Array of articles, stacks of books and endless relative’s recommendations is always about losing weight
except for your grandmother.” You have become thin “is a universal happy statement for the past few
decades. Whereas the multiple facets and complications of involuntary weight loss is ignored. When the
world is literally” running “to lose weight on one end the medical fraternity runs to investigate on this
one alarming statement “I am rapidly losing weight with no reason”.
The loss of weight and lack of nutrition associated with chronic illness is called cachexia. Weight loss is
losing more than 5% of body weight in 6 to 12 months. Causes for unintentional weight loss are
innumerous but can be broadly classified into organic/medical, functional/psychological.
1. Infections: tuberculosis, typhoid, acute febrile illness causing loss of appetite, HIV, GI infections,
hepatitis, parasitic infections and amebiasis.
2. Chronic diseases: diabetes, COPD hyperthyroidism, heart failure, liver failure, kidney failure,
rheumatoid arthritis, SLE parkinsons diseases and malignancy.
3. Gastrointestinal pathology: acid reflux disorder, achalasia cardia, hiatus hernia, peptic ulcer,
pyloric stenosis, ulcerative colitis, celiac disease, irritable bowel syndrome, GI fistula,
hepatobiliary diseases, cholecystitis, crohns disease, chronic pancreatitis and cirrhosis.
4. Others: addisons disease, changes in taste/smell perception, dental problems, hypercalcemia,
substance abuse (cigarette smoking, alcohol, cocaine etc) and medications.
5. unlisted and idiopathic pathologies can also cause weight loss
1. Stressful life events
2. Dementia
3. Depression
4. Anorexia nervosa
5. Psychoses
6. Food phobia
7. Hallucinations
Lab investigations should be ordered taking into consideration the number of kilograms lost in a given
period of time and other presenting complains.
1. Blood work for Hb%, CRP, ESR, allergens and glucose levels to identify malnourishment,
infection, inflammation, food sensitivity and diabetes respectively.
2. Liver, kidney and renal function test to rule out organ failure.
3. Chest xray and USG abdomen to diagnose respiratory or GI pathology.4. Laryngoscopy, Endoscopy, enteroscopy, and colonoscopy to diagnoses any ulcer, obstruction
and space occupying lesions.
5. Any other appropriate and relevant investigation
Positive findings on infections or chronic inflammation will pave way for further medical treatment
If there are no abnormalities detected from the lab investigations, then patient needs to be counselled
on a psychological level to identify the underlying stress and advised further psychological therapy
Like in every ailment, identifying and treating the cause will provide us with cure and the support system
of diet and exercise will help us yield optimum health benefits. Attaining an optimum weight should be
managed by increasing muscle mass than increasing body fat percentage. Excessive intake of
carbohydrates/sugars will increase the ’bad’ fat and inflammatory reactions in our body. At no point in
time should doctors resent to weight increasing drugs like oxymethalone, oxandralone,
methytestosterone or artificial formula feed for gaining weight.
The best way forward is by including proteins and fat in our diet predominantly as it will help us reduce
inflammation, repair and build our muscles.
1. Diet rich in protein – grass fed meat, organ meat, fish, organic eggs, bone broth, whey protein,
hemp seeds, cottage cheese, sprouts, legumes and pulses.
2. Diet rich in omega 3 – fish cod liver oil, flax seeds, coconut, ghee and avacados.
3. Vitamins and minerals from all fruits and vegetables, Fermeneted food/drink to be added for
provision and absorption of nutrients.
4. Muscle mass can be increased through strength and conditioning exercises, yoga, swimming, weight training, cycling, cardio exercises etc.
5. Smoking, alcohol and drug abuse to be strictly prohibited.
A wholistic approach to any illness will give the treating doctor an advantage of accurately pointing out
the cause. Diet and lifestyle changes needs to be stressed upon beyond limits to experience the ecstasy
of ‘diseasesless’ and quality living.