Extreme Weight Loss

1 Extreme Weight Loss Summary

Changes in body weight, with slight increase or decrease, is common over time. Weight loss can be intentional or involuntary. Involuntary weight loss refers to a loss of weight without diet or any other efforts to lose it.

Involuntary weight loss is of concern when a person loses more than 10 pounds. For people with a comparatively smaller structure, this criteria is more than 5% of their body weight.

This extreme, involuntary weight loss may be an indication of an underlying physical or mental disorder. In such cases, people may have other symptoms like loss of appetite, fever, night sweats, or pain.

Symptoms of weight loss may vary with the underlying condition. The most common ways by which somebody notices a change in weight is through fitting of clothes or by the shape of the face.

Extreme weight loss is very obvious. In children, involuntary loss of body weight is associated with a change in appetite, fussiness over certain food, abdominal pain, and fever.

Some of the symptoms that are of concern are: 

  • Fever and night sweats
  • Bone pain
  • Breathlessness
  • Increased urination and thirst
  • A headache and jaw pain

An unintentional loss of body weight is very distressing, particularly when there is a significant loss. It may be caused by multiple factors ranging from a stomach virus to a serious underlying disease.

Weight loss may be caused by:

  • Loss of appetite and conditions that prevent food intake
  • Continuous vomiting
  • Malabsorption
  • Certain medications
  • Endocrine diseases
  • Cancer
  • Systemic diseases
  • Acute infection
  • Chronic infections
  • Drug abuse
  • Psychological conditions
  • Malnutrition
  • Social isolation

It is most commonly seen in people who have some medical conditions including cancer, depression, or even AIDS.

Some of the common causes of unintentional weight loss are diarrhea, depression, mouth ulcers and viral infections. Some less common causes are hyperthyroidism, abdominal infection, depression, celiac disease, gastroenteritis, and dementia.

In addition to physical examination and medical history, the doctor may look at the recent changes in lifestyle and also other symptoms, to diagnose the underlying cause of extreme weight loss.

Information on changes in diet, recent illnesses, recent travels, digestive problems, and new medications may all be helpful in finding the most probable cause of the loss in weight.

Nutritional assessment helps to evaluate the diet or digestive disorder if any. Blood tests are also suggested to check out deficiencies of minerals and vitamins, and also anemia. Hormonal disorders can also be detected using blood tests.

Unintentional weight loss caused by nutritional deficiency is treated with the help of a dietician who will be of help to chart out a diet plan for correcting the deficiencies.

Digestive disorders like inflammatory bowel disease (IBD) is treated with the help of medications and specialized diet that provides the additional nutrients. Hormonal disorders are corrected by medications.

Increasing fluid intake, adequate bed rest, and medications are helpful in managing during general illnesses like influenza and the common cold. If left untreated, weight loss may lead to complications. The risk of infections and depression increase with extreme weight loss.

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2 Causes

Stressful events in life often result in involuntary weight loss. This includes bereavement, divorce or mental trauma of some kind. Significant loss of body weight may also occur due to eating disorders like anorexia or bulimia.

In some cases, it is difficult to pinpoint an underlying cause for the loss of weight. Some of the most common causes of the disease are depression, hyperthyroidism, and cancer.

Less frequently, it may also result from: 

  • Certain medications
  • Nutritional deficiency
  • Substance abuse
  • Systemic diseases
  • Endocrine gland disorders like undiagnosed diabetes and Addison’s disease
  • Chronic inflammatory diseases like rheumatic arthritis and lupus
  • Conditions that lead to dysphagia
  • Gastrointestinal disorders
  • Persistent gastroenteritis
  • Tuberculosis
  • HIV and AIDS
  • Dementia

Nutritional deficiency – deficiency results when the body fails to absorb nutrients from food. Malnutrition results in unintentional weight loss. This is one of the most common causes of extreme weight loss.

Cancerlung cancer remains undetected in the early stages. This cancer also results in extreme weight loss, one of the symptoms of the condition. Cancer originating in the liver also leads to a loss in body weight.

Cancer of esophagus inhibits the movement of food through the food pipe, affecting the digestion and absorption of food. Stomach cancer originates in the cells lining the stomach. It remains undetected until the cancer is more advanced and leads to loss of body weight.

Cancer of endometrium, the uterine lining, also results in severe weight loss. Laryngeal cancer affects the throat and inhibits the easy movement of food into the esophagus, leading to loss of body weight.

Stomach ulcer – painful ulcers in the stomach affects digestion and absorption and is a common cause of weight loss. Peptic ulcers in the lining of the intestine is also a common health problem that leads to malabsorption and weight loss.

Tuberculosis – or TB is an infectious disease caused by bacteria and mainly affects lungs. Fatigue, fever, night sweats and involuntary weight loss are the main symptoms of the condition.

Cirrhosis – inflammation and scarring of liver tissue due to toxins, alcohol or viral infections is known as liver cirrhosis. Extreme weight loss is one of the symptoms of the condition.

Crohn’s disease – this disease is characterized by chronic inflammation of digestive tract. It is associated with symptoms like abdominal pain and diarrhea, in addition to weight loss.

Colitis – as the name indicates, it relates to inflammation of the colon. In addition to the many symptoms that lead to malabsorption of nutrients, weight loss is also seen as a symptom.

Hormonal disorders – hyperthyroidism is a condition in which thyroid gland produces excess hormones. Increased metabolic rate and weight loss are symptoms of this disorder. Addison’s disease is characterized by abnormal functioning of adrenal glands resulting in reduced production of steroid hormones.

Achalasia – abnormal functioning of the lower esophageal sphincter is referred to as achalasia. It often leads to extreme weight loss.

Parasitic infections – infection by hookworms that affect the lungs and small intestine often lead to significant weight loss. Amebiasis is a parasitic infection common in tropical regions caused by a protozoan. Diarrhea and weight loss are characteristic symptoms of this infection.

AIDS – AIDS is an infectious disease characterized by severe weight loss, night sweats, persistent skin rashes, and mouth sores.

Depression – this mood disorder is characterized by sadness and extreme hopelessness. People suffering from depression often have severe weight loss.

Gastroenteritis – viral gastroenteritis, also known as the viral flu, has weight loss as a major symptom.

3 Diagnosis and Treatment

Symptoms and medical history of the patient are important in identifying the probable causes of weight loss.


Information on changes in diet and food intake, difficulty in swallowing, changes in bowel movements, other accompanying symptoms, the onset of symptoms, history of weight loss, other medications were taken, and recent changes in the living situation or life will all help in identifying the cause of the sudden and involuntary weight loss.

Physical examination also reveals clues regarding the cause of loss. Vital signs are checked for fever, blood pressure, heart rate, and breathing rate. The condition of organs like lungs and heart, liver, joints, and skin are all evaluated during a physical examination.

Body weight and height are measured to calculate the body mass index (BMI). Other investigations are based on the suspected cause of the condition.

Blood tests are conducted to look for probable causes like fungal infection, giant cell arteritis, HIV/AIDS, kidney disease, liver function abnormalities, infections, adrenal gland underactive, diabetes mellitus, and thyroid function.

A biopsy is suggested if alcoholism or fungal infection are the probable cause of the condition. Stool testing is suggested when malabsorption or worm infection are implicated in the development of the symptom. Imaging studies like CT are used for checking specific diseases. Organ-specific tests are recommended for different types of cancer.

Treatment depends on the underlying disorder that causes weight loss. Nutritional deficiency is treated with the help of a dietician who helps in devising a healthy diet plan to compensate the deficiency.

Specialized diet is suggested for digestive disorders like IBD, so as to obtain all the nutrients from food. Over-the-counter supplements are suggested in some cases. Behavioral measures are suggested in some conditions so that the patient is encouraged to have a healthy and balanced diet.

When behavioral therapy is not effective, food rich in nutrition or supplements is suggested. In some eating disorders, feeding with the help of a tube inserted into the stomach is suggested.

Hormonal disorders are treated with the help of medications. Many general illnesses like influenza, common cold, and food poisoning also cause weight loss. In these conditions, adequate bed rest, enough fluid intake, and medications are the best methods to control the symptom.

One can get back to a normal diet once the condition is resolved. If unintentional weight loss is caused by more serious conditions like cancer, appropriate treatment methods are suggested. This may include surgery, chemotherapy or radiation therapy.

Depression and dementia are treated with psychotherapy and medications. Nutritional supplements are suggested for elderly people. The supplements are given after nutritional assessment and given between meals. It may also be given at bedtime so that it does not affect the appetite of the person.

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