, smell, or taste
- Abdominal pain, nausea, vomiting, diarrhea, constipation, dysphagia
Assessment of
people with weight loss.
Those with significant weight loss usually manifest , four cardinal manifestation.They are given below
- Loss of appetite
- Loss of muscle mass Cachexia (combines weight loss, loss of muscle and adipose tissue,loss of appetite, and weakness)
- Dehydration.
- Detailed history and physical examination including dental evaluation is very important .
Other things to be done as part of assessment are
- Cancer screening
- Mini-Mental State Examination
- Mini-Nutritional Assessment
- Assessment Questionnaire
- Observation of eating
- Activities of daily living
- Instrumental activities of daily
- Living
Almost all patients with malignancy and more than 90% of
those with weight loss due to a reason will have at least one laboratory
abnormality.Tests to be done are
Laboratory tests
Complete blood count
Comprehensive electrolyte and metabolic panel,including liver and kidney function tests
Comprehensive electrolyte and metabolic panel,including liver and kidney function tests
Thyroid function tests
C-reactive protein
Ferritin
HIV testing, if indicated in high risk persons
Radiology
Chest x-ray
Abdominal ultrasound (USG)
Treatment
- First thing to be done is to identification and treatment of the underlying cause.
- Certain causes are treatable which include metabolic, psychiatric, infectious, or other systemic disorders .That will help to restore the weight.
- Drugs causing nausea and loss of appetite should be changed.
- Nutritional supplementation , high-energy drinks,supplements should be taken between meals
- In some patients antidepressant mirtazapine results in a significant increase in body weight.
