Weight Loss: When to Monitor and When to Investigate

Sometimes, weight changes raise more questions than answers!

Weight loss is often pursued intentionally for health benefits, but unintentional weight loss can be a red flag. Clinically, a loss of more than 5% of body weight within 6–12 months without trying is considered significant and warrants evaluation (NEJM, 2020).

When Weight Loss is Less Concerning

Mild weight loss may result from increased physical activity, dietary changes, or transient stress. If appetite and energy return to baseline, the symptom is usually benign.

When to Suspect Underlying Disease

Persistent, unexplained weight loss may indicate:

• Malignancy: GI, lung, and pancreatic cancers commonly present with cachexia (JAMA, 2021).

• Endocrine disorders: Hyperthyroidism and uncontrolled diabetes can accelerate metabolism and cause weight loss (NIH).

• GI diseases: Celiac disease, IBD, or malabsorption syndromes reduce nutrient uptake (Gastroenterology, 2020).

• Chronic infections: Tuberculosis and HIV/AIDS often lead to muscle wasting.

• Mental health issues: Depression and anxiety may suppress appetite and nutrition.

Diagnostic Approach

A structured workup includes a detailed history, physical examination, complete blood count (CBC), thyroid function tests, glucose levels, inflammatory markers, and imaging studies as indicated. Early detection enables timely intervention and improves outcomes.

Keywords: Unintentional weight loss, cancer symptoms, malabsorption, hyperthyroidism, depression, diagnostic approach, when to worry about weight loss.