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Friday, February 7, 2014

WEIGHT LOSS (its physiological,psychiatric,systemic causes) and how to loss your weight rapidly

    Weight loss may be 'physiological' due to dieting, exercise, starvation, or the decreased nutritional intake which accompanies old age. Alternatively, weight loss may signify disease; a loss of more than 3 kg over 6 months is significant. Hospital and general practice weight records may be valuable,as may reweighing patients at intervals, as sometimes weight is regained or stabilizes in those with no obvious cause. 
Pathological weight loss can be due to psychiatric illness, systemic disease, gastrointestinal causes or advanced disease of any specific organ system
History and examination
When weight loss is due to serious organic disease a careful history, physical examination and simple laboratory tests will usually define other features that lead to a specific diagnosis
'Physiological' weight loss
This may be obvious in cases of young individuals who describe changes in physical activity or social circumstances. It may be more difficult to be sure in older patients when a history of nutritional intake may be unreliable; professional help from a dietitian is often valuable.

Psychiatric illness
Features of anorexia nervosa, bulimia and affective disorders may only be apparent after formal psychiatric input.
Alcoholic patients lose weight as a consequence of self-neglect and poor dietary intake.
Systemic diseases
Chronic infections including tuberculosis, recurrent urinary or chest infections, and a range of parasitic and protozoan infections should be considered. A history of foreign travel, high-risk activities and specific features such as fever, night sweats, rigors, productive cough and dysuria must be sought. Sensitive, appropriate questions regarding lifestyle (promiscuous sexual activity and drug misuse) may suggest HIV-related illness
Weight loss is a late feature of disseminated malignancy (carcinoma, lymphoma or other hematological disorders). Specific symptoms, physical signs, relevant imaging, or biochemical or hematological abnormalities are almost invariable.


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