Significant Weight Loss in Women – An Awareness
As we all age, our basal metabolic rate declines, and there is a weight gain of about 0.5-1kg per year after the age of 35 called ”the middle-age spread”. Weight gain and weight loss both are highly subjective. We need to be aware of our own metabolism as to what causes weight loss and weight gain and find ways to maintain optimal weight for our age and height. Significant weight loss is most often ignored, and it is important to realize that it might harbour an underlying major clinical disease. Exercise and diet induced weight loss should also be gradual based on the person’s initial weight.
Significant weight loss
If there is weight loss of more than 4.5kg [10 lbs] or>5% of body weight in 6 months, it called significant weight loss. But this definition is not strict, for example, if someone has a weight loss of few Kilograms with loss of appetite and inability to carry on the normal day-to-day activities, it becomes clinically very significant. It holds good even for fitness freaks and obese people not to lose too much in a short span of time.
Main causes of weight loss
Cancer
The most common cause of weight loss is cancer in any population. Cancer can be associated with loss of appetite leading to loss of weight or rapidly spreading cancers eating away the nutritional reserves in the body (Cancer Cachexia). The most common gynaecological cancers are breast cancer, uterine cancer, cervical cancer, and ovarian cancer. Most of these are curable if diagnosed early and treated properly at the right time. So we advise Pap smear screening for cervical cancers at least once in 3 years, annual mammogram for women after the age of 40 years, and an annual scan of the pelvis to diagnose uterine and ovarian problems.
Infections
Any prolonged infection can lead to weight loss. Most common infections seen in elderly are recurrent urinary infections that may spread to the kidneys and can lead to a kidney infection. Other common infections are tuberculosis which is endemic in our country. TB can affect people of any age group. Most infections can be cured completely.
Malnutrition
In our country, women always eat leftover food after serving their family members. They have always been compromising their health and nutrition. Malnutrition is one of the causes of of weight loss in women. Please take care of your health so that you can take care of your family and friends. (“சுவர் இருந்தால் தான் சித்திரம் வரைய முடியும்”)
Othermetabolic diseases
Hyperthyroidism (excessive production of thyroid hormone) is one of the major cause of weight loss. It can be associated with diarrhoea, palpitations, tremors, and excessive sweating. Please consult your doctor for regular check of these in your routine blood tests and get treated early to prevent complications.
Uncontrolled diabetes
In people having diabetes, if the sugar control is not optimal, it can lead to weight loss. It can also lead to diabetic gastropathy, where gut motility is deranged, and appetite is poor.
Stress, depression, and sleeplessness
In general, loneliness can lead to depression and poor appetite. In this Covid era, we have seen many patients who were in quarantine or admitted in isolation wards, were psychologically disturbed, lost their appetite, and had weight loss. We have counsellors who can speak to them and cheer them. Many women get worried when they are not able to perform their activities of daily living independently.
To conclude, weight loss is a major clinical problem that might give us a clue to an underlying physical or mental illness. Early identification and treatment is the main key to manage weight loss and ensure good quality of life.
Dr Karpagambal Sairam, DGO, DNB, MRCOG (London)
Consultant Obstetrician, Gynaecologist and Fertility Specialist
Kauvery Hospital, Chennai