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Weight Loss: Causes, Symptoms & Treatment

Weight loss refers to a reduction in body weight. It can be intentional or unintentional and may indicate various underlying health conditions.

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Things worth knowing about "Weight loss"

Weight loss refers to a reduction in body weight. It can be intentional or unintentional and may indicate various underlying health conditions.

What is Weight Loss?

Weight loss refers to a decrease in total body weight over a period of time. A distinction is made between intentional weight loss – achieved through dietary changes or increased physical activity – and unintentional weight loss, which may signal an underlying medical condition. Unintentional weight loss of more than 5 % of body weight within 6 to 12 months is considered clinically significant and warrants medical evaluation.

Causes

The causes of weight loss are diverse and range from lifestyle-related factors to serious medical conditions:

Dietary causes: Caloric deficit due to reduced food intake or increased energy expenditure
Metabolic disorders: e.g., hyperthyroidism, type 1 diabetes mellitus
Gastrointestinal conditions: e.g., Crohn disease, coeliac disease, chronic diarrhoea
Infectious diseases: e.g., tuberculosis, HIV/AIDS, parasitic infections
Cancer: Malignant diseases are frequently associated with unintentional weight loss (cancer cachexia)
Mental health conditions: e.g., depression, anxiety disorders, eating disorders such as anorexia nervosa
Medications: Certain drugs can suppress appetite or alter metabolism
Heart failure or chronic kidney disease

Symptoms and Associated Complaints

Unintentional weight loss often occurs alongside other symptoms that may point to the underlying cause:

Fatigue and general weakness
Loss of appetite (anorexia)
Nausea or vomiting
Changes in bowel habits (diarrhoea, constipation)
Fever or night sweats
Enlarged lymph nodes
Mood changes or depressive symptoms

Diagnosis

When unintentional weight loss is present, a thorough diagnostic workup is carried out by a healthcare provider:

Medical history: Assessment of weight trends, dietary habits, accompanying symptoms, and current medications
Physical examination: Evaluation of general condition, palpation of organs and lymph nodes
Laboratory tests: Complete blood count, thyroid function, blood glucose, inflammatory markers, kidney and liver function
Imaging: Ultrasound, X-ray, or CT scan depending on the suspected diagnosis
Specialised tests: e.g., endoscopy if a gastrointestinal cause is suspected

Treatment

Treatment depends on the underlying cause of the weight loss:

Treatment of the underlying condition: e.g., medication for hyperthyroidism, diabetes, or infections
Nutritional therapy: Dietary counselling, calorie-dense foods, oral nutritional supplements, or – in severe cases – artificial nutrition
Psychotherapy: For weight loss related to eating disorders or mental health conditions
Appetite stimulants: Pharmacological options may be considered in specific cases
Physiotherapy and exercise therapy: To preserve muscle strength and overall functional capacity

When to See a Doctor?

Medical attention is strongly recommended when:

more than 5 % of body weight has been lost within 6 to 12 months without an obvious reason,
weight loss is accompanied by fever, night sweats, severe fatigue, or other concerning symptoms,
known risk factors are present, such as older age, smoking, or pre-existing conditions.

References

Deutsches Ärzteblatt – Unintentional Weight Loss: Causes and Diagnostic Approach (2020)
World Health Organization (WHO) – Nutrition and weight management guidelines
Longo DL et al. – Harrison's Principles of Internal Medicine, 20th edition, McGraw-Hill (2018)

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