Unexplained weight loss: Can it be dangerous?

Apr 08, 2018 Features / Columnists

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By Dr Zulfikar Bux
Assistant professor of Emergency Medicine

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 is also common to lose weight if you have a serious disease. It may be the first symptom, but for most serious diseases, there will usually be one or more other symptoms that develop well before any weight loss.
Today we will focus on weight loss associated with medical conditions that are more serious and often life-threatening. We will discuss each condition so that you can understand why they cause weight loss.

CANCER

In the vast majority of cases of cancer, other symptoms will develop before any weight loss. There are many symptoms that can occur, depending on the type and site of the cancer. However, occasionally, weight loss is the first symptom noticed. The weight loss is partly due to the increased activity of cancer cells in the body that require nutrition and they “feed on the body”. The more advanced the cancer gets, the more the weight loss.

TYPE 2 DIABETES

Type 2 diabetes occurs mainly in people aged over 40, although it can occur at younger ages. The four common symptoms are being thirsty a lot of the time, passing large amounts of urine, tiredness and weight loss. Some people pass off the first three symptoms to do with other things, or ‘getting older’. So, weight loss is sometimes the first thing reported to a doctor. The weight loss is due to our body’s inability to properly use the sugar from food. It ends up breaking down fats and muscle tissue to get sugar, causing weight loss.

DEPRESSION

Depression has a number of symptoms. However, some people do not recognize that they have depression. They may feel low and not right but cannot say why. They may even think of it as just normal for them. Many people with depression can hide their true feelings from friends and family. Weight loss may develop due to a lack of appetite and not wanting to eat.

ALCOHOL ABUSE

Some people who drink a lot of alcohol do not look after themselves very well. Their diet may not be very good and they may lose weight. However, they may be in denial about an alcohol problem. It may be friends or family who actually notice that the person has lost weight. After they get addicted, they tend to skip meals and focus on drinking. Over time, their stomach gets damaged and they are unable to properly absorb nutrients. This leads to further weight loss.
HYPERTHYROIDISM

Hyperthyroidism means that you make too much of a hormone called thyroxine. The thyroid gland is in your neck and may sometimes malfunction, causing this to happen. The extra thyroxine causes many of your body’s functions to speed up, causing you to lose weight despite having an increased appetite. This may be a first symptom. But, again, some of the other symptoms that may occur such as being restless, nervous, emotional or irritable, may just be put down to a stressful time of life or to your personality. In the early stages of hyperthyroidism some people actually feel well and full of energy and don’t realize they have a problem but lose weight.

PERSISTENT/CHRONIC INFECTION

It would be unusual not to have other symptoms with a chronic infection. But, occasionally, the first symptom that is noticed with infections such as tuberculosis or HIV is weight loss. Hookworm infection of the gut is another example where weight loss may be the first indication of disease. Hookworm is a very common problem and is present in Guyana.

MALABSORPTION SYNDROMES

There are various diseases that can affect the way food is absorbed and taken into the body from the gut. These would normally cause symptoms such as diarrhea. However, weight loss may be the first symptom noticed. Examples include coeliac disease, disease and ulcerative colitis.

EATING DISORDERS

In conditions such as anorexia, a person usually knows they are tightly controlling their diet and exercise and are actively trying to lose weight. Over time it becomes more of a mental condition and the affected person becomes obsessed with weight loss. However, this may be hidden from friends and family, and may not be divulged even to the doctor.

SIDE-EFFECTS FROM MEDICATION

Sometimes medication may cause side-effects resulting in weight loss. For example, some pills may cause a loss of appetite, or a dry mouth. Some cause heartburn or give a mild tummy discomfort. Others may affect the sense of taste or smell, or make people feel sick. Any of these side-effects could affect eating habits and result in a loss of weight.

WHAT ASSESSMENT AND TESTS MAY BE DONE?

If you have lost weight and do not know why then see a doctor. This is because, as a general rule, the earlier a serious problem is diagnosed, the better the chance that treatment may improve the outlook.
Your doctor is likely to ask various questions. He or she may actually uncover other symptoms that you were either unaware of or did not think were significant. He or she may also examine you. Tests, such as blood tests, may or may not be appropriate depending on the cause of your weight loss.
Often, treatment depends on the cause of the weight loss. Finding out the cause is often the key. Visit your doctor if you have unexplained weight loss.

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