Weight loss

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Overview

Weight loss
ICD-10	R63.4 Abnormal weight loss R64 Cachexia
ICD-9	783.21
DiseasesDB	28440
MeSH	D015431

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List of terms related to Weight loss

Weight loss, in the context of medicine or health or physical fitness, is a reduction of the total body weight, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue.

Differential Diagnosis of Causes of Weight loss

Causes include;

Chronic Renal Failure
Liver Failure
Tuberculosis
Malignancy

• Interceded by production of cytokines
• Anorexia Nervosa

• Low albumin
• Parotid enlargement
• Lesions on hands from inducing vomit
• Tooth decay from frequent vomiting
• Menstrual irregularities (Amenorrhea)

Addison's Disease
Gastrointestinal/malabsorbtion disorders

• Diarrhea is often present
• Celiac Disease
• Crohn's Disease
• Cystic Fibrosis
• Peptic ulcer disease
• Depression
• HIV Infection

Hypercalcemia

• Most common in cancer patients

• Advanced cardiac and pulmonary disease

• Chronic Heart Failure
• Chronic Obstructive Pulmonary Disease

• Chronic drug use

• Nicotine
• Opiates

• Hyperthyroidism

• Increased appetite/energy
• Patient may present with

• Tachycardia
• Hypertension
• Opthalmopathy

• Hyperemesis gravidarum

• Exaggerated nausea in early pregnancy
• Elevated hormone levels

• Adrenal insufficency

• Anorexia Nervosa
• Nausea
• Fatigue

• Thriving difficulties(infants)

• Parental neglect
• Metabolism problems
• Significant disease (heart, lung)

Complete Differential Diagnosis of the causes of Weight loss

(In alphabetical order)

Abatacept Injection (patient information) Achalasia Actinomyces Acute lymphoblastic leukemia Acute myeloid leukemia Acute promyelocytic leukemia Adderall Addison's disease Adjustable gastric band Adrenocorticotropic hormone deficiency Aerobic exercise Aggressive NK-cell leukemia Alcoholic Hepatitis Allopurinol (patient information) Aminopterin Amiodarone Oral (patient information) Amphotericin B Injection (patient information) Anorexia nervosa Arsenic Poisoning Aspergillus clavatus Aspergillus fumigatus Autoimmune pancreatitis Barrett's esophagus Basedow syndrome Benzodiazepine withdrawal syndrome Beriberi Bevacizumab Injection (patient information) Blastocystosis Blastomycosis Blind loop syndrome Botulinum toxin Bulimia nervosa Bumetanide (patient information) Busulfan (patient information) Byssinosis Calcitriol (patient information) Calorie restriction Cancer Cannabis (drug) Carboplatin (patient information) Carmustine (patient information) Castleman's disease Celiac disease Cervical cancer Cetuximab Injection (patient information) Chagas disease Chlorambucil (patient information) Cholangiocarcinoma Chronic fatigue syndrome Chronic Obstructive Pulmonary Disease Chronic pancreatitis Chronic Renal Failure Chronic wasting disease Churg-Strauss Syndrome Cirrhosis Cladosporium Clenbuterol Clofarabine Injection (patient information) Cocaine Cogan syndrome Colorectal cancer Congestive Heart Failure Crohn's disease Cystic Fibrosis Cytarabine (patient information) Dehydration Dexatrim Dexfenfluramine Dexmethylphenidate Dextroamphetamine Diabetes mellitus type 1 Diabulimia Diaphoresis Diarrhea Dientamoeba fragilis Dieting Diphyllobothrium infection DKA Donepezil (patient information) Duloxetine Dysphagia

Eating disorder ECA stack Empyema Thoracis Enfuvirtide Injection (patient information) Entamoeba histolytica Eosinophilic gastroenteritis Ephedra Eskatrol Esophageal cancer Esophageal candidiasis Ethosuximide Exenatide Familial adenomatous polyposis Fasciola hepatica Felbamate (patient information) Fluorouracil (patient information) Fluticasone Nasal Spray (patient information) Fluticasone Oral Inhalation (patient information) Folate deficiency Food intolerance Frailty syndrome Fucus vesiculosus L. Fundic gland polyposis Furosemide (patient information) Galantamine (patient information) Gallbladder cancer Gastric bypass surgery Gastric lymphoma Gastroesophageal reflux disease Gatifloxacin (patient information) Gefitinib (patient information) Giardia lamblia Glucagonoma Syndrome Glucose-galactose malabsorption Graves' Disease Hashimoto's thyroiditis Hemangiosarcoma Hepatitis C HIV Hodgkin's lymphoma Hookworm Hydrolyzed collagen (hydrolysate) Hydroxycitric acid Hypercalcemia Hyperemesis gravidarum Hyperthyroidism Ileitis Indapamide (patient information) Inflammatory bowel disease Interferon beta-1a Intramuscular Injection (patient information) Interferon beta-1a Subcutaneous Injection (patient information) Interferon Beta-1b Injection (patient information) Interstitial nephritis Irritable bowel syndrome Ischemic colitis Isosporiasis Kaposi's sarcoma Kikuchi disease Krabbe disease Leflunomide (patient information) Leishmania infection Leukemia Leuprolide (patient information) Levothyroxine Liothyronine (patient information) Liposarcoma Liposuction Lithium (patient information) Liver Failure Lomustine (patient information) Lung cancer Malabsorption Malaria Malassimilation Malignancy Malnutrition Mantle cell lymphoma Marasmus Marburg virus Mechlorethamine (patient information) Mediastinal tumor

Melphalan (patient information) Ménétrier's disease Mercaptopurine (patient information) Mesothelioma Methsuximide Oral (patient information) Methylphenidate Micropolyspora faeni Mini sleeve gastrectomy Mitochondrial myopathy Modafinil Mucor stolonifer Mycobacterium avium complex infection Myxoma Natalizumab injection (patient information) Neuroendocrine tumors Nevirapine (patient information) Nicotine Non-Hodgkin lymphoma Osteoporosis Oxaliplatin injection (patient information) Pancreatic cancer Panniculitis Parkinson's disease Peginterferon alfa-2a (patient information) Peginterferon alfa-2b (patient information) Pemetrexed injection (patient information) Pemoline (patient information) Peptic ulcer Phendimetrazine Phenformin Phenmetrazine Phenylbutazone Phenytoin oral (patient information) Pheochromocytoma Piroxicam (patient information) Polyarteritis nodosa Polymyalgia Rheumatica Posaconazole (patient information) Pott's disease Pramipexole (patient information) Pramlintide Protriptyline (patient information) Pulmonary alveolar proteinosis Pyloric stenosis Q Fever Rasagiline (patient information) Renal cell carcinoma Ribavirin (patient information) Rift Valley fever Rivastigmine (patient information) Sarcoidosis Selective serotonin reuptake inhibitor Short bowel syndrome Silicosis Sitophilus granarius Small intestine cancer Sorafenib (patient information) Spironolactone and hydrochlorothiazide (patient information) SSRI discontinuation syndrome Stomach cancer Streptobacillus Sultiame Sunitinib (patient information) Synephrine Syphilis Systemic lupus erythematosus Takayasu's Arteritis Tamoxifen (patient information) Thioguanine (patient information) Thiotepa (patient information) Thyroglobulin (patient information) Torsemide Injection (patient information) Toxic multinodular goiter Trimetrexate Glucuronate (patient information) Tuberculosis Tularemia Ulcerative colitis Vorinostat (patient information) Waldenström's macroglobulinemia Whipple disease Zoledronic Acid Injection (patient information) Zonisamide (patient information)

Complete Differential Diagnosis of the Causes of Weight loss

(By organ system)

Cardiovascular	Congestive Heart Failure,
Chemical / poisoning	Ephedra, Fucus vesiculosus L., Arsenic Poisoning, Cannabis (drug), Cocaine, Nicotine,
Dermatologic	No underlying causes
Drug Side Effect	Abatacept Injection (patient information), Adderall, Allopurinol (patient information), Aminopterin, Amiodarone Oral (patient information), Amphotericin B Injection (patient information), Benzodiazepine withdrawal syndrome, Bevacizumab Injection (patient information), Bumetanide (patient information), Busulfan (patient information), Calcitriol (patient information), Carboplatin (patient information), Carmustine (patient information), Cetuximab Injection (patient information), Chlorambucil (patient information), Clenbuterol, Clofarabine Injection (patient information), Cytarabine (patient information), Dexmethylphenidate, Donepezil (patient information), Duloxetine, Enfuvirtide Injection (patient information), Ethosuximide, Felbamate (patient information), Fluorouracil (patient information), Fluticasone Nasal Spray (patient information), Fluticasone Oral Inhalation (patient information), Furosemide (patient information), Galantamine (patient information), Gatifloxacin (patient information), Gefitinib (patient information), Indapamide (patient information), Interferon beta-1a Intramuscular Injection (patient information), Interferon beta-1a Subcutaneous Injection (patient information), Interferon Beta-1b Injection (patient information), Leflunomide (patient information), Leuprolide (patient information), Levothyroxine, Liothyronine (patient information), Lithium (patient information), Lomustine (patient information), Mechlorethamine (patient information), Melphalan (patient information), Mercaptopurine (patient information), Methsuximide Oral (patient information), Methylphenidate, Modafinil, Natalizumab injection (patient information), Nevirapine (patient information), Oxaliplatin injection (patient information), Peginterferon alfa-2a (patient information), Peginterferon alfa-2b (patient information), Pemetrexed injection (patient information), Pemoline (patient information), Phenformin, Phenylbutazone, Phenytoin oral (patient information), Piroxicam (patient information), Posaconazole (patient information), Pramipexole (patient information), Pramlintide, Protriptyline (patient information), Rasagiline (patient information), Ribavirin (patient information), Rivastigmine (patient information), Sorafenib (patient information), Spironolactone and hydrochlorothiazide (patient information), Sultiame, Sunitinib (patient information), Tamoxifen (patient information), Thioguanine (patient information), Thiotepa (patient information), Thyroglobulin (patient information), Torsemide Injection (patient information), Trimetrexate Glucuronate (patient information), Vorinostat (patient information), Zoledronic Acid Injection (patient information), Zonisamide (patient information),
Drug used medically	Dexfenfluramine, Dexatrim, Dextroamphetamine, ECA stack, Eskatrol, Exenatide, Hydrolyzed collagen (hydrolysate), Hydroxycitric acid, Phendimetrazine, Phenmetrazine, Synephrine,
Ear Nose Throat	Dysphagia, Eating disorder,
Endocrine	Addison's disease, Adrenocorticotropic hormone deficiency, Basedow syndrome, Diabetes mellitus type 1, Graves' Disease, Hashimoto's thyroiditis, Hyperthyroidism, Pheochromocytoma, Toxic multinodular goiter,
Environmental	No underlying causes
Gastroenterologic	Achalasia, Alcoholic Hepatitis, Autoimmune pancreatitis, Barrett's esophagus, Blind loop syndrome, Celiac disease, Cholangiocarcinoma, Chronic pancreatitis, Cirrhosis, Crohn's disease, Diarrhea, Eosinophilic gastroenteritis, Esophageal cancer, Esophageal candidiasis, Familial adenomatous polyposis, Fundic gland polyposis, Gallbladder cancer, Gastric lymphoma, Gastroesophageal reflux disease, Glucose-galactose malabsorption, Ileitis, Inflammatory bowel disease, Irritable bowel syndrome, Ischemic colitis, Liver Failure, Malabsorption, Malassimilation, Ménétrier's disease, Pancreatic cancer, Peptic ulcer, Pyloric stenosis, Stomach cancer, Ulcerative colitis,
Genetic	Cystic Fibrosis,
Hematologic	Acute lymphoblastic leukemia, Acute myeloid leukemia, Acute promyelocytic leukemia, Waldenström's macroglobulinemia,
Iatrogenic	Adjustable gastric band, Gastric bypass surgery, Mini sleeve gastrectomy, Short bowel syndrome,
Infectious Disease	Actinomyces, Aspergillus clavatus, Aspergillus fumigatus, Blastocystosis, Blastomycosis, Byssinosis, Chagas disease, Cladosporium, Dientamoeba fragilis, Diphyllobothrium infection, Entamoeba histolytica, Fasciola hepatica, Giardia lamblia, Hepatitis C, HIV, Hookworm, Isosporiasis, Leishmania infection, Malaria, Marburg virus, Micropolyspora faeni, Mucor stolonifer, Mycobacterium avium complex infection, Q Fever, Streptobacillus, Syphilis, Tuberculosis, Tularemia, Whipple disease,
Musculoskeletal / Ortho	Mitochondrial myopathy, Osteoporosis, Panniculitis, Pott's disease,
Neurologic	Krabbe disease, Parkinson's disease,
Nutritional / Metabolic	Beriberi, Calorie restriction, Dieting, Folate deficiency, Food intolerance, Malnutrition, Marasmus,
Obstetric/Gynecologic	Hyperemesis gravidarum,
Oncologic	Aggressive NK-cell leukemia, Cervical cancer, Colorectal cancer, Glucagonoma Syndrome, Hemangiosarcoma, Hodgkin's lymphoma, Kaposi's sarcoma, Liposarcoma, Malignancy, Mantle cell lymphoma, Mediastinal tumor, Neuroendocrine tumors, Small intestine cancer,
Opthalmologic	Cogan syndrome,
Overdose / Toxicity	Nevirapine (patient information), Botulinum toxin,
Psychiatric	Anorexia nervosa, Bulimia nervosa,
Pulmonary	Chronic Obstructive Pulmonary Disease, Diabulimia, Empyema Thoracis, Lung cancer, Mesothelioma, Pulmonary alveolar proteinosis, Silicosis,
Renal / Electrolyte	Chronic Renal Failure, Diabetic Ketoacidosis, Hypercalcemia, Interstitial nephritis, Renal cell carcinoma,
Rheum / Immune / Allergy	Churg-Strauss Syndrome, Polyarteritis nodosa, Polymyalgia Rheumatica, Sarcoidosis, Systemic lupus erythematosus, Takayasu's Arteritis,
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	Aerobic exercise, Castleman's disease, Chronic fatigue syndrome, Chronic wasting disease, Dehydration, Diaphoresis, Frailty syndrome, Kikuchi disease, Liposuction, SSRI discontinuation syndrome,

Laboratory Findings

• CBC
• Glucose(diabetes test)
• Albumin/prealbumin
• ESR
• Thyroid function
• Serum chemistry
• HIV

Electrolyte and Biomarker Studies

• Morning ACTH stimulation test if suspect of adrenal insufficiency

Electrocardiogram

• Voltage on the EKG may increase with dramatic weight loss.

Other Imaging Findings

• Age appropriate screenings for cancer
• Upper GI endoscopy
• Colonoscopy

Treatment

Acute Pharmacotherapies

• Anti depressants to stimulate hunger
• Pancreatic enzymes for malabsorbtion in the pancreas
• Nutritionist referral
• Social Services referral

Chronic Pharmacotherapies

• Anorexia of malignancy and AIDS can be relieved with megestrol acetate or dronabinal.

Primary Prevention

• Aggressive therapy with a psychiatrist or psychologist for Anorexia Nervosa.

Unintentional weight loss

A significant loss of total body weight is a serious, chronic illness. Substantial, unintentional weight loss is a symptom of acute or chronic illness, especially if other evidence is present.

Weight loss, for example, accompanied by insatiable thirst and hunger and fatigue may indicate diabetes mellitus, a chronic disease characterized by an abnormal accumulation of carbohydrates in the bloodstream due to insufficient production of insulin, a hormone produced in the pancreas that, when secreted into the bloodstream, permits cellular metabolism and utilization of glucose.

Poor management of insulin-dependent diabetes mellitus (IDDM), also known as diabetes mellitus type I, leads to an excessive amount of glucose and an insufficient amount of insulin in the bloodstream. This triggers the release of triglycerides from adipose tissue and catabolism of amino acids in muscle tissue. This results in a loss of both fat and lean mass, predisposing a significant reduction in total body weight.

A myriad of additional scientific considerations are applicable to weight loss, including but not limited to physiological and exercise sciences, nutrition science, behavioral sciences, and other sciences.

One area involves the science of bioenergetics including biochemical and physiological energy production and utilization systems, that is frequently evidence of diabetes, and ketone bodies, acetone particles occurring in body fluids and tissues involved in acidosis, also known as ketosis, somewhat common in severe diabetes.

In addition to weight loss due to a reduction in fat and lean mass, illnesses such as diabetes, certain medications, lack of fluid intake and other factors can trigger fluid loss. And fluid loss in addition to a reduction in fat and lean mass exacerbates the risk for cachexia.

Infections such as HIV may alter metabolism, leading to weight loss.

Hormonal disruptions, such as an overactive thyroid (hyperthyroidism) , may also exhibit as weight loss.

Intentional weight loss

Weight loss may refer to the loss of total body mass in an effort to improve fitness, health, or appearance.

Therapeutic weight loss, in individuals who are overweight, can decrease the likelihood of developing diseases such as diabetes . Overweight and obese individuals face a greater risk of health conditions such as type 2 diabetes, heart disease, high blood pressure, stroke, osteoarthritis and certain types of cancer. For healthy weight loss, a physician should be consulted to develop a weight loss plan that is tailored to the individual.

Weight loss occurs when an individual is in a state of negative energy balance. When the human body is spending more energy in work and heat than it is gaining from food or other nutritional supplements, it will catabolise stored reserves of fat or muscle.

It is not uncommon for people who are already at a medically healthy weight to intentionally lose weight. In some cases it is with the goal of improving athletic performance or to meet weight classifications in a sport. In other cases, the goal is to attain a more attractively shaped body. Being underweight is associated with health risks. Health problems can include fighting off infection, osteoporosis, decreased muscle strength, trouble regulating body temperature and even increased risk of death.

Therapeutic weight loss techniques

Main article: Bariatrics

The least intrusive weight loss methods, and those most often recommended by physicians, are adjustments to eating patterns and increased physical exercise. Usually, health professionals will recommend that their overweight patients combine a reduction of the caloric content of the diet with an increase in physical activity.

Other methods of losing weight include use of drugs and supplements that decrease appetite, block fat absorption, or reduce stomach volume. Surgery is another method. Bariatric surgery artificially reduces the size of the stomach, limiting the intake of food energy. Some of these treatments may have serious side-effects.

External links

• Weight-control Information Network
• U.S. FDA - Losing Weight Safely
• Healthy Weight Loss