Not all weight loss is serious. Weight loss can occur after a life-changing or stressful event. However, significant unexplained or unintentional weight loss may be an early sign of an underlying medical condition. Unintentional weight loss is characterized as the inadvertent reduction of at least 5% of one’s body weight within a timeframe of six to 12 months. For instance, this would translate to a 10-pound decline in a 200-pound man or a decrease of 6 to 7 pounds in a 130-pound woman. Unexplained weight loss is a decrease in body weight when you did not try to lose the weight on your own.
Many people gain and lose weight. Contact your provider if:
- You or a family member loses more weight than is considered healthy for their age and height.
- You have lost more than 10 pounds (4.5 kilograms) or 5% of your normal body weight over 6 to 12 months or less, and you do not know the reason.
- You have other symptoms in addition to the weight loss.
Medical Conditions Associated with Unintentional Weight Loss
Unintentional weight loss can be associated with a myriad of underlying medical conditions and lifestyle factors. A considerable number of individuals diagnosed with cancer reported experiencing weight loss, with approximately 40% citing this phenomenon at the time of diagnosis. The initial indication of blood-related cancers like leukemias and lymphomas, or solid tumors such as lung cancer (particularly adenocarcinoma of the lung), colon cancer, ovarian cancer, and pancreatic cancer, may manifest as weight loss. Research from 2024 suggests that the most common causes of unexplained weight loss include cancer, digestive disorders, or psychiatric disorders.
According to a 2017 study, the majority of people diagnosed with cancer after experiencing unexplained weight loss had pancreatic cancer or lymphoma. After that, kidney, bladder, and ureteral cancers were most common.
Some health issues that can cause unintentional weight loss include the following:
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Digestive Disorders
Celiac disease, an autoimmune disease in which gluten causes the immune system to attack the body’s cells, can cause weight loss and nutritional deficiencies. In the event that your small intestine is not functioning properly, a drop in weight could occur. Some conditions that fall into this category include celiac disease and irritable bowel syndrome.
Inflammatory Bowel Disease (IBD)
Chronic inflammation from IBD, including Crohn’s disease and ulcerative colitis, can lead to unintended weight loss. This can result from:
- Malabsorption
- Decreased appetite due to pain and discomfort
- Eating a restricted diet to prevent symptoms
- Pain from complications, such as strictures and obstructions
IBD can also put your body in a catabolic state where it constantly uses energy.
Mental Health Conditions
Mental health conditions, like depression and anxiety, can affect the same parts of the brain that control appetite. This can lead to reduced appetite and, eventually, unintentional weight loss. Depression can significantly influence eating habits, resulting in either weight loss or weight gain. This mental health condition can affect individuals from diverse backgrounds, with approximately one in every six people experiencing depression at some juncture in their lives.
In some people, depression or anxiety may increase appetite. The symptoms vary from person to person. Have you been experiencing increased levels of stress? If so, these sensations can have an impact upon your appetite. Some individuals eat more as a result, while others might, instead, lose interest in their favorite foods.
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Cancer
Cancer causes abnormal cells to quickly divide and spread. Cancer increases inflammation and muscle wasting and can disrupt appetite-regulating hormones. This phenomenon is particularly prominent in individuals with cancer and those diagnosed with HIV/AIDS and is recognized as cachexia within these groups. Cachexia, a type of weight loss commonly observed among cancer patients, is characterized by the loss of both muscle mass and fat. Cachexia is a serious complication of cancer and can have a significant impact on a patient’s overall health and quality of life. It often leads to weakness, fatigue, and a decreased ability to perform daily activities.
Its growth rate can also increase your resting energy expenditure (REE), or how much energy your body burns at rest. Unexplained weight loss of 10 pounds (lb) or more can be an early indicator of various types of cancer.
Hyperthyroidism
An overactive thyroid develops when your thyroid gland makes too much thyroid hormone. These hormones control many functions in the body, including metabolism. If your thyroid is overactive, you’ll quickly burn calories even if you have a good appetite. Hyperthyroidism, a condition characterized by an overactive thyroid gland in the neck, can arise from various underlying conditions. These include autoimmune disorders like Graves’ disease, which stands as the predominant cause of hyperthyroidism in the United States.
Rheumatoid Arthritis (RA)
RA causes the immune system to attack the lining of the joints. This leads to inflammation that can speed up metabolism and reduce your overall weight. Rheumatoid arthritis (RA) is primarily recognized for its characteristic joint pain and damage. However, this autoimmune condition can also trigger muscle wasting and weight loss, a condition known as rheumatoid cachexia. The inflammatory processes associated with RA may extend to the digestive system and gastrointestinal tract, potentially contributing to unintentional and unexplained weight loss. Some autoimmune disorders, such as rheumatoid arthritis (RA) and Graves’ disease, are more commonly observed in women.
Muscle Loss (Muscle Atrophy)
Muscle loss can lead to unexpected weight loss from loss of muscle, most commonly if you don’t use your muscles for a while. It’s most common in people who don’t exercise, work desk jobs, or are not able to move around.
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Type 1 Diabetes
Type 1 diabetes is an autoimmune disease in which your immune system attacks cells in your pancreas that make insulin. Without insulin, your body can’t use glucose for energy. Individuals with diabetes typically fall into two main categories: Type 1 diabetes, an autoimmune disease, and Type 2 diabetes, which often develops later in life when the body struggles to produce or utilize insulin effectively. This leads to high blood glucose and causes your body to burn fat and muscle for energy.
Chronic Obstructive Pulmonary Disease (COPD)
This progressive lung disease includes emphysema and chronic bronchitis. In later stages, COPD can cause weight loss because labored breathing burns many calories.
Endocarditis
Endocarditis is an infection usually caused by bacteria that results in inflammation of the heart’s inner lining (endocardium). Most people with endocarditis develop a fever, and many also have a reduced appetite. Elevated body temperature also increases metabolism and burns fat, causing weight loss. On the other hand, men face their own set of risks concerning weight loss. They may be susceptible to conditions like cancer cachexia, digestive issues, and infections like endocarditis that can lead to unintended weight loss.
Tuberculosis (TB)
This contagious bacterial infection usually affects the lungs. Many people with TB experience weight loss and decreased appetite, but the reasons aren’t fully understood.
Addison Disease
Though rare, Addison’s disease causes the immune system to damage the adrenal glands, which then cannot make enough hormones like cortisol and aldosterone. Cortisol regulates many functions, including metabolism and appetite. Addison’s disease, classified as an endocrine disorder, arises from issues with the adrenal glands situated atop each kidney. These crucial glands are responsible for producing essential hormones, including cortisol, which act as chemical messengers within the body. In Addison’s disease, there is an insufficient production of these hormones, leading to symptoms such as weight loss, fatigue, and various other manifestations. Low levels of cortisol cause a reduced appetite.
HIV
HIV attacks immune cells called T cells, which reduces the body’s ability to resolve infections. Untreated, HIV can progress to stage 3, which can cause weight loss from nutritional deficiency and decreased hunger. These may result from illnesses the immune system is unable to manage.
Congestive Heart Failure (CHF)
CHF develops when the heart can’t fill up with enough blood, pump blood with enough force, or both. Less blood for the digestive system can lead to nausea and early fullness. It may also be difficult to breathe while eating, and inflammation in damaged heart tissue can also increase metabolism and burn more calories.
Other Factors Influencing Unexplained Weight Loss
A few other factors can increase the likelihood of unexplained weight loss in different populations. These include:
Older adults: Research suggests 15% to 20% of adults 65 years and older experience unexplained weight loss. Smoking and having less body fat may increase the likelihood. The impact of age plays a significant role in determining the underlying causes of unexplained weight loss. Despite advances in medical knowledge, some cases of unintentional weight loss still remain unexplained. The variation in underlying causes based on age underscores the importance of considering age as a relevant factor when assessing and diagnosing unexplained weight loss.
Children and adolescents in poverty: In the United States, living in poverty is the biggest risk factor for failure to thrive, which is a child below the standard height and weight values for their age.
Newborns and infants with difficulty nursing: Infants who have trouble latching or nursing during breastfeeding or chestfeeding may not experience necessary weight gain. If an infant won’t nurse, it’s best to talk with a pediatrician or nursing specialist for help increasing your baby’s weight.
Diagnosis and Evaluation
Diagnosing the cause of unexplained weight loss usually begins with a thorough evaluation, during which the doctor will ask about other symptoms and medical history. If you experience unintentional weight loss, it is essential to be prepared to provide your healthcare team with a comprehensive and detailed medical history. Together with a thorough physical examination, this information enables healthcare providers to assess your risk factors and narrow down potential underlying medical conditions contributing to weight loss.
The specific symptoms you experience may help a doctor recommend specific tests. If the cause is not apparent, they may recommend more general testing and exams to rule out specific health conditions.
Some of the tests may include:
- In-office physical exam
- Blood tests, including a complete blood count (CBC) and a metabolic panel. The blood tests ordered by your healthcare provider will be determined by various factors, including any presenting symptoms.
- Urinalysis
- Tests to measure your blood sugar
- Tests for illnesses and infections like tuberculosis
- Imaging tests, like a CT scan or ultrasound. Imaging tests play a crucial role in the diagnostic process and can provide valuable insights into potential underlying causes of weight loss. Additionally, an echocardiogram, which utilizes ultrasound technology, plays a crucial role in diagnosing various conditions, including infections affecting the heart valves, such as infectious endocarditis.
- Depression screening
- Do you have any dental issues that might be affecting your ability to eat comfortably?
Doctors don’t always recognize unexplained weight loss. In a 2023 study, researchers found that doctors recognized this as a symptom in only 21% of cases.
Treatment
The specific treatment for unexplained weight loss depends on the underlying cause. The treatment approach for unintentional weight loss depends on identifying and addressing the underlying cause or causes, which are likely present in most cases. It is essential to recognize the significance of treating the weight loss itself, even if a specific cause is identified through exams, blood tests, or other diagnostic procedures.
In cases where the weight loss is severe enough that the doctor suspects nutritional deficiency, they may ask you to adjust your diet or take a nutritional supplement even if an exact cause hasn’t yet been established. To effectively address unintentional weight loss, it is crucial to have open communication with your healthcare provider.
For individuals diagnosed with cancer, it is essential to consider a palliative care consultation. Palliative care teams specialize in addressing concerns beyond cancer-related treatments, such as chemotherapy or radiation therapy.
When to Seek Medical Advice
It’s common for your body weight to fluctuate. However, weight loss that occurs without changing your habits can have an underlying cause. While any amount of weight loss can be a cause for concern, the medical definition of unintentional weight loss is specifically characterized by a loss of 10 pounds or 5% of the total body weight within a period of six to 12 months. Recognizing and monitoring weight loss within these parameters is crucial for early detection and intervention, as unintentional weight loss can be a sign of underlying health issues that require attention and medical evaluation.
Unexplained weight loss might initially appear inconsequential or even go unnoticed, leading some individuals to disregard it. However, it serves as a crucial clue that an underlying illness may be present, requiring prompt diagnosis and treatment. By seeking professional medical guidance, individuals can receive comprehensive evaluations, undergo appropriate tests, and work collaboratively with their healthcare provider to determine the underlying health issue responsible for the weight loss. If you experience a weight loss of 5% to 10% without intentional effort, it is crucial to consult your healthcare provider, even if you believe there might be a reasonable explanation for the changes.
The provider will do a physical exam and check your weight. You will be asked questions about your medical history and symptoms, including:
- How much weight have you lost?
- When did the weight loss begin?
- Has the weight loss occurred quickly or slowly?
- Are you eating less?
- Are you eating different foods?
- Are you exercising more?
- Have you been sick?
- Do you have any dental problems or mouth sores?
- Do you have more stress or anxiety than usual?
- Have you vomited? Did you make yourself vomit?
- Have you been fainting?
- Do you have occasional uncontrollable hunger with palpitations, tremor, or sweating?
- Have you had constipation or diarrhea?
- Do you have increased thirst or are you drinking more?
- Are you urinating more than usual?
- Have you lost any hair?
- What medicines are you taking?
- Do you feel sad or depressed?
- Are you pleased or concerned with the weight loss?
You may need to see a dietitian for nutrition advice.