Abnormal Loss of Weight

Abnormal weight loss is a frequently occurring condition among adults and is linked to a host of adverse health outcomes, including higher mortality rates, and a number of progressive debilitating illnesses. While this condition commonly presents with a contributing disorder, many patients present with no immediately discernable medical reason to explain their abnormal weight loss. A variety of pharmacologic and nonpharmacologic measures can be undertaken to address the underlying weight loss and to improve nutritional status. Physicians should not assume that weight loss is a natural phenomenon until they have thoroughly reviewed and eliminated other social and pathologic causes. CORRESPONDENCE: Raena Pettitt, DO | rmpettitt@liberty.edu 1877-5773X/$ see front matter. © 2017 ACOFP. All rights reserved. INTRODUCTION Abnormal weight loss is an unintentional drop in body weight over time. It occurs in 8% of all adult outpatients and is even more prevalent among elderly individuals, occurring in approximately 30% of all such individuals defined as individuals 65 and older. As a risk factor in elderly patients, even slight weight loss is connected with higher morbidity and mortality rates. While voluntary weight loss among the general adult population is not generally considered problematic, even slight weight loss among elderly individuals is correlated with joint fractures and higher mortality rates. Thus, physicians should stress to their patients the medical benefits of maintaining a healthy body weight throughout adulthood and of taking early preventive measures through proper diet and exercise. Abnormal weight loss is also linked to a higher frequency of admission to institutions, to an elevated risk of in-hospital complications, to a deterioration in the ability to perform activities of daily living, to somatic dysfunction, and to an overall decrease in the quality of life. Certain individuals require heightened monitoring for abnormal weight loss, more specifically, those who: (a) are disabled; (b) have a co-existing medical illness; (c) have previously been admitted to an institution; (d) have a cognitive impairment; (e) are smokers, (f) have experienced the loss of a significant other; or (g) already have a low baseline body weight. MAJOR ETIOLOGIES OF WEIGHT LOSS Malignancy When evaluating the potential causes of unintentional weight loss, the physician must consider the possibility of an underlying malignancy, especially if the presenting patient is elderly. A recent study ranked cancer as the most common cause of weight loss, with the