Weight Loss

Weight Loss

Definition

Weight loss occurs when a person burns more calories, or energy, than he or she takes in. It may be deliberate or unintentional.

What is going on in the body?

A loss of weight is due to one of three factors:
  • fewer calories are consumed
  • more calories or energy are burned off during activity
  • a person's basic resting metabolism speeds up
Weight loss may or may not be intended. Unplanned weight loss is often a sign of serious illness.

Risks

What are the causes and risks of the condition?

Some of the causes of weight loss are as follows:
  • cancer, including colon cancer, lung cancer, cancer of the pancreas, or leukemia
  • conditions that affect the ability of the intestines to absorb food and other nutrients
  • diabetes, a condition that results in high blood glucose levels
  • digestive diseases, such as inflammatory bowel disease or peptic ulcers
  • hormone imbalances, such as an increased thyroid hormone level known as hyperthyroidism
  • increased level of physical activity, due to exercise or manual labor
  • infections, such as HIV or tuberculosis
  • intake of fewer calories
  • medicine or drugs, such as amphetamines, ephedrine, cocaine, heroin, or alcohol
  • psychiatric conditions, such as depression, anorexia, or schizophrenia
  • severe kidney, liver, or heart disease
Other causes of weight loss are also possible. Sometimes a cause cannot be found.

Prevention

What can be done to prevent the condition?

For unintended weight loss, prevention is related to the cause. Avoiding the drugs that cause weight loss could prevent those cases due to drugs. Practicing safest sex can nearly eliminate the risk of sexually-transmitted HIV infection. Practicing safer sex can reduce, but not eliminate, cases due to sexually-transmitted HIV infection. Many cases of unintended weight loss cannot be prevented.

Diagnosed

How is the condition diagnosed?

In some cases, the cause of the weight loss is obvious from the medical history and a physical exam. In other cases, further tests are needed. Blood and urine tests may be ordered to diagnose underlying health problems. X-ray tests may be done, such as a chest X-ray to look for heart or lung disease. An abdominal CT scan can be used to look for cancer of the pancreas or liver.

Long Term Effects

What are the long-term effects of the condition?

Intentional weight loss from a healthy diet and exercise decreases the risk of:
  • blood clots, such as deep venous thromboses
  • cancer
  • death
  • diabetes
  • gallstones
  • heart disease
  • high blood pressure
  • osteoarthritis, which is also called wear and tear arthritis, the most common type of arthritis
  • varicose veins, which are enlarged veins often seen in the legs
Intentional weight loss through smoking can cause all the heart, lung, and other negative health consequences of tobacco use. Misuse of diuretics can cause dehydration with all its resulting consequences. Intentional weight loss that is part of an eating disorder such as anorexia nervosa can cause illness in nearly every body system, and is sometimes fatal if not successfully treated.
The long-term effects of unintentional weight loss are related to the cause. Cancer, diabetes, HIV, and severe heart, liver, or kidney disease are common causes of death. Many people who abuse drugs have long-term effects related to social, legal, and psychological problems from the drug abuse.

Other Risks

What are the risks to others?

Weight loss is not contagious. If infection is the cause of unintended weight loss, however, the infection may be contagious. HIV, for example, can be sexually transmitted. Tuberculosis can be spread through respiratory secretions.

Treatments

What are the treatments for the condition?

Weight management plans are helpful for obese or overweight people who want to lose weight.
Treatment for unintended weight loss is directed at the cause. For example, a person with diabetes may need insulin injections or other medicines to control his or her blood glucose levels. Someone who is abusing drugs may need to enter a rehabilitation program. An individual with an infection may need antibiotics. A person with cancer may need surgery, chemotherapy, or radiation therapy.

Side Effects

What are the side effects of the treatments?

Side effects depend on the treatment used for weight loss. Medicines may cause allergic reactions or stomach upset. Surgery can be complicated by bleeding, infection, or allergic reactions to anesthetic.

After Treatment

What happens after treatment for the condition?

A person who loses weight from diet and exercise often feels healthier and happier. Someone with unintentional weight loss may be cured by treatment, such a person with depression. Others may die, such as those with advanced cancer, HIV, or severe liver disease.

Monitor

How is the condition monitored?

Weight can be monitored at home and at every visit to the healthcare professional. Further monitoring is related to the cause. For example, a person with diabetes needs frequent blood tests to monitor his or her blood glucose level. Any new or worsening symptoms should be reported to the healthcare professional.

Sources

Harrison's Principles of Internal Medicine, 1998, Fauci et al.

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