What can cause unintentional weight loss?

It's natural for your weight to fluctuate during the year. A couple of extra or fewer pounds on the scale is just normal — and nothing to worry about. Weight loss is often a matter of choice. We choose to change our diet and exercise habits to become healthier. If there is a clear and healthy reason, then weight loss is normal.

However, it isn't normal to lose a significant amount of weight without any obvious reason. Losing than 5% of body weight over the course of a six to twelve-month period without any obvious change in your diet or activity should be investigated.

There can be a variety of causes for weight loss including under eating, medication, sedentary lifestyle and illness. Occasionally, the first symptom to show in some serious conditions is weight loss. Other symptoms usually develop at some point later. Also, some people with weight loss as a first symptom actually have one or more symptoms if they were questioned about them.

You should pay particular attention if you experience other symptoms, such as:

• tiredness
• loss of appetite
• a change in your toilet habits
• an increase in illnesses or infections

For this reason, if you have experienced weight loss without seeking to, you should see your doctor in order to determine what is causing the weight loss.

Unintentional weight loss in persons older than 65 years is associated with increased morbidity and mortality. If you are 65 years or older and noticed that you have dropped weight unexpected, go to talk to your doctor about it.
A doctor's assessment and tests will usually be able to find the cause. Normally, the first approach will involve a thorough history, a physical examination and basic laboratory testing.

Sometimes, if the basic evaluation comes back negative, watchful waiting for one to six months is a reasonable next step. Your weight is affected by your calorie intake, activity level, overall health, age, nutrient absorption, and economic and social factors.
Medication use and polypharmacy can interfere with taste or cause nausea and should not be overlooked.

Treatment should focus on the underlying cause. This often involves a multidisciplinary team, including dentists; dieticians; speech, occupational, or physical therapists; and social service workers.

References:
• Bouras EP et al. Rational approach to patients with unintentional weight loss.Mayo Clin Proc. 2001 Sep;76(9):923-9.
• Podolsky DK et al. Approach to the Patient with Unintentional Weight. LossYamada' s Textbook of Gastroenterology
• McMinn J, Steel C, Bowman A. Investigation and management of unintentional weight loss in older adults. BMJ. 2011;