Endocrinology Book

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Unintentional Weight Loss Causes

Aka: Unintentional Weight Loss Causes, Meals on Wheels Mnemonic
  1. See Also
    1. Unintentional Weight Loss
    2. Medications Associated with Unintentional Weight Loss
  2. Causes: "Meals on Wheels" Mnemonic
    1. Medication Effects
    2. Emotional Problems (Major Depression)
    3. Anorexia Nervosa or Alcoholism
    4. Late-life paranoia
    5. Swallowing Disorders (See Dysphagia)
    6. Oral factors (e.g. Poorly fitting dentures)
    7. No Money
    8. Wandering (Dementia related behavior)
    9. Hyperthyroidism, Hyperparaythyroidism, Hypoadrenalism
    10. Enteric problems (e.g. Malabsorption)
    11. Eating problems (e.g. difficult self-feeding)
    12. Low salt diet or low Cholesterol diet
    13. Stones (Cholecystitis) or social problems (isolation)
    14. References
      1. Morley (1995) Ann Intern Med 123:850-9 [PubMed]
  3. Causes: 9Ds of Weight Loss Mnemonic
    1. Dementia
    2. Dentition
    3. Depression
    4. Diarrhea
    5. Disease
    6. Drugs
    7. Dysfunction (e.g. ADL)
    8. Dysgeusia
    9. Dysphagia
    10. Robbins (1989) Geriatrics 44(4): 31-7 [PubMed]
  4. Causes: Common
    1. Idiopathic in one quarter of cases
    2. Malignancy (19 to 36%)
      1. See Cachexia in Cancer
      2. Stomach Cancer
      3. Pancreatic Cancer
      4. Colon Cancer
      5. Other cancers (e.g. Breast Cancer)
    3. Non-malignant Gastrointestinal Causes (9 to 19%)
      1. Cholecystitis
      2. Peptic Ulcer Disease
      3. Gastroesophageal Reflux Disease and other Esophageal disorders (e.g. Esophageal Dysmotility)
      4. Colitis
      5. Mesenteric Ischemia
      6. Celiac Sprue and other malabsorption
    4. Cardiopulmonary Disorders
      1. Congestive Heart Failure (5-10%)
      2. Chronic Obstructive Pulmonary Disease (5-10%)
    5. Social Factors
      1. Alcoholism or other Drug Abuse (5-10%)
      2. Major Depression and other mental illness (9 to 24%)
      3. Social isolation and loneliness
      4. Financial contraints
      5. Impaired Activities of Daily Living
  5. Causes: Other Causes
    1. Endocrine Conditions
      1. Diabetes Mellitus
      2. Hyperthyroidism
      3. Hypothyroidism
    2. Connective Tissue Disease
      1. Sarcoidosis
      2. Rheumatoid Arthritis
    3. Medication adverse effects
      1. Polypharmacy
      2. Medications Associated with Unintentional Weight Loss
    4. Neurologic Diseases
      1. Muscular Dystrophy
      2. Bulbar Palsy
      3. Cerebrovascular Accident
      4. Myasthenia Gravis
      5. Parkinson's Disease
      6. Dementia
      7. Delirium
    5. Anorexia Nervosa
    6. Chronic Infection
      1. HIV Infection
      2. Tuberculosis
    7. Fever (See also Fever of Unknown Origin)
      1. Basal metabolic rate increases 7% per degree F
    8. Malabsorption
      1. Pancreatic Insufficiency
      2. Celiac Sprue
  6. References
    1. Heizer in Dornbrand (1992) Ambulatory Care, p. 15-18
    2. Karsh in Friedman (1991) Medical Diagnosis, p. 13-16
    3. Gaddey (2014) Am Fam Physician 89(9):718-22 [PubMed]
    4. Grazewood (1998) J Fam Pract 47(1): 19-25 [PubMed]
    5. Huffman (2002) Am Fam Physician 65(4):640-50 [PubMed]
    6. Morley (1995) Ann Intern Med 123:850-9 [PubMed]
    7. White (1991) Am Fam Physician 44(6): 2087-97 [PubMed]
    8. Zawada (1996) Postgrad Med 100(1):207-25 [PubMed]

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