Weight loss Unintentional DDx

Unintentional Weight loss – Differential Diagnosis

Common causes

• Stress/Anxiety
• Depression
• Dementia
• Hyperthyroidism
• Eating disorder
  • Anorexia nervosa
  • Bulimia nervosa

Must Not Miss

• Malignancy
• Diabetes
• Major organ failure
  • Cardiac failure
  • Respiratory failure
    • Severe COPD
  • Hepatic failure
  • Renal failure
• Tuberculosis
• HIV

Easily missed

• Drug& Alcohol abuse
• Medication
• Malabsorption
  • Coeliac disease
  • Chronic Pancreatitis
  • Crohn’s dis/ Ulcerative colitis
  • Parasites
• Addison’s disease

Red flags

• Rapid weight loss >5% body weight
• Systemic symptoms
  • (fever, night sweats, bone pain)
• Lymphadenopathy
• Polyuria & Polydipsia
• Localising Red flags
  • Haemoptysis/ Dyspnoea
  • Jaundice
  • New onset Dyspepsia > 50 years old
  • Dysphagia
  • Persistent altered bowel habit
  • Rectal bleeding
  • Haematuria
  • Breast lump
  • PMB
• Past history of cancer

Investigations to consider

• FBC, CRP/ESR
• U+Es, LFTs, TFTs Bone profile, Serum glucose, Amylase
• Coeliac screen
• HIV screen
• Mantoux test
• Urinalysis
• CXR
• OGD
• Barium enema/Colonoscopy
• CT scan (chest, abdomen, pelvis)