How to approach a patient having weight loss

How to approach a patient having weight loss

1. Weight Loss: Introduction, Causes, and Patient Approach.

2. Introduction Definition of weight loss: Clinically significant weight loss is >5% of body weight over 6–12 months Differentiation: Intentional weight loss (diet, exercise, medical therapy) Unintentional weight loss (often concerning)

3. : Importance of Evaluating Weight Loss Can be a sign of underlying illness Associated with increased morbidity and mortality Common in elderly, cancer patients, and those with chronic diseases

4. Common Causes of Weight Loss 1. Decreased Intake • Depression, dementia, anorexia • Dental problems, swallowing disorders • Chronic infections (HIV, TB) 2. Malabsorption • Celiac disease, Crohn’s disease • Pancreatic insufficiency (chronic pancreatitis)

5. Common Causes of Weight Loss 3. Increased Metabolism • Hyperthyroidism • Malignancies • Chronic infections 4. Increased Losses • Diabetes mellitus (polyuria) • Protein-losing enteropathy

6. Red Flags in Weight Loss Unintentional weight loss >10% in 6 months • Night sweats, fever, chronic cough • Dysphagia, early satiety • Blood in stool, melena, or hematemesis • Persistent vomiting or diarrhea • Severe fatigue

7. How to Approach a Patient with Weight Loss 1. History Taking • Onset & Duration: Acute vs. chronic • Amount of Weight Lost: Quantify loss • Dietary History: Appetite changes, food intake

8. • Associated Symptoms: Fever, GI symptoms, pain, night sweats • Psychosocial Factors: Stress, depression, access to food • Past Medical History: Cancer, chronic diseases How to Approach a Patient with Weight Loss

9. 2. Physical Examination • BMI, general appearance • Signs of malnutrition (muscle wasting, edema) • Abdominal, thyroid, and neurological exams How to Approach a Patient with Weight Loss

10. 3. Investigations • Blood Tests: CBC, thyroid function tests, glucose, albumin • Imaging: Chest X-ray, abdominal ultrasound • Endoscopy: If GI malignancy suspected How to Approach a Patient with Weight Loss

11. Management Approach • Treat Underlying Cause (e.g., hyperthyroidism, infections) • Nutritional Support • Increase caloric intake • Dietitian referral • Supplements if necessary • Psychosocial Support • Address depression, social isolation • Follow-Up & Monitoring

12. Summary & Key Takeaways • Weight loss can indicate serious underlying conditions • A thorough history, examination, and investigations are key • Management depends on identifying and treating the cause • Nutritional and psychological support are crucial