Weight loss: Difference between revisions
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* [http://www.fda.gov/opacom/lowlit/weightls.html U.S. FDA - Losing Weight Safely] | * [http://www.fda.gov/opacom/lowlit/weightls.html U.S. FDA - Losing Weight Safely] | ||
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[[Category:Obesity]] | [[Category:Obesity]] |
Revision as of 00:43, 30 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; M.Umer Tariq [3]
Overview
Weight loss, can be either:
- In the context of medicine or health or physical fitness, is a reduction of the total body weight, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue.
- Intentional weight loss (bariatrics)
Causes
Common Causes
- Aerobic exercise
- Cancer
- Chronic renal failure
- Drug side effect (e.g. Adderall)
- Eating disorder
- Hyperthyroidism
- Intentional weight loss (e.g. dieting, dexatrim)
- Nicotine and smoking
Causes by Organ System
Causes in Alphabetical Order
- Abatacept Injection (patient information)
- Achalasia
- Actinomyces
- Acute lymphoblastic leukemia
- Acute myeloid leukemia
- Acute promyelocytic leukemia
- Adderall
- Addison's disease
- Adjustable gastric band
- Adrenocorticotropic hormone deficiency
- Aerobic exercise
- Aggressive NK-cell leukemia
- Alcoholic Hepatitis
- Allopurinol (patient information)
- Aminopterin
- Amiodarone Oral (patient information)
- Amphotericin B Injection (patient information)
- Anorexia nervosa
- Arsenic Poisoning
- Aspergillus clavatus
- Aspergillus fumigatus
- Autoimmune pancreatitis
- Barrett's esophagus
- Basedow syndrome
- Benzodiazepine withdrawal syndrome
- Beriberi
- Bevacizumab Injection (patient information)
- Blastocystosis
- Blastomycosis
- Blind loop syndrome
- Botulinum toxin
- Bulimia nervosa
- Bumetanide (patient information)
- Busulfan (patient information)
- Byssinosis
- Calcitriol (patient information)
- Calorie restriction
- Cancer
- Cannabis (drug)
- Carboplatin (patient information)
- Carmustine (patient information)
- Castleman's disease
- Celiac disease
- Cervical cancer
- Cetuximab Injection (patient information)
- Chagas disease
- Chlorambucil (patient information)
- Cholangiocarcinoma
- Chronic fatigue syndrome
- Chronic Obstructive Pulmonary Disease
- Chronic pancreatitis
- Chronic Renal Failure
- Chronic wasting disease
- Churg-Strauss Syndrome
- Cirrhosis
- Cladosporium
- Clenbuterol
- Clofarabine Injection (patient information)
- Cocaine
- Cogan syndrome
- Colorectal cancer
- Congestive Heart Failure
- Crohn's disease
- Cystic Fibrosis
- Cytarabine (patient information)
- Dehydration
- Dexatrim
- Dexfenfluramine
- Dexmethylphenidate
- Dextroamphetamine
- Diabetes mellitus type 1
- Diabulimia
- Diaphoresis
- Diarrhea
- Dientamoeba fragilis
- Dieting
- Diphyllobothrium infection
- DKA
- Donepezil (patient information)
- Duloxetine
- Dysphagia
- Eating disorder
- ECA stack
- Empyema Thoracis
- Enfuvirtide Injection (patient information)
- Entamoeba histolytica
- Eosinophilic gastroenteritis
- Ephedra
- Eskatrol
- Esophageal cancer
- Esophageal candidiasis
- Ethosuximide
- Exenatide
- Familial adenomatous polyposis
- Fasciola hepatica
- Felbamate (patient information)
- Fluorouracil (patient information)
- Fluticasone Nasal Spray (patient information)
- Fluticasone Oral Inhalation (patient information)
- Folate deficiency
- Food intolerance
- Frailty syndrome
- Fucus vesiculosus L.
- Fundic gland polyposis
- Furosemide (patient information)
- Galantamine (patient information)
- Gallbladder cancer
- Gastric bypass surgery
- Gastric lymphoma
- Gastroesophageal reflux disease
- Gatifloxacin (patient information)
- Gefitinib (patient information)
- Giardia lamblia
- Glucagonoma Syndrome
- Glucose-galactose malabsorption
- Graves' Disease
- Hashimoto's thyroiditis
- Hemangiosarcoma
- Hepatitis C
- HIV
- Hodgkin's lymphoma
- Hookworm
- Hydrolyzed collagen (hydrolysate)
- Hydroxycitric acid
- Hypercalcemia
- Hyperemesis gravidarum
- Hyperthyroidism
- Ileitis
- Indapamide (patient information)
- Inflammatory bowel disease
- Interferon beta-1a Intramuscular Injection (patient information)
- Interferon beta-1a Subcutaneous Injection (patient information)
- Interferon Beta-1b Injection (patient information)
- Interstitial nephritis
- Irritable bowel syndrome
- Ischemic colitis
- Isosporiasis
- Kaposi's sarcoma
- Kikuchi disease
- Krabbe disease
- Leflunomide (patient information)
- Leishmania infection
- Leukemia
- Leuprolide (patient information)
- Levothyroxine
- Liothyronine (patient information)
- Liposarcoma
- Liposuction
- Lithium (patient information)
- Liver Failure
- Lomustine (patient information)
- Lung cancer
- Malabsorption
- Malaria
- Malassimilation
- Malignancy
- Malnutrition
- Mantle cell lymphoma
- Marasmus
- Marburg virus
- Mechlorethamine (patient information)
- Mediastinal tumor
- Melphalan (patient information)
- Ménétrier's disease
- Mercaptopurine (patient information)
- Mesothelioma
- Methsuximide Oral (patient information)
- Methylphenidate
- Micropolyspora faeni
- Mini sleeve gastrectomy
- Mitochondrial myopathy
- Modafinil
- Mucor stolonifer
- Multiple endocrine neoplasia type 1
- Mycobacterium avium complex infection
- Myxoma
- Natalizumab injection (patient information)
- Neuroendocrine tumors
- Nevirapine (patient information)
- Nicotine
- Nilutamide
- Non-Hodgkin lymphoma
- Osteoporosis
- Oxaliplatin injection (patient information)
- Pancreatic cancer
- Panniculitis
- Parkinson's disease
- Peginterferon alfa-2a (patient information)
- Peginterferon alfa-2b (patient information)
- Pemetrexed injection (patient information)
- Pemoline (patient information)
- Peptic ulcer
- Phendimetrazine
- Phenformin
- Phenmetrazine
- Phenylbutazone
- Phenytoin oral (patient information)
- Pheochromocytoma
- Piroxicam (patient information)
- Polyarteritis nodosa
- Polymyalgia Rheumatica
- Posaconazole (patient information)
- Pott's disease
- Pramipexole (patient information)
- Pramlintide
- Protriptyline (patient information)
- Pulmonary alveolar proteinosis
- Pyloric stenosis
- Q Fever
- Rasagiline (patient information)
- Renal cell carcinoma
- Ribavirin (patient information)
- Rift Valley fever
- Rivastigmine (patient information)
- Sarcoidosis
- Sargramostim
- Selective serotonin reuptake inhibitor
- Short bowel syndrome
- Silicosis
- Sitophilus granarius
- Small intestine cancer
- Sorafenib
- Spironolactone and hydrochlorothiazide (patient information)
- SSRI discontinuation syndrome
- Stomach cancer
- Streptobacillus
- Sultiame
- Sunitinib (patient information)
- Synephrine
- Syphilis
- Systemic lupus erythematosus
- Takayasu's Arteritis
- Tamoxifen (patient information)
- Thioguanine (patient information)
- Thiotepa (patient information)
- Thyroglobulin (patient information)
- Tiagabine
- Torsemide Injection (patient information)
- Toxic multinodular goiter
- Trimetrexate Glucuronate (patient information)
- Tuberculosis
- Tularemia
- Ulcerative colitis
- Vorinostat (patient information)
- Waldenström's macroglobulinemia
- Whipple disease
- Zoledronic Acid Injection (patient information)
- Zonisamide (patient information)
Diagnosis
Laboratory Findings
The following laboratory studies should be considered:
Electrolyte and Biomarker Studies
- Morning ACTH stimulation test should be done if there is a suspicion of adrenal insufficiency
Electrocardiogram
- QRS voltage may increase with dramatic weight loss.
Other Imaging Findings
- Age appropriate screenings for cancer
- Upper GI endoscopy
- Colonoscopy
Treatment
Medical Therapy
Acute Pharmacotherapies
- Anti depressants to stimulate hunger
- Pancreatic enzymes for malabsorption in the pancreas
- Nutritionist referral
- Social Services referral
Chronic Pharmacotherapies
- Anorexia of malignancy and AIDS can be relieved with megestrol acetate or dronabinal.
Primary Prevention
- Aggressive therapy with a psychiatrist or psychologist for anorexia nervosa.
Unintentional Weight Loss
A significant loss of total body weight is a serious, chronic illness. Substantial, unintentional weight loss is a symptom of acute or chronic illness, especially if other evidence is present.
Weight loss, for example, accompanied by insatiable thirst and hunger and fatigue may indicate diabetes mellitus, a chronic disease characterized by an abnormal accumulation of carbohydrates in the bloodstream due to insufficient production of insulin, a hormone produced in the pancreas that, when secreted into the bloodstream, permits cellular metabolism and utilization of glucose.
Poor management of insulin-dependent diabetes mellitus (IDDM), also known as diabetes mellitus type I, leads to an excessive amount of glucose and an insufficient amount of insulin in the bloodstream. This triggers the release of triglycerides from adipose tissue and catabolism of amino acids in muscle tissue. This results in a loss of both fat and lean mass, predisposing a significant reduction in total body weight.
A myriad of additional scientific considerations are applicable to weight loss, including but not limited to physiological and exercise sciences, nutrition science, behavioral sciences, and other sciences.
One area involves the science of bioenergetics including biochemical and physiological energy production and utilization systems, that is frequently evidence of diabetes, and ketone bodies, acetone particles occurring in body fluids and tissues involved in acidosis, also known as ketosis, somewhat common in severe diabetes.
In addition to weight loss due to a reduction in fat and lean mass, illnesses such as diabetes, certain medications, lack of fluid intake and other factors can trigger fluid loss. And fluid loss in addition to a reduction in fat and lean mass exacerbates the risk for cachexia.
Infections such as HIV may alter metabolism, leading to weight loss.[1]
Hormonal disruptions, such as an overactive thyroid (hyperthyroidism) , may also exhibit as weight loss.[2]
Intentional Weight Loss
Weight loss may refer to the loss of total body mass in an effort to improve fitness, health, or appearance.
Therapeutic weight loss, in individuals who are overweight, can decrease the likelihood of developing diseases such as diabetes.[3] Overweight and obese individuals face a greater risk of health conditions such as type 2 diabetes, heart disease, high blood pressure, stroke, osteoarthritis,[4] and certain types of cancer. For healthy weight loss, a physician should be consulted to develop a weight loss plan that is tailored to the individual.
Weight loss occurs when an individual is in a state of negative energy balance. When the human body is spending more energy in work and heat than it is gaining from food or other nutritional supplements, it will catabolize stored reserves of fat or muscle.
It is not uncommon for people who are already at a medically healthy weight to intentionally lose weight. In some cases it is with the goal of improving athletic performance or to meet weight classifications in a sport. In other cases, the goal is to attain a more attractively shaped body. Being underweight is associated with health risks. Health problems can include fighting off infection, osteoporosis, decreased muscle strength, trouble regulating body temperature and even increased risk of death.[5]
Therapeutic Weight Loss Techniques
The least intrusive weight loss methods, and those most often recommended by physicians, are adjustments to eating patterns and increased physical exercise. Usually, health professionals will recommend that their overweight patients combine a reduction of the caloric content of the diet with an increase in physical activity.[6]
Other methods of losing weight include use of drugs and supplements that decrease appetite, block fat absorption, or reduce stomach volume. Surgery is another method. Bariatric surgery artificially reduces the size of the stomach, limiting the intake of food energy. Some of these treatments may have serious side-effects.
References
- ↑ Mangili A, Murman DH, Zampini AM, Wanke CA (2006). "Nutrition and HIV infection: review of weight loss and wasting in the era of highly active antiretroviral therapy from the nutrition for healthy living cohort". Clin. Infect. Dis. 42 (6): 836–42. doi:10.1086/500398. PMID 16477562.
- ↑ Overactive thyroid and weight loss
- ↑ Diabetes Study Shows Value In Diet, Exercise, september 2001
- ↑ Prevalence of various medical conditions increases with overweight and obesity
- ↑ Mayo Clinic: Being Underweight Poses Health Risks. Retrieved January 13,2007
- ↑ Choosing a Safe and Successful Weight Loss Program