Approach to the patient with unintentional weight loss
- Arthur T Evans, MD, MPH
Arthur T Evans, MD, MPH
- Professor of Medicine
- Weill Cornell Medical College
- Renuka Gupta, MD
Renuka Gupta, MD
- Clinical Instructor
- New York Presbyterian Hospital
- Weill Cornell Medical Center
Weight loss is a common problem seen by generalists. Patients who are overweight or obese may intentionally lose weight to improve their health. However, progressive unintentional (involuntary) weight loss often indicates a serious medical or psychiatric illness.
This topic will discuss the approach to unintentional weight loss in the adult patient. Weight loss and nutritional issues in older adults and weight loss or inadequate weight gain in children and adolescents is discussed separately. (See "Geriatric nutrition: Nutritional issues in older adults" and "Failure to thrive (undernutrition) in children younger than two years: Etiology and evaluation" and "Poor weight gain in children older than two years of age".)
●Unintentional weight loss – Unintentional weight loss is also referred to as involuntary or unintended weight loss . This term excludes weight loss as an expected consequence of treatment (eg, weight loss from diuretic therapy in patients with heart failure) or as a result of a known illness. Clinically important weight loss is often defined as loss of more than 5 percent of usual body weight over 6 to 12 months [1,2].
Clinically significant weight loss and nutritional issues in older adult patients is discussed elsewhere. (See "Geriatric nutrition: Nutritional issues in older adults", section on 'Weight loss'.)
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- Nonmalignant gastrointestinal diseases
- Psychiatric disorders
- Infectious diseases
- Advanced chronic disease
- Neurologic diseases
- Physical examination
- Diagnostic testing
- - Initial testing
- - Subsequent evaluation
- SUMMARY AND RECOMMENDATIONS