Evaluation of unintentional weight loss

Last reviewed: 6 Apr 2025
Last updated: 25 Jun 2024

Summary

Differentials

Common

  • Stomach cancer
  • Colorectal cancer
  • Esophageal cancer
  • Pancreatic cancer
  • Hepatoma
  • Small cell lung cancer
  • Non-small cell lung cancer
  • Non-Hodgkin lymphoma
  • Hodgkin lymphoma
  • Chronic leukemia
  • Multiple myeloma
  • Oropharyngeal cancer
  • Laryngeal cancer
  • Ovarian cancer
  • Prostate cancer
  • Breast cancer
  • Celiac disease
  • Exocrine pancreatic insufficiency
  • Crohn disease
  • Ulcerative colitis
  • Mesenteric ischemia
  • Depression
  • Bipolar disorder
  • Generalized anxiety disorder
  • Anorexia nervosa
  • Substance misuse
  • Parkinson disease
  • Dementia
  • Hyperthyroidism
  • Tuberculosis
  • Adverse medication effects
  • Sarcopenia
Full details

Uncommon

  • Cholangiocarcinoma
  • Acute leukemia
  • Zollinger-Ellison syndrome
  • VIPoma
  • Carcinoid syndrome
  • Peptic ulcer disease
  • Chronic hepatitis
  • Esophageal webs, rings, and diverticula
  • Small intestinal bacterial overgrowth (SIBO)
  • Gastroparesis
  • Postsurgical complications
  • Stomatitis
  • Bulimia nervosa
  • Multiple sclerosis
  • Amyotrophic lateral sclerosis
  • Prion disease
  • Cardiac cachexia syndrome
  • Poststroke complications
  • Pulmonary cachexia syndrome
  • Cystic fibrosis
  • Microscopic polyangiitis
  • Renal cachexia syndrome
  • Diabetes mellitus
  • Adrenal insufficiency
  • Hypopituitarism
  • Pheochromocytoma
  • Rheumatoid arthritis
  • Systemic lupus erythematosus
  • Granulomatosis with polyangiitis
  • Polyarteritis nodosa
  • Systemic sclerosis (scleroderma)
  • Sarcoidosis
  • Mixed connective tissue disease (overlap syndromes)
  • Adult-onset Still disease
  • HIV infection
  • Mycobacterium avium complex (MAC)
  • Histoplasmosis
  • Amebiasis
  • Giardiasis
  • Cryptosporidiosis
  • Cystoisosporiasis
  • Cyclosporiasis
  • Strongyloidiasis
  • Infective endocarditis
  • Whipple disease
  • Bartonella infection
  • Inadequate nutrition
  • Elder abuse/neglect
  • Child abuse/neglect
Full details

Contributors

Authors

Christopher J. Wong, MD

Associate Professor

Division of General Internal Medicine

Department of Medicine

University of Washington

Seattle

WA

Disclosures

CJW is an author of a reference cited in this topic. He also receives royalties from Springer for textbooks on perioperative medicine and primary care of solid organ transplant recipients.

Peer reviewers

Alan Shand, MD, FRCP (ed)

Clinical Director

Gastro-intestinal Unit

Western General Hospital

Edinburgh

UK

Disclosures

AS declares that he has no competing interests.

Sherman M. Chamberlain, MD, FACP, AGAF, FACG

Professor of Medicine

Medical Director, Endoscopy

Section of Gastroenterology/Hepatology

Georgia Regents University-Medical College of Georgia

Augusta

GA

Disclosures

SMC declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Wong CJ. Involuntary weight loss. Med Clin North Am. 2014;98:625-43. Abstract

McMinn J, Steel C, Bowman A. Investigation and management of unintentional weight loss in older adults. BMJ. 2011 Mar 29;342:d1732. Abstract

National Institute for Health and Care Excellence. Suspected cancer: recognition and referral. Oct 2023 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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