It could be that you have scales that you use to monitor your weight at home. Or you may be going by your looks or how tight or loose your clothes feel. But sometimes you notice a decline, and you ask, “why am I losing weight?”
Dear Reader you are worried because you are losing a lot of weight. Whether you are losing weight fast or slowly, does not matter. What matters is that you have lost significant amounts of weight, being 10% (ten percent) or more of your body weight.
And you are losing weight without trying. You are not on a weight loss program. You don’t have loss of appetite and are eating normally. Yet your weight is going down significantly and noticeably.
This article will lay out for you, the commonest causes of severe weight loss. The list is not exhaustive, but should provide answers for the overwhelming majority of people experiencing weight loss.
The gastrointestinal tract handles food from the point of intake, through digestion, to absorption. There can be pathology at various levels of the tract. This pathology will obviously interfere with the process of getting nourishment to the body’s cells.
For various reasons, people can have malabsorption syndrome. Malabsorption syndrome essentially prevents food, even if it is of adequate quality and quantity, to get to the body. This manifests as weight loss despite adequate food intake.
Malabsorption causes include
- destruction of the gut flora by e.g. antibiotics
- repeated or radical resective operations of the bowel
Another common and well known gastrointestinal disorder that can cause weight loss, is coeliac disease. This is a sensitivity to gluten, a protein found in grains.
DEPRESSION (MAJOR DEPRESSIVE EPISODE)
This has among other symptoms, loss of appetite and loss of weight.
However, weight loss can occur in depression, without loss of appetite. There can still be adequate food intake, and yet weight loss occur. This is thought to result from the biochemical derangements caused by depression.
You could be losing weight because of a metabolic disease. This is what this and the next chapter deals with.
Metabolic disorders cause weight loss by a variety of mechanisms. We start by discussing thyrotoxicosis or hyperthyroidism.
Thyrotoxicosis is the excessive functioning of the thyroid gland. This excessive production of thyroid hormones, causes the body’s metabolic rate to be high. The high metabolic rate leads to breakdown of tissues, resulting in weight loss.
But thyrotoxicosis usually has other symptoms and signs. Top of that list is an enlarged thyroid gland, whether globally enlarged, or enlarged on one side. These other signs should alert sufferers of weight loss or their caregivers, to the underlying cause of weight loss.
There are other metabolic disorders that can present with weight loss. These include the inherited disorders of metabolism.
Diabetes, which causes abnormally high blood sugar levels, is a metabolic disease. It is very common all over the world. And it is increasing in incidence and prevalence.
Diabetes does have a collection of symptoms and signs that are well known. These though, are frequently absent or late to manifest. Significant, and often rapid weight loss, could be the only externally visible sign or symptom of diabetes.
In diabetes, the weight loss is often caused by loss of total body water. This is caused by the fact that sugar like other solutes, draws water wherever it goes. Water is therefore drawn out of the body’s cells, which may or may not result in excessive urination.
INFECTIONS – HUMAN IMMUNODEFICIENCY VIRUS
The Human Immunodeficiency Virus (HIV) is an ongoing pandemic. It is still very prevalent in some parts of the world.
At the onset of the HIV pandemic, what was noticed was an unknown disease that caused people to lose weight severely. The disease was indeed in Eastern Africa, called “The slimming disease”.
So yes dear Reader, unexplained weight loss can be a manifestation of infection with the Human Immunodeficiency Virus, HIV. And this certainly means that HIV counseling and testing services should be sought.
Early detection of HIV infection is now well known to have many benefits. There are many effective and safe treatment modalities, which are now instituted as soon as HIV infection is confirmed. This has a tremendous impact in prolonging life and improving the quality thereof.
INFECTIONS – TUBERCULOSIS
Tuberculosis or TB is also still common, or even very common, in some parts of the world. It has indeed resurged over the last forty years, due to the HIV pandemic.
One of the classic and profound presenting symptoms of tuberculosis, is weight loss. The weight loss often accompanies cough, night sweats, lethargy. But weight loss in TB often occurs with severe anorexia (loss of appetite).
Cancer is a basket term for pathology that affects many organs and tissues. There are hundreds of different types of cancer. But all of them have as one of their classic presentations, weight loss.
The weight loss in cancer, just like in HIV and TB, is typically very profound. It is given the technical term of “cachexia”.
As can be seen from the foregoing discussion, weight loss, especially unexplained weight loss, can be a symptom and sign of disease. And the underlying disease can be very serious.
It is therefore advisable to never ignore weight loss. Timely detection of many of the conditions mentioned above can improve the chances of preventing morbidity or mortality from the disease.
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