Unexplained Weight Loss: When to Seek Medical Advice?

Weight has been continuously decreasing?

Hello, doctor.
Since January of this year, my weight has dropped from 43 kg to 39 kg, but I haven't been exercising much, and I eat three meals a day without any issues with appetite.
Should I see a doctor about this? (In February, I had an upper gastrointestinal endoscopy and a colonoscopy, which showed mild gastric ulcers and nonspecific intestinal inflammation.) I don't have any other discomfort except for occasional blood in my stool, which was diagnosed as an anal fissure.

Wen, 20~29 year old female. Ask Date: 2019/07/07

Dr. Cai Dongqi reply Family Medicine

Hello, abnormal weight loss is defined as a decrease of 3% in one month, 5% in three months, or over 10% in six months.
It is recommended to visit a hospital for further evaluation.

Reply Date: 2019/07/07

More Info

Unexplained weight loss can be concerning, especially when it occurs without any intentional changes in diet or exercise. In your case, losing 4 kilograms (approximately 8.8 pounds) over a few months, despite eating regularly and not engaging in significant physical activity, warrants attention. Here’s a comprehensive overview of what you should consider and when to seek medical advice.

When to Seek Medical Advice
1. Significant Weight Loss: A weight loss of more than 5% of your body weight over a short period (typically within 6-12 months) is considered significant and should be evaluated by a healthcare professional. In your case, dropping from 43 kg to 39 kg represents a loss of about 9.3%, which is concerning.

2. Underlying Health Conditions: You mentioned having a mild gastric ulcer and non-specific intestinal inflammation, which could contribute to weight loss. These conditions can affect nutrient absorption and appetite, leading to unintended weight loss. If these issues are not adequately managed, they could exacerbate your symptoms.

3. Other Symptoms: While you indicated that you do not have major discomfort aside from occasional blood in your stool (which has been attributed to anal fissures), any new or worsening symptoms should be taken seriously. Blood in the stool can indicate various gastrointestinal issues, and it’s essential to monitor this closely.

4. Changes in Appetite or Energy Levels: If you notice a decrease in appetite, increased fatigue, or any other changes in your overall health, these could be signs of an underlying condition that requires medical evaluation.

5. Duration of Symptoms: If your weight loss continues or if you experience other symptoms such as persistent abdominal pain, changes in bowel habits, or unexplained fatigue, it is crucial to consult a healthcare provider.

What to Discuss with Your Doctor
When you visit your doctor, be prepared to discuss the following:
- Medical History: Provide a detailed account of your medical history, including your previous gastrointestinal issues, any medications you are taking, and any other health concerns.

- Diet and Lifestyle: Share information about your eating habits, any recent changes in your diet, and your physical activity levels. This will help your doctor understand potential factors contributing to your weight loss.

- Symptoms: Be specific about any symptoms you are experiencing, including the frequency and severity of blood in your stool, any abdominal pain, or changes in bowel habits.

Possible Investigations
Your doctor may recommend further investigations to determine the cause of your weight loss, which could include:
- Blood Tests: To check for signs of infection, inflammation, or nutritional deficiencies.

- Imaging Studies: Such as an abdominal ultrasound or CT scan, to evaluate your gastrointestinal tract further.

- Endoscopy: If necessary, to get a closer look at your stomach and intestines, especially if your symptoms persist or worsen.

Conclusion
In summary, while some weight loss can be normal, especially with changes in lifestyle or health, unexplained weight loss should not be ignored. Given your history of gastrointestinal issues and the current weight loss, it is advisable to seek medical advice. Early intervention can help identify any underlying conditions and prevent further complications. Remember, your health is paramount, and addressing these concerns with a healthcare professional is the best course of action.

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