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1. WEIGHT LOSS
A measurable decline in body weight (BW) either intentionally or from malnutri
tion or illness. It is considered mild when 5% of BW is lost, moderate when 5-
10% of BW is lost, and high when more than 10% of BW is lost.

2. REMEMBER
• Always ask about weight change
• Change of 5% over 6 months is significant
• Relative change is also important
• Significant weight loss – marker of serious
illness
• Persistence & periodic evaluation to
identify the cause - important

3. MECHANISMS OF WEIGHT LOSS
•Increased energy expenditure
•Increased energy loss
•Decreased food intake

4. WEIGHT LOSS CLASSIFICATION

5. WEIGHT LOSS CLASSIFICATION

6. IF THE PATIENT COMPLAINS OF WEIGHT LOSS, ASK:
• How much weight did you lose? Over
what period?
• How is your appetite?
• How is your bowel habit? (If frequent
diarrhea or loose motion, ask details
regarding color, amount, presence of
blood, etc.).

7. IF THE PATIENT COMPLAINS OF
WEIGHT LOSS, ASK:
• Do you feel excessively thirsty and
micturate frequently?
• Do you have other symptoms, such as
cough, fever, night sweat?
• Do you have palpitation?
• Do you prefer hot or cold environment?

8. IF THE PATIENT COMPLAINS OF
WEIGHT LOSS, ASK:

9. IF THE PATIENT COMPLAINS OF
WEIGHT LOSS, ASK:

10. IF THE PATIENT COMPLAINS OF WEIGHT LOSS, ASK:
• Do you feel that you are getting darker
than before? (any change in your
complexion?)
• Do you have vomiting? If yes, is it
spontaneous or induced?
• Do you take alcohol or any other
substance?

11. WEIGHT LOSS IN ADDISON’S DISEASE

12. NOTE ALSO REMEMBER THE FOLLOWING POINTS:
• ¯¯ A detailed systematic enquiry should be made to find out any
malignancy.
• ¯¯ History regarding intravenous drug intake, blood or blood product
transfusion, extramarital sexual contact, traveling abroad and other high-
risk behavior for HIV infection should be sought.
• ¯¯ Weight loss means reduction of 5% of body weight or 5 kg within 6
months is considered significant.
• ¯¯ Weight loss may be physiological because of dieting, exercise,
starvation or less intake in old age.

13. CAUSES OF WEIGHT LOSS
I. Involuntary with increased appetite
A. Increased energy expenditure B. Increased energy loss
Hyperthyroidism
Pheochromocytoma
Extensive exercise
Diabetes Mellitus
Malabsorption syndromes
Chronic pancreatitis
Ulcerative colitis
Chrohn’s disease
Celiac sprue

14. CAUSES OF WEIGHT LOSS
II. Involuntary with decreased appetite
Medical disorders Psychiatric Disorders Chronic drug use
Cancer and chronic
Infections, Diabetes Mellitus
Depression Alcohol, Metformin, Anti
cancers, ART