Unexplained Weight Loss: A Case Study in Mental Health and Lifestyle

Weight loss

Hello Doctor: Since April of this year, I have been working full-time collecting scrap metal.
I am a person with a mental disability, and finding a job is not easy; therefore, I resorted to recycling.
Initially, it was just a hobby, and I would only collect occasionally, mainly working temporary jobs on weekends.
However, after getting injured while working a temporary job, I have relied on recycling for my livelihood.
Currently, I still receive disability benefits, but they will soon run out, and I will have to rely solely on recycling for income, which only amounts to a few thousand dollars a month—likely not enough to get by!
I originally weighed 64 kg and had a good appetite.
However, since I started working full-time collecting scrap metal, even working late into the night, I feel exhausted and overwhelmed.
When I weighed myself afterward, I found that I had dropped to 56 kg.
I visited a family medicine clinic to find out the cause, but my blood sugar levels were normal both before and after meals, and there were no issues like hyperthyroidism.
The family medicine doctor said I do not have diabetes and am generally healthy, suggesting that my weight loss might be a result of increased activity.
However, I do not have time to exercise; I am constantly busy with collecting, sorting, and selling recyclables.
My life feels like a rush, and I usually eat two bento boxes for dinner to feel full, which is more than I used to eat! Sometimes, if I skip lunch, I can eat three bento boxes for dinner!
Additionally, I drink a lot of fluids, including not only plain water but also 1000 cc of sugary commercial beverages daily! (I am unsure if my psychiatric medication is causing me to feel particularly thirsty.) I eat a lot, drink a lot, and urinate frequently, yet tests show I do not have diabetes.
However, my weight continues to decrease.
What could be the reason for this? I would appreciate your guidance.
Thank you.

Xiao Jie, 30~39 year old female. Ask Date: 2014/06/22

Dr. Xiao Yongxun reply Internal Medicine

1.
Generally, the most common causes of weight loss include diabetes, hyperthyroidism, chronic illnesses, cancer, and others; it also encompasses physical exertion, depression, anorexia, and so on.
Since you have already been evaluated by a physician who ruled out the possibility of diabetes and hyperthyroidism, it is indeed important to consider weight loss due to labor-related factors in your case.
It is recommended that you measure your weight at least once a week, record changes in weight along with your daily labor and dietary habits, and then discuss these findings with your physician to identify the underlying cause.
2.
Some psychiatric medications can indeed cause dry mouth and thirst; simply increasing your water intake can help alleviate these symptoms.
It is not advisable to consume sugary or carbonated beverages to quench your thirst, as they can adversely affect your body's metabolism.

Reply Date: 2014/06/22

More Info

Understanding unexplained weight loss can be complex, especially when mental health and lifestyle factors are involved. In your case, it seems that your current lifestyle, which includes working full-time in a physically demanding job, has led to significant changes in your body weight despite your increased food intake.
Firstly, it’s important to recognize that weight loss can occur for various reasons, and in your situation, it appears to be linked to your physical activity level and possibly stress. Engaging in strenuous physical work, such as collecting recyclables, can lead to a higher caloric expenditure. Even if you feel you are eating more, the energy you burn during these activities may exceed your caloric intake, resulting in weight loss.
Moreover, the psychological aspect cannot be overlooked. Stress and anxiety can significantly impact appetite and metabolism. Even if you are consuming what seems to be a sufficient amount of food, if your body is under stress, it may not absorb nutrients effectively. Additionally, certain medications, particularly those used to treat mental health conditions, can also affect appetite and metabolism. If you suspect that your medication might be causing increased thirst and urination, it would be wise to discuss this with your prescribing physician. They can evaluate whether your current medication regimen is appropriate or if adjustments are necessary.

Another factor to consider is the quality of your diet. While you mention eating multiple servings of meals, the nutritional content of those meals is crucial. If your diet lacks essential nutrients, it could lead to weight loss despite high caloric intake. It might be beneficial to consult with a nutritionist who can help you create a balanced meal plan that meets your energy needs while ensuring you receive adequate nutrition.

Additionally, the psychological stress of your situation, including financial concerns and the physical demands of your job, can contribute to a cycle of anxiety that may further exacerbate your weight loss. Chronic stress can lead to hormonal changes in the body that affect weight regulation. It might be helpful to explore stress management techniques, such as mindfulness, meditation, or even therapy, to address the underlying anxiety and improve your overall well-being.

In summary, the unexplained weight loss you are experiencing could be attributed to a combination of increased physical activity, potential stress-related factors, and possibly the effects of your medication. It is essential to have a comprehensive evaluation by healthcare professionals, including a physician and a nutritionist, to address these concerns holistically. They can help you identify the underlying causes of your weight loss and develop a tailored plan to stabilize your weight while considering your mental health needs. Remember, taking care of your mental health is just as important as addressing physical health concerns, and seeking support is a positive step towards achieving balance in your life.

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