causes of WEIGHT LOSS and causes of unexplained weight loss and how to control it

its causes 

Gastrointestinal disease

Almost any disease of the gastrointestinal tract can cause weight loss.

Dysphagia and gastric outflow obstruction cause defective dietary intake. Malignancy at any site may cause weight loss by mechanical obstruction, anorexia or cytokine-mediated systemic effects.

 •Malabsorption from pancreatic diseases or small bowel causes may lead to profound weight loss with specific nutritional deficiencies.

•Inflammatory diseases such as

Crohn's disease or ulcerative 

colitis cause anorexia, fear of 

eating and loss of protein, blood

and nutrients from the gut.

Specific diseases of any 

major organ system

These may be difficult to diagnose

without a high index of suspicion. 

They may cause weight loss by a range

of mechanisms, including altered

metabolism in diabetes mellitus,

Addison's disease and thyrotoxicosis

   

Weight loss occurs as a 

consequence of increased



metabolic demands in


patients with end-stage



respiratory and cardiac



diseases. Multiple



mechanisms are responsible



in many cases:

  for example, patients with



active or advanced

rheumatological and collagen-




vascular disorders lose weight 

from a combination of anorexia

physical disability, altered metabolic demands and the systemic effects of their conditions.

In many diseases anorexia and weight loss may be compounded by the effects of drug therapies (e.g. digoxin) which may cause nausea, dyspepsia, constipation or depressaion.

Some easily overlooked causes of weight loss are listed in

SOME EASILY OVERLOOKED CAUSES OF UNEXPLAINED WEIGHT LOSS

qDepression/anxiety

q  Chronic pain or sleep deprivation

q  Psychosocial deprivation/malnutrition in the elderly

  Existing conditions, e.g. severe chronic obstructive pulmonary disease (COPD), cardiac failure

•Diabetes 

mellitus/hyperthyroidism

•Occult malignancy (e.g. 

proximal colon, renal, 

lymphoma)

•Anorexia nervosa in atypical 

groups, e.g. young men

•Rare endocrine disorders, e.g.

Addison's disease, 

panhypopituitarism

Investigations

In cases where the cause of weight loss 

is not obvious after thorough history-

taking and physical examination, or 

where it is considered that an existing 

condition is unlikely, the following 

investigations are indicated: urinalysis 

for sugar,

protein and blood; blood tests including

liver function tests, random blood


glucose, and thyroid function tests;

ESR (may be raised in unsuspected 

infections such as TB, connective


tissue disorders and malignancy).
Sometimes invasive tests such as


bone marrow aspiration or liver biopsy

may be necessary to identify

conditions like cryptic miliary 

tuberculosis Rarely,

 abdominal and pelvic imaging by CT may be necessary, but before embarking on invasive or very costly investigations it is always worth revisiting the patient's history and reweighing patients at intervals.