Seven sick reasons that cause of Unintentional weight loss

Did you know that approximately 50% of patients who claim significant weight loss actually have no objectively measurable change in body weight?
Therefore, when consulting a patient for weight loss, before conducting a thorough investigation, it is important to verify that there has already been weight loss and measure the period in which it has occurred.

It is not uncommon to see patients who did not realize that they had already lost weight to an appropriate degree.
Any significant weight loss that was not deliberately sought by a previously healthy person usually indicates the presence of systemic disease.
That is why it is important to systematically determine the body weight of each patient at the consultation.

What are the symptoms of Unintentional weight loss?

Unintentional weight loss has many causes

Patients who suffer from pathological conditions that justify weight loss usually have signs and symptoms that allow us to suspect the condition of a certain organ, apparatus or body system.

1. Tumors of the digestive system, including those of the pancreas and liver, can impair food intake early and cause weight loss before other symptoms appear.
2. Lung cancer can manifest as postobstructive pneumonia with dyspnea, or cough and hemoptysis, but it is also often asymptomatic and should be suspected even in nonsmokers.
3. Depression and isolation can lead to significant weight loss, particularly in the elderly. Anorexia and increased energy expenditure at rest may occur in chronic obstructive pulmonary disease and congestive heart failure.
4. Unintentional Weight loss can be the first manifestation of some infectious diseases, such as HIV infection, tuberculosis, endocarditis, and fungal and parasitic infections.
5. Hyperthyroidism or pheochromocytoma increases basal metabolism; Elderly patients with apathetic hyperthyroidism may present with weight loss and weakness, with few other manifestations of thyrotoxicosis.
6. New-onset diabetes mellitus is often associated with weight loss due to glycosuria and loss of the anabolic effects of insulin.
7. Adrenal insufficiency may be suspected from hyperpigmentation, hyponatremia, and hyperkalemia.

How is Unintentional weight loss diagnosed?

Look for signs or symptoms that are associated with conditions that commonly cause weight loss, such as fever, aches, dyspnea or cough, palpitations, changes in urination, and signs of neurologic disease.

Gastrointestinal disorders, such as difficulty eating, dysphagia, anorexia, nausea, and changes in bowel habits, should also be sought.
It is necessary to ask about travel and the consumption of cigarettes, alcohol and all kinds of medications, and also inquire about the history of other diseases or surgical interventions, as well as about the illnesses of relatives.
Risk factors for HIV infection should be evaluated, and signs of depression or senile dementia should also be sought.
The physical examination that is carried out is complete and is assessed device by device to check if there are alterations. In men, a digital rectal examination should be performed to palpate the prostate and a study to identify fecal occult blood; and all women should undergo a gynecological examination, even if the womb has been removed.
Laboratory tests should include a complete blood count with glucose counts, electrolytes, liver and kidney function tests, calcium and TSH, urinalysis, and a chest x-ray.
In all cases, it is necessary to update/repeat the selective detection tests (screening) recommended for some cancers, according to sex and age group, such as mammography and Pap smears.
If gastrointestinal signs or symptoms are present, upper or lower endoscopy (or both) and abdominal study using computed tomography or magnetic resonance imaging have a relatively high rate of diagnostic confirmation.
If no cause is detected to explain the weight loss, careful clinical monitoring of the patient should be scheduled, rather than insisting on other tests without any clinical guidance.