Unexplained weight loss

DEFINITION

Unexplained weight loss, or losing weight without trying — particularly if it’s significant or persistent — may be a sign of an underlying medical disorder.

The point at which unexplained weight loss becomes a medical concern is not exact. But many doctors agree that a medical evaluation is called for if you lose more than 5 percent of your weight in six months to a year, especially if you’re an older adult. For example, a 5 percent weight loss in someone who is 160 pounds (72 kilograms) is 8 pounds (3.6 kilograms). In someone who is 200 pounds (90 kilograms), it’s 10 pounds (4.5 kilograms).

Your weight is affected by your calorie intake, activity level, overall health, age, nutrient absorption, and economic and social factors.

CAUSES

Unexplained weight loss has many causes, medical and nonmedical. Often, a combination of things results in a general decline in your health and a related weight loss. Sometimes a specific cause isn’t found.

Usually, an unrecognized cancer will have other symptoms or abnormalities of laboratory tests, in addition to unexplained weight loss.

Potential causes of unexplained weight loss include:

Addison’s disease (adrenal insufficiency)

Cancer

Celiac disease

Changes in diet or appetite

Changes in sense of smell

Changes in sense of taste

COPD

Crohn’s disease

Dementia

Dental problems

Depression

Diabetes

Heart failure

HIV/AIDS

Hypercalcemia

Hyperthyroidism (overactive thyroid)

Hypothyroidism (underactive thyroid)

Medications

Parkinson’s disease

Peptic ulcer

Substance abuse (alcohol, cocaine, other)

Tuberculosis

Ulcerative colitis

WHEN TO SEE A DOCTOR

If you’re losing weight without trying and you’re not sure why, consult your doctor — especially if you lose 5 percent of your weight within six to 12 months. If you’re a frail, older adult, talk with your doctor for even a smaller amount of weight loss.

Your doctor will work with you to try to determine what’s causing the weight loss. At first that will involve a thorough history, a physical examination and basic laboratory testing. Full body scans to look for hidden cancers are not usually helpful unless some other clue points in that direction.

Sometimes, if the basic evaluation is negative, watchful waiting for a few months is a reasonable next step. You may need a special diet to prevent further weight loss or to regain lost pounds.