Significance of involuntary weight loss and its causes.
Weight loss may be voluntary or involuntary. Voluntary weight loss occur due to dieting,exercise and starvation or decreased intake in older people. But the weight loss is involuntary particular attention cshould be given since it may be an indicator of underlying serious disease.Weight loss can be identified from the hospital or general practice weight record.In some patients weight loss occur without an underlying cause ,which is regained and stabilise over time.
What is significant weight loss
Loss of weight more than 4.5 kg or more than 5% of one’s body weight over a
period of 6 - 12 months is called significant weight loss
Important causes of weight loss
They belong to four main group
1.Cancer,
2.Chronic infection and inflammation
3.Metabolic disorder such as Diabetes ,hyperthyroidism
4.Psychiatric disorders
Cancer - It is the cause of weight loss in upto 25% of cases. Following are the malignancies which are frequently associated with weight loss .
Gastrointestinal,liver, blood , lung, breast, genitourinary, ovarian, and prostate.20% of cancer death is due to severe weight loss and cachexia.
Gut problems(gastrointestinal)
Almost any disease of gut can result in weight loss.
Inflammatory bowel disease, Crohn’s disease or ulcerative colitis cause loss of appetite ,fear of eating, loss of blood, protein and nutrients from body. Malabsorption, Peptic ulcer Pancreatitis Obstruction/constipation Pernicious anemia are the most common gut problems leading to weight loss.
Infections
Tuberculosis, parasites, fungal diseases , subacute bacterial endocarditis, and HIV are common treatable causes
Endocrine and metabolic
Hyperthyroidism Diabetes mellitus Pheochromocytoma Adrenal insufficiency
Chronic Heart and lung disease
Causes weight loss due to increased metabolic demand ,decreased food intake due to disease and decreased appetite
Psychiatric causes
Significant weight loss is seen associated with depression and isolation so that patient fail to take care of nutritional needs. Bereavement is also a well known cause of weight loss especially in men.Alcoholism is an important cause due to malnutrition and self neglet .Other psychiatric disease causing weight loss are Anxiety and Paranoia, anorexia nervosa, ), bulimia
Neurologic disease
Stroke Parkinson’s disease Neuromuscular disorders Dementia
Old age
Decreased taste and smell ,functional disabilities ,age related change in body all result in poor nutrition.
Drugs
Cause loss of weight due to decreased appetite ,nausea ,vomiting ,stomach ulceration ,diarrhea ,dry mouth,altered taste all these are more common in elderly who are 5 or more drugs .Examples are Sedatives ,Antibiotics Nonsteroidal anti inflammatory drugs ,Serotonin reuptake inhibitors, Metformin Levodopa ,Angiotensin-converting enzyme
Weight loss may be voluntary or involuntary. Voluntary weight loss occur due to dieting,exercise and starvation or decreased intake in older people. But the weight loss is involuntary particular attention cshould be given since it may be an indicator of underlying serious disease.Weight loss can be identified from the hospital or general practice weight record.In some patients weight loss occur without an underlying cause ,which is regained and stabilise over time.
What is significant weight loss
Loss of weight more than 4.5 kg or more than 5% of one’s body weight over a
period of 6 - 12 months is called significant weight loss
Important causes of weight loss
They belong to four main group
1.Cancer,
2.Chronic infection and inflammation
3.Metabolic disorder such as Diabetes ,hyperthyroidism
4.Psychiatric disorders
Cancer - It is the cause of weight loss in upto 25% of cases. Following are the malignancies which are frequently associated with weight loss .
Gastrointestinal,liver, blood , lung, breast, genitourinary, ovarian, and prostate.20% of cancer death is due to severe weight loss and cachexia.
Gut problems(gastrointestinal)
Almost any disease of gut can result in weight loss.
Inflammatory bowel disease, Crohn’s disease or ulcerative colitis cause loss of appetite ,fear of eating, loss of blood, protein and nutrients from body. Malabsorption, Peptic ulcer Pancreatitis Obstruction/constipation Pernicious anemia are the most common gut problems leading to weight loss.
Infections
Tuberculosis, parasites, fungal diseases , subacute bacterial endocarditis, and HIV are common treatable causes
Endocrine and metabolic
Hyperthyroidism Diabetes mellitus Pheochromocytoma Adrenal insufficiency
Chronic Heart and lung disease
Causes weight loss due to increased metabolic demand ,decreased food intake due to disease and decreased appetite
Psychiatric causes
Significant weight loss is seen associated with depression and isolation so that patient fail to take care of nutritional needs. Bereavement is also a well known cause of weight loss especially in men.Alcoholism is an important cause due to malnutrition and self neglet .Other psychiatric disease causing weight loss are Anxiety and Paranoia, anorexia nervosa, ), bulimia
Neurologic disease
Stroke Parkinson’s disease Neuromuscular disorders Dementia
Old age
Decreased taste and smell ,functional disabilities ,age related change in body all result in poor nutrition.
Drugs
Cause loss of weight due to decreased appetite ,nausea ,vomiting ,stomach ulceration ,diarrhea ,dry mouth,altered taste all these are more common in elderly who are 5 or more drugs .Examples are Sedatives ,Antibiotics Nonsteroidal anti inflammatory drugs ,Serotonin reuptake inhibitors, Metformin Levodopa ,Angiotensin-converting enzyme
