10 MINUTE CLINIC PODCAST UNINTENTIONAL WEIGHT LOSS

Unexplained weight loss is often a cause for concern, as it may signal a significant underlying health problem. Unlike intentional weight loss achieved through diet and exercise, this loss of weight occurs without any conscious effort. While occasional fluctuations in weight are normal, losing a significant amount—typically defined as more than 5% of body weight within the previous 3 to 6 months—without any clear reason can indicate potentially serious medical or psychological conditions. Understanding the causes and implications of unexplained weight loss is essential for addressing it effectively. In this podcast, we look at a logical pathway of investigating it, possible differential diagnoses and what to remember when assessing weight loss in an elderly patient.

Key take-home points

There is no formal consensus definition of unintentional weight loss
The weight loss must be considered unintentional by both the patient and their healthcare professional
It is often defined as being weight loss of at least 5% of the patient’s usual body weight that occurs in the preceding 6 months and is not due to treatment of a known existing illness
There are multiple possible causes, including malignancy, psychiatric illness and gastroenterological disorders
Related syndromes include sarcopenia and cachexia
It is often a diagnostic challenge
The key diagnostic criteria are to assess for malignancy or other conditions where early treatment may significantly improve outcome
Unintentional weight loss is associated with both high rates of hospital admission and increased mortality, especially in older people
Investigating unexplained weight loss requires a detailed history and clinical examination, along with baseline primary care investigations such as blood tests, chest X-ray and faecal occult blood testing
When considering weight loss in the elderly, remember the mnemonics of the ‘9 Ds’ and ‘Meals on Wheels’
Unexplained weight loss can represent several different tumour types, including colorectal, gastro-oesophageal, lung, prostate, urological and pancreatic cancers
Always take a holistic approach to the management of the patient with unexplained weight loss