Unintentional weight loss: diagnosis and prognosis. The first prospective follow-up study from a secondary referral centre.
OBJECTIVE
To establish the incidence and causes of unintentional weight loss and to compare prognoses.


METHODS
Prospective.


METHODS
Secondary referral centre.


METHODS
158 patients (89 female, 56%; 69 male, 44%) referred by general physicians for unexplained weight loss or for other reasons. In the latter case, weight loss was established after admission to hospital. Follow-up lasted for up to 3 years.


METHODS
Determining the course of weight loss in patients with diagnosed and undiagnosed causes.


RESULTS
The cause of weight loss was established in 132 (84%) patients and remained unclear in 26 (16%). Reasons were non-malignant (60% of patients) and malignant (24%) diseases. Psychological disorders represented 11% of the non-malignant group. A gastrointestinal disease caused weight loss in 50 (30%) patients. Of malignant disorders, 53% (20 of 38 patients) were gastrointestinal. Amongst the non-malignant group, 39% (30 of 77 patients) had somatic disorders. The prognosis for unknown causes of weight loss was the same as for non-malignant causes.


CONCLUSIONS
Contrary to common belief, weight loss is not usually due to a malignant disease. A gastrointestinal tract disorder accounts for weight loss in every third patient. If minimal diagnostic procedures cannot establish a diagnosis, then endoscopic investigation of the upper and lower gastrointestinal tract and function tests should be performed to exclude malabsorption.
Lankisch
P
P
Department of Internal Medicine, Municipal Clinic of Lüneburg, Lüneburg, Germany. lankisch@uni-lueneburg.de
Gerzmann
M
M
Gerzmann
J F
JF
Lehnick
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis; D011379:Prognosis; D011446:Prospective Studies; D012017:Referral and Consultation; D015431:Weight Loss