Weight Loss : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 10/09/2022

Weight loss is a decrease in body weight within 5-15% of the original values ​​in a short period of time. A person can suddenly or greatly lose weight with voluntary or forced malnutrition, pathology of the oral cavity and digestive tract, infectious, psychiatric and neurological diseases. To determine the cause of weight loss, advanced blood tests, sonography and x-ray imaging, and a neurological examination are performed. To restore metabolism and return to normal weight, a high-calorie diet is combined with drug therapy.

Reasons for weight loss

Malnutrition

Common causes of weight loss are voluntary restriction of food intake, increased physical activity. The condition is more typical for young and middle-aged women who, in pursuit of ideal body parameters, resort to strict diets. With such rapid weight loss, weight loss can be up to 5-1 kilograms per month, which provokes the appearance of problems with appearance and health. Hair begins to fall out and nails exfoliate, the skin becomes flabby, white stretch marks form. Complaints of general weakness, loss of strength, apathy, constant drowsiness are typical.

In the elderly, malnutrition and weight loss are often due to socio-economic characteristics of lifestyle - the predominance of cereals and bakery products in the diet, insufficient consumption of nutritious meat and fish dishes. As a result, the percentage of adipose and muscle tissue decreases, the body seems to “dry out”, the ribs, collarbones, and pelvic bones become clearly visible. The skin is pale with a yellowish tint, sagging. Lack of nutrients causes problems in all organs, constant sharp weakness, dizziness.

Depression

Depressive states are manifested by a complete loss of interest in ongoing events and loss of appetite. Patients sharply reduce the amount of food taken up to the refusal of food. Weight loss in depression reaches 10-15% of the initial body weight, weight loss is combined with severe weakness, drowsiness - sometimes a person sleeps 14-16 hours a day and does not feel rested. The appearance changes - the skin looks dry and pale, the hair on the head falls out, the nails exfoliate and crumble. In such a situation, in order to prevent depletion of the body, qualified medical assistance is required.

dental problems

Dental diseases (caries, pulpitis), lesions of the oral mucosa of a traumatic or infectious cause lead to sharp pains and fear of eating. With extensive pathological processes, there is a refusal to eat and rapid weight loss. If the pains are of an infectious origin, the temperature usually rises, a general malaise is expressed. In elderly patients, in the absence of some teeth, chewing is disturbed, food enters the stomach insufficiently processed. Because of this, the digestibility of nutrients decreases, as a result, a person loses weight.

Damage to the pancreatobiliary system

With pathologies of the liver, biliary tract and pancreas (hepatitis, cholecystitis, pancreatitis, etc.), a sharp weight loss is due to enzyme deficiency, due to which most of the food is not broken down and absorbed in the small intestine. At first, the appetite does not suffer, patients eat food in the usual volumes, but lose weight. In this case, after eating, there is heaviness and pain in the abdomen. In the future, the appetite decreases, constant nausea, flatulence disturb. The amount of food consumed is reduced by 2-3 times, up to 1 kg of weight is lost. Typical violations of the stool - the alternation of diarrhea and constipation, periodic tenesmus.

Diseases of the gastrointestinal tract

With any inflammation or destructive pathologies of the intestinal wall, the absorption of nutrients is reduced. Weight loss develops gradually, weight loss rarely reaches 10%. Symptoms are associated not only with insufficient calorie intake, which causes general exhaustion and reduces performance, but also with vitamin deficiencies. Vitamin deficiency is manifested by a deterioration in the appearance of the skin and hair, characteristic changes in the tongue - it becomes bright red and shiny. Common gastroenterological causes of weight loss:

  • Inflammatory processes : gastroenteritis, duodenitis, colitis.
  • Functional disorders : pylorospasm, gastroptosis, dyspepsia.
  • Chronic inflammatory bowel disease : Crohn's disease, ulcerative colitis.
  • Insufficiency of pancreatic enzymes .

infections

Any infectious process is accompanied by intoxication of the body, fever and general malaise, in which the appetite worsens and the person loses weight. With prolonged viral or bacterial diseases, significant weight loss is observed up to exhaustion. The skin becomes pale with a cyanotic tint, the eyes sink, the bones of the skeleton are well contoured. Malnutrition leads to beriberi: hair becomes dull and brittle, nails exfoliate. Weight loss with increased appetite is pathognomonic for helminthiasis and protozoan invasions.

Endocrine pathology

Hormonal shifts and metabolic disorders are often accompanied by dramatic weight loss. With a lack or excess of certain hormones, all metabolic processes change, catabolism prevails over synthesis. The breakdown of proteins, fats and carbohydrates causes rapid weight loss by reducing the volume of adipose tissue and muscle fibers. Weight loss occurs evenly, body proportions do not change. In addition to the general signs of exhaustion of the body, specific symptoms are noted. The main endocrine causes of noticeable weight loss are:

  • Diabetes mellitus . Weight loss is more common in type 1 diabetes in children and young adults. The lack of insulin provokes the activity of contrainsular hormones responsible for catabolic reactions. Despite a sharp increase in appetite, there is a rapid loss of body weight by 5-1 kg. There is also general weakness and headaches, severe thirst, and the volume of urine increases.
  • Hyperthyroidism . An increase in the concentration of thyroxine in the blood increases the level of basal metabolism. Appetite is pathologically increased, patients are constantly hungry, but the weight is steadily decreasing. Then the amount of food taken decreases, which is due to difficulty in swallowing due to an increase in the volume of the thyroid gland. The skin remains pink and moist for a long time.
  • Hypopituitarism. A sharp decrease or cessation of the production of pituitary hormones disrupts all types of metabolism and provokes rapid weight loss. Pituitary causes accelerate the breakdown of fats and the destruction of proteins in muscle tissue, muscle tone and strength decrease, and the functioning of internal organs is disrupted. The skin is dry, thinned, hanging in folds on the arms, abdomen, thighs.

Complications of pharmacotherapy

Weight loss is most often associated with the use of cytostatics for the treatment of tumor pathology and severe collagenoses. The drugs disrupt the functioning of the gastrointestinal tract, cause destruction of the epithelium of the entire digestive canal, which causes loss of appetite and a sharp decrease in the absorption capacity of the small intestine. Common causes of clinically significant weight loss are the use of antibacterial drugs that inhibit the microflora in the intestine and provoke dysbacteriosis. Weight loss is also observed with the regular use of laxatives, antipsychotics, tranquilizers.

Rare Causes

  • Oncological diseases : leukemias and lymphomas, cancer or sarcoma of any localization.
  • Joint diseases : rheumatoid arthritis, osteoarthritis.
  • Degenerative neurological processes : senile dementia, dyscirculatory encephalopathy, consequences of strokes.
  • Cardiological pathology : decompensated heart failure, myocarditis, endocarditis.

Diagnostics

Weight loss for no apparent reason is an indication for consultation with a general practitioner (family doctor or internist). The specialist conducts a comprehensive examination and excludes the most typical diseases manifested by weight loss. An instrumental study begins with an assessment of the work of the gastrointestinal tract, with the appearance of other pathological symptoms, the nervous, cardiovascular systems are examined, infections are excluded. The following have the greatest diagnostic value:

  • Blood study . Standard general and biochemical blood tests reveal nonspecific signs of the inflammatory process (leukocytosis, increased C-reactive protein and sialic acids). To exclude the pathology of the gastrointestinal tract, the levels of the main digestive enzymes are specified. The concentration of rheumatoid factor is determined.
  • Hormonal profile . First, a standard blood test for glucose, free insulin levels in the blood, and C-peptide is performed to confirm the presence of type 1 diabetes. When weight loss is combined with symptoms of thyrotoxicosis, the amount of T3 and T4 in the blood is measured, the concentration of thyroid-stimulating hormone of the pituitary gland and thyreoliberin of the hypothalamus is assessed.
  • Ultrasound . To confirm or refute the gastroenterological causes of sudden weight loss, an abdominal ultrasound is prescribed, during which attention is paid to structural anomalies, intestinal wall defects or diffuse changes in the echogenicity of parenchymal organs. Ultrasound of the thyroid gland can rule out hyperthyroidism.
  • Instrumental Visualization . If pathological signs are detected on ultrasound, endoscopy, colonoscopy, or x-ray examination of the digestive tract with oral contrast is recommended. If a pituitary lesion is suspected, a targeted x-ray of the Turkish saddle, MRI or CT of the brain is performed.
  • Additional Methods . In case of pain in the teeth, a consultation with a dentist, radiography of the jaws is indicated. If weight loss is accompanied by mental disorders, a neurological and psychiatric examination is required. To confirm the infectious cause of weight loss, the results of a bacteriological study of feces, serological reactions are needed.

Treatment

Help before diagnosis

When complaining of a large weight loss, self-medication is not allowed, since such a symptom indicates serious disorders in the body. If a person loses more than 15% of their weight, or if the weight loss is accompanied by a sharp deterioration in the condition, urgent medical attention is needed. Until the cause of the disorder is clarified, high-calorie nutrition, non-specific symptomatic drugs are prescribed. For pain in the abdomen or headaches, analgesics are indicated, in case of an increase in temperature to febrile values, NSAIDs are acceptable.

Conservative therapy

Medical tactics depend on the specific disease that caused weight loss, but in all situations it is necessary to ensure sufficient intake of nutrients in the body. If the patient can eat on his own, select an individual diet with a high content of calories and vitamins. Patients in serious condition are fed through a tube or parenterally infused solutions of glucose, proteins. In addition to a high-calorie diet, drugs of etiotropic and pathogenetic action are prescribed:

  • Non-steroidal anti-inflammatory drugs . They are used for a wide range of diseases - inflammatory lesions of the intestine, stomatitis, gingivitis. To reduce their negative impact on the gastrointestinal mucosa, selective COX-2 inhibitors are used.
  • Antibiotics . Antibacterial drugs are effective for bacterial infections of any localization. A specific drug is selected after receiving the results of bacteriological culture and a test for the sensitivity of the flora.
  • Antiseptics . Rinsing the mouth with solutions of chlorhexidine, miramistin can remove pathogenic microorganisms and plaque. This speeds up recovery from stomatitis, periodontal disease and gum disease.
  • Hormones . Weight loss in thyroid disease is treated with thyroxine antagonists, which inhibit hormone synthesis. In severe diabetes, short-acting or long-acting (prolonged) insulins are administered.
  • Enzymes . In chronic pancreatitis, enzyme preparations are recommended in combination with bile acids, which improve the processes of digestion and absorption of nutrients. Means appoint long courses.
  • Antidepressants . Weight loss on the background of depressive symptoms is the basis for the use of specific serotonin receptor agonists. Drugs normalize the emotional sphere, increase interest in life.

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