When there is a decrease in energy intake compared with energy expenditure, weight loss is likely to occur. The dicrease may be the result of deliberate weight reduction or a change in diet or activity level. Weight loss may also result from fluid loss (for example, because of sweating in a hot climate) or it may be a symptom of a disorder. Any unexplained weight loss should always be investigated by a doctor.

LOSS OF APPETITE

Many diseases can disrupt the appetite to the extent that an individual loses the desire to eat, which in turn leads to a weight loss. Loss of appetite may also be a sign of generalized ill health. Depression reduces a person’s motivation to eat; peptic ulcer causes pain and, in some cases, food avoidance; and some kidney disorders cause loss of appetite due to the effects of uraemia (raised levels of the waste product urea in the blood). In anorexia nervosa and bulimia, complex psychological factors affect an individual’s eating pattern, sometimes with dramatic results.

DIGESTIVE CAUSES

Digestive disorders, such as gastroenteritis, lead to weight loss as a result of vomiting and diarrhoea. Weight is also affected by cancer of the oesophagus and stomach cancer. Malabsorption also affects weight.

METABOLIC CAUSES

Some disorders cause weight loss by increasing the rate of metabolic activity in cells. Examples are any type of cancer, chronic infection such as tubercolosis, and hyperthyroidism (overactivity of the tyroid gland). Untreated diabetes mellitus may also cause weight loss.

WEIGHT REDUCTION

Weight reduction is the process of losing body fat. A person who is severely overweight (obesity) is at an increased risk of developing various illnesses, such as diabetes mellitus, hypertension (high blood pressure) and heart disease.

HOW IT IS DONE

The most efficient way to lose weight is to eat a healthy diet. This may involve reducing the intake of excess calories (those over the recommended daily limit), combined with regular exercise, both aerobic (fat-burning) and toning (muscle-building). Motivation, emotional support, and exploration of psychological factors affecting eating are also important for success.

DRUG AND OTHER TREATMENTS

In most circumastances, drugs play little part in a weight-loss programme. However, orlistat (an antiobesity drug) or appetite suppressant (such as sibutramine and rimonabant) may be useful adjunts to a reduced diet in specific individuals who have a high body mass index (BMI). Surgery – such as wiring of the jaws or operations to reduce the capacity of the stomach or bypass part of the intestinal tract – may be considered for some people who are very obese (with a BMI over 40).

RECOMMENDATIONS FOR WEIGHT REDUCTION

1. Cut down drastically on all visible fats, including butter, margarine, cream, and cooking oils, as well as the invisible fats that are present in pastries, biscuits, and cakes. Choose low-fat milk, cheeses, and yogurts.
2. Choose lean cuts of meat and avoid processed meat such as salami. Grill or roast meat without adding fat instead of frying.
3. Eat more boild legumes (e.g. lentils and beans), which provide protein but contain very little fat.
4. Avoid refined carbohydrates such as sugar (sucrose) as well as refined grain products such as white flour and white rice.
5. Increase your consumption of unrefined carbohydrates. Eat wholemeal bread, whole-grain rice and cereals, fresh fruit, and plenty of vegetables.
6. Reduce your intake of alcoholic drinks, which are high in calories.

Source: A-Z family medical encyclopedia by BMA

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