Weight loss

Epidemiology

Differential Diagnosis

• Cancer - any cancer can cause weight loss
• Endocrine - hyperthyroidism, Addison's disease, type 1 diabetes
• GI - IBD, malabsoprtion (coeliac), bowel surgery, gastoenteritis
• Chronic illness - get chronically ill and you lose weight. Try it!
• Psych - anorexia nervosa, bulimia, depression,

Clinical and Associated Features

• Cancer - weight loss, anorexia, tiredness, unexplained fever
• Hyperthyroidism - Neck: goitre; GI: diarrhoea/steatorrhoea, weight loss, change in appetite; neuromuscular: fine tremor, brisk reflexes, proximal myopathy, exopthalmos (bulgy eyes), lid lag (sclera visible betwen top of pupil and bottom of upper eyelid), weakness & fatigue, proximal myopathy; skin: urticaria, pruritis, sweating, sweaty palms, palmar erythema, hair thinning, intolerance to heat; psych: anxiety, psychosis, irritability, loss of libido; others: gynaecomastia, oligomenorrheoa/amennorhoea, tachycardia ([[AF)
• Addison's disease - fatigue, dizziness, muscle weakness, weight loss, difficulty in standing up, vomiting, anxiety, diarrhoea, headache, sweating, changes in mood and personality, sudden drops in blood pressure (particularly postural hypotension), and joint and muscle pains.
• Type 1 diabetes - weight loss, polyuria, polydipsia (excessive thirst), coma, DKA, tiredness
• IBD - weight loss, alternating diarrhoea and constipation, blood in stools, tiredness, ascites
• Coeliac - weight loss, floaty and smelly poo, excess wind-breaking, diarrhoea, mouth ulcers, tiredness, anaemia (due to lack or iron, leading to breathlessness, arrhythmias)
• Anorexia nervosa - not eating
• Bulimia - throwing it all up
• Depression - look up depression

Management

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