Weight Loss
Is a reduction of the total body mass, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue. It can occur unintentionally due to an underlying disease or can arise from a conscious effort to improve an actual or perceived overweight or obese state.
Suspected causes of weight loss
Ankylosing spondylitis
Bilateral lesions of the lateral hypothalamus (hypothalamic anorexia)
Decreased food intake/malnutrition
· Abdominal angina
· Anorexia of aging
· Chronic/recurrent nausea/vomiting
· Dementia/Alzheimer disease
· Esophageal disease/dysphagia
· Medications
o Angiotensin-converting enzyme inhibitors (distortion of taste)
o Antibiotics
o Antidepressants
o Digoxin
o Levodopa
o Metformin
o Nonsteroidal anti-inflammatory agents
o Sedatives
o Theophylline
· Obstructive disease (including pyloric obstruction due to chronic peptic ulcer disease)
· Oral disease (e.g., loose dentures, poor or absent teeth)
· Pain
· Poor social situation
· Postantrectomy (especially Billroth II) or gastrectomy
· Poverty
· Unpalatable diets
Endocrine disorders
· Adrenal insufficiency
· Diabetes mellitus
· Diabetic neuropathic cachexia
· Hypercalcemia
· Panhypopituitarism
· Pheochromocytoma
· Thyrotoxicosis
Extensive exercise
Infection, especially:
· Amebic abscess
· Bacterial endocarditis
· Chronic suppurative pleuropulmonary disease
· Cryptosporidiosis
· Fungal diseases
· Giardiasis
· Human immunodeficiency virus (HIV)
· Mycobacterium avium pulmonary infections
· Parasitic infestations
· Paraspinal/epidural abscess
· Tuberculosis
· Visceral leishmaniasis
Maldigestion/malabsorption
· Inflammatory bowel disease
· Pernicious anemia
Malignancy, especially:
· Biliary
· Breast
· Gastrointestinal
· Glucagonoma
· Hepatic
· Leukemia
· Lymphoma
· Myeloma
· Pancreatic
· Pulmonary
· Somatostatinoma
Myelofibrosis
Myotonic dystrophy
Neuromuscular disorders
Parkinson disease
Pink disease (mercury poisoning in children)
Psychiatric disease
· Alcoholism
· Anorexia nervosa
· Anxiety disorders
· Bulimia
· Conversion disorders
· Depression
· Manipulative behaviors
· Psychosis/paranoia
· Schizophrenia
· Substance abuse
Severe chronic organ failure
· Heart failure (cardiac cachexia)
· Hepatic disease
· Pulmonary disease
· Renal failure
Stroke
Systemic lupus erythematosus
References
1. Reife CM. Weight loss, p. 234. See Bibliography, 1.
2. Baron RB. Protein-energy malnutrition, p. 1315. See Bibliography, 5.