Assessment of weight loss and treatment
- 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 atleast one laboratory abnormality.
Tests to be done are
Laboratory tests
- Complete blood count
- Comprehensive electrolyte and metabolic panel,
- including liver and kidney function tests
- Thyroid function tests
- Erythrocyte sedimentation rate
- C-reactive protein
- Ferritin
- HIV testing, if indicated in high risk persons
- Radiology
- Chest x-ray
- Abdominal ultrasound (USG)
Treatment
1.First thing tobe done is to identification and treatment of the underlying cause.
2.Certain causes are treatable which include metabolic, psychiatric, infectious, or other systemic disorders .That will help to restore the weight.
3.Drugs causing nausea and loss of appetite should be changed.
4.Nutritional supplementation , high-energy drinks,supplements should be taken between meals
5.In some patients antidepressant mirtazapine results in a significant increase in body weight,
1.First thing tobe done is to identification and treatment of the underlying cause.
2.Certain causes are treatable which include metabolic, psychiatric, infectious, or other systemic disorders .That will help to restore the weight.
3.Drugs causing nausea and loss of appetite should be changed.
4.Nutritional supplementation , high-energy drinks,supplements should be taken between meals
5.In some patients antidepressant mirtazapine results in a significant increase in body weight,
