Weight Loss
Weight loss is a decrease in body weight within 5-15% of baseline values in a short period of time. A person can suddenly or greatly lose weight with voluntary or involuntary malnutrition, pathology of the oral cavity and digestive tract, infectious, psychiatric and neurological diseases. To find out the reason for losing weight, advanced blood tests, sonography and X-ray imaging, and neurological examinations are performed. To restore metabolism and return to normal weight, a high-calorie diet is combined with drug therapy.
Weight loss reasons
Malnutrition
Dépression
Dental problems
Damage to the pancreatobiliary system
Diseases of the gastrointestinal tract
Infections
Endocrine pathology
Complications of pharmacotherapy
Rare Causes
Diagnostics
Treatment
Pre-diagnosis help
Conservative therapy
Treatment prices
Weight loss reasons
Malnutrition
Frequent reasons for losing weight are voluntary restriction of food intake, increased physical activity. The condition is more typical for young and middle-aged women who, in pursuit of ideal body parameters, resort to rigid diets. With such a rapid weight loss, weight loss can be up to 5-10 kilograms per month, which provokes the appearance of problems with appearance and health. Hair begins to fall out and nails exfoliate, the skin becomes flabby, white stretch marks form. Complaints of general weakness, loss of strength, apathy, constant drowsiness are typical.
In older people, malnutrition and weight loss are often caused by socio-economic characteristics of the lifestyle - the predominance of cereals and bakery products in the diet, insufficient intake of nutritious meat and fish dishes. As a result, the percentage of adipose and muscle tissue decreases, the body seems to "dry out", the ribs, clavicle, and pelvic bones become clearly visible. The skin is pale with a yellowish tinge, sagging. Lack of nutrients causes problems in all organs, constant severe weakness and dizziness disturb.
Dépression
Depressive states are manifested by a complete loss of interest in current events and loss of appetite. Patients sharply reduce the amount of food taken, up to refusal to eat. Weight loss with depression reaches 10-15% of the initial body weight, weight loss is combined with severe weakness, drowsiness - sometimes a person sleeps 14-16 hours a day and does not feel rested. The appearance changes - the skin looks dry and pale, the hair on the head falls out, the nails exfoliate and crumble. In such a situation, in order to prevent depletion of the body, qualified medical assistance is required.
Dental problems
Diseases of the teeth (caries, pulpitis), lesions of the oral mucosa of a traumatic or infectious cause lead to severe pain and fear of eating. With extensive pathological processes, food refusal and rapid weight loss occur. If the pain is of an infectious origin, the temperature usually rises, and general malaise is expressed. In elderly patients, in the absence of some teeth, chewing is disturbed, and food enters the stomach insufficiently processed. Because of this, the absorption of nutrients decreases, as a result, a person loses weight.
Damage to the pancreatobiliary system
With pathologies of the liver, biliary tract and pancreas (hepatitis, cholecystitis, pancreatitis, etc.), a sharp weight loss is caused by enzyme deficiency, due to which most of the food is In the small intestine, it is not broken down or absorbed.. At first, the appetite does not suffer, the patients eat food in the usual amounts, but they lose weight. In this case, after eating, there is heaviness and pain in the abdomen. In the future, appetite decreases, constant nausea, and flatulence disturb. The amount of food consumed is reduced by 2-3 times, up to 10 kg of weight is lost. Stool disorders are typical - alternating diarrhea and constipation, periodic tenesmus.
Diseases of the gastrointestinal tract
With any inflammation or destructive pathologies of the intestinal wall, the absorption of nutrients is reduced. Weight loss develops gradually, weight loss rarely reaches 10%. Symptoms are associated not only with inadequate caloric intake, causing general wasting and impairing performance, but also with vitamin deficiencies. Avitaminosis is manifested by a deterioration in the appearance of the skin and hair, characteristic changes in the tongue - it becomes bright red and shiny. Common gastroenterological reasons for losing weight:
Inflammatory processes: gastroenteritis, duodenitis, colitis.
Functional disorders: pylorospasm, gastroptosis, dyspepsia.
Chronic inflammatory bowel disease: Crohn's disease, ulcerative colitis.
Lack of pancreatic enzymes.
Infections
Any infectious process is accompanied by intoxication of the body, fever and general malaise, in which appetite worsens and a person loses weight. With protracted viral or bacterial diseases, significant weight loss is observed up to exhaustion. The skin becomes pale with a cyanotic shade, the eyes sink, the bones of the skeleton are well contoured. Malnutrition leads to vitamin deficiency: hair becomes dull and brittle, nails exfoliate. Weight loss with increased appetite is pathognomonic for helminthiasis and protozoal invasions.
Endocrine pathology
Hormonal changes and metabolic disorders are often accompanied by a sharp weight loss. With a lack or excess of certain hormones, all metabolic processes change, catabolism prevails over synthesis. The breakdown of proteins, fats and carbohydrates causes rapid weight loss by reducing the volume of adipose tissue and muscle fibers. Weight loss occurs
evenly, body proportions do not change. In addition to general signs of depletion of the body, specific symptoms are noted. The main endocrine causes of noticeable weight loss are:
Diabetes. Weight loss is more common in type I diabetes in children and young adults. Lack of insulin provokes the activity of counterinsular hormones responsible for catabolic reactions. Despite the sharp increase in appetite, weight loss of 5-10 kg rapidly occurs. There is also general weakness and headaches, severe thirst, and an increase in the volume of urine.
Hyperthyroidism. An increase in the concentration of thyroxine in the blood increases the level of basal metabolism. The appetite is pathologically increased, the patients constantly want to eat, but the weight is steadily decreasing. Then the amount of food intake decreases, which is due to difficulty swallowing due to the increase in the volume of the thyroid gland. The skin remains pink and moist for a long time.
Hypopituitarism. A sharp decrease or cessation of the production of pituitary hormones disrupts all types of metabolism and provokes rapid weight loss. Pituitary causes accelerate the breakdown of fats and the destruction of muscle tissue proteins, decrease muscle tone and strength, and disrupt the work of internal organs. The skin is dry, thinned, hanging down in folds on the arms, abdomen, and thighs.
Complications of pharmacotherapy.
Weight loss is most often associated with the use of cytostatics for the treatment of tumor pathology and severe collagenosis. The drugs disrupt the work of the gastrointestinal tract, cause destruction of the epithelium of the entire alimentary canal, which leads to loss of appetite and a sharp decrease in the absorption capacity of the small intestine. Common causes of clinically significant weight loss are the use of antibacterial drugs that inhibit the intestinal microflora and provoke dysbiosis. Weight loss is also observed with the regular use of laxatives, antipsychotics, tranquilizers.
Rare Causes
Oncological diseases: leukemia and lymphoma, cancer or sarcoma of any localization.
Joint diseases: rheumatoid arthritis, osteoarthritis.
Degenerative neurological processes: senile dementia, discirculatory encephalopathy, consequences of strokes.
Cardiological pathology: decompensated heart failure, myocarditis, endocarditis.
Diagnostics
Losing weight for no apparent reason is an indication for the consultation of a general practitioner (family doctor or therapist). The specialist conducts a comprehensive examination and excludes the most typical diseases manifested by weight loss. Instrumental research begins with an assessment of the work of the gastrointestinal tract, when other pathological symptoms appear, the nervous and cardiovascular systems are examined, and infections are excluded. The greatest diagnostic value is possessed by:
Blood test. Standard general and biochemical blood tests reveal nonspecific signs of the inflammatory process (leukocytosis, increased C-reactive protein and sialic acids). To exclude the pathology of the gastrointestinal tract, the levels of the main digestive enzymes are specified. The concentration of rheumatoid factor is determined.
Hormonal profile. First, a standard blood glucose test is performed, measuring the level of free insulin in the blood and C-peptide to confirm the presence of type 1 diabetes. When weight loss is combined with symptoms of thyrotoxicosis, the amount of T3 and T4 in the blood is measured, the concentration of thyroid-stimulating hormone of the pituitary gland and thyroliberin of the hypothalamus are estimated.
Ultrasound procedure. To confirm or refute the gastroenterological reasons for a sharp weight loss, an abdominal ultrasound is prescribed, during which attention is paid to structural abnormalities, defects of the intestinal wall, or diffuse changes in the echogenicity of parenchymal organs. An ultrasound of the thyroid gland can rule out hyperthyroidism.
Instrumental visualization. If pathological signs are found on ultrasound, EGDS, colonoscopy or X-ray examination of the digestive tract with oral contrast are recommended. If you suspect a lesion of the pituitary gland, a sighting radiograph of the sella turcica, MRI or CT of the brain is performed.
Additional methods. In case of pain in the teeth, a dentist's consultation, x-ray of the jaws is indicated. If weight loss is accompanied by mental disorders, neurological and psychiatric evaluation is required. To confirm the infectious cause of weight loss, the results of bacteriological examination of feces, serological reactions are necessary.
Treatment
Pre-diagnosis help
Self-medication is not allowed for complaints of large weight loss, since such a symptom indicates serious disorders in the body. If a person loses more than 15% of weight, or weight loss is accompanied by a sharp deterioration in the condition, urgent medical attention is needed. Until the cause of the disorder is clarified, high-calorie meals, nonspecific symptomatic drugs are prescribed. For pain in the abdomen or headaches, analgesics are indicated, in case of an increase in temperature to febrile values, NSAIDs are acceptable.
Conservative therapy
Medical treatment depends on the specific disease causing the weight loss, but in all situations, it is necessary to ensure an adequate intake of nutrients in the body. If the patient can eat independently, an individual diet with a high content of calories and vitamins is selected. Patients in serious condition are fed through a tube or parenterally infused solutions of glucose, proteins. In addition to a high-calorie diet, drugs of etiotropic and pathogenetic action are prescribed:
Non-steroidal anti-inflammatory drugs. They are used for a wide range of diseases - inflammatory bowel lesions, stomatitis, gingivitis. To reduce their negative effect on the gastrointestinal mucosa, selective COX-2 inhibitors are used.
Antibiotics Antibacterial drugs are effective for bacterial infections of any location. A specific preparation is selected after receiving the results of bacteriological inoculation and flora sensitivity test.
Antiseptics. Rinsing the mouth with solutions of chlorhexidine, miramistin can remove pathogenic microorganisms and dental plaque. This speeds up recovery from stomatitis, periodontal and gum disease.
Hormones. Weight loss in thyroid disorders is treated with thyroxine antagonists, which inhibit hormone synthesis. In severe diabetes mellitus, insulins of short or long-acting (prolonged) action are administered.
Enzymes. In chronic pancreatitis, enzyme preparations are recommended in combination with bile acids, which improve the processes of digestion and absorption of nutrients. Funds are prescribed in long courses.
Antidepressants. Weight loss against the background of depressive symptoms is the basis for the administration of specific serotonin receptor agonists. The drugs normalize the emotional sphere, increasing interest in life.