Involuntary Weight Loss: Evaluation and Management

Involuntary weight loss is defined as a decrease of at least 5% of body weight in a 6-month period that is not due to dieting, diuretic use or medical diseases known to affect weight. Up to 8% of patients presenting to primary-care physicians complain of weight loss. In 25% of those, no cause for the weight loss is ever found. Another one fourth will have malignancies... of the remaining 50%, half will have depression or some psychiatric disease and half will have a medical cause. If a physical cause for the weight loss exists, it usually becomes evident within six months. Consequently, continued weight loss should be monitored, even when the initial evaluation does not supply a diagnosis. The findings of the history and physical examination will guide the initial diagnostic assessment. The treatment of unintentional weight loss is directed at the underlying causes. The goal is to prevent further weight loss.


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