Dr. Prabhat AryaMD · Internal Medicine

Losing weight without trying is worth a check.

Weight goes up and down a little all the time. Losing a noticeable amount when you are not dieting or exercising more is different: it means the body is using up more than it takes in, or not taking in what you eat. The reason is usually treatable, and the sooner it is found, the better.

Book a video consultationEverything he looks after

In plain words.

Doctors look closely when someone loses more than 5 in every 100 kilograms of body weight over 6 to 12 months without trying. For a person of 70 kg, that is about 3.5 kg or more. Clothes becoming loose and a belt needing a new hole are good clues if you have not been weighed.

Common reasons: diabetes, where sugar is lost in the urine; an overactive thyroid, which burns fuel too fast; TB and other long infections; and stomach and bowel problems where food is not taken in properly, such as an ulcer, coeliac disease or inflammation of the bowel.

Low mood, worry and loneliness are among the commonest reasons of all, especially in older people living alone. Poor teeth, dentures that hurt, trouble swallowing, alcohol and some medicines also play a part.

Sometimes weight loss is the first sign of a cancer. That is one reason not to wait, but most people with weight loss turn out to have another cause.

Where the weight goes

A bathroom scale beside a chart of weight over a year. When weight is steady, the needle stays near 70 kilograms and the line on the chart stays flat. When weight falls without trying, the needle slides to 64 and the line slopes down month after month, past the mark for 5 kilograms in every 100. Then five places the weight can go are shown: a fast thyroid burning fuel too quickly, sugar lost in the urine in diabetes, TB or another long illness, a gut that does not absorb food, and eating too little because of low mood, teeth or trouble swallowing. 60646872 kg on the scale 70686664 now6 mo1 yr steady all year down 6 kg in a yearpast 5 kg in 100: check thyroid burns fastsugar lost in urineTB, long illnessgut not absorbingeating too little

In a healthy adult, weight stays much the same from month to month. What we eat matches what the body burns.

Go to hospital now if

  • Vomiting blood, or black, sticky stools: go to hospital now.
  • Food or even saliva cannot go down at all: go to hospital now.
  • Very thirsty and passing a lot of urine, with vomiting, fast deep breathing or drowsiness: go to hospital now.
  • Vomiting everything and unable to keep fluids down for a day: go to hospital now.
  • Yellow eyes with fever, confusion or drowsiness: go to hospital now.
  • Thoughts of harming yourself: call 112 or go to hospital now. You can also call Tele-MANAS, the free national helpline, on 14416.

Call 112 or go to the nearest emergency department. Ambulance: 108 (102 in some states).

See a doctor within a week or two if

  • You have lost weight without trying, especially if you are over 50
  • Food sticks when you swallow, or you vomit often
  • You have blood in the stools, a change in bowel habit for weeks, or ongoing stomach pain
  • You have a cough for more than two weeks, or have coughed up blood
  • You have fever, night sweats, or a new lump anywhere
  • For women: bleeding after periods have stopped

Tests that help.

Not everyone needs every test. He decides which ones are worth doing for you.

TestsA general guide, not a prescription
TestWhat it tells
Complete blood count (CBC), ESR and CRPLook for anaemia, infection and inflammation.
Fasting sugar and HbA1cLook for diabetes.
Thyroid (TSH)Looks for an overactive thyroid.
Liver and kidney function, and a urine testCheck how these organs are working.
Chest X-ray, and an ultrasound of the bellyLook for TB, enlarged glands and problems in the liver and other organs.
Next steps, where the clues pointFor example a stool test for blood, an HIV test (with your consent), a coeliac blood test, an endoscopy or colonoscopy, or a CT scan.

Have it ready.

Tick them off as you gather them. The ticks stay on this phone only.

Online, or in person?

Tonics and appetite syrups do not fix the cause and can delay finding it. If you are losing weight, find out why first. Weight lost on purpose, by eating less or exercising more, is not a worry.

A video call can

  • Work out the likely causes from your story and your weight record
  • Order a sensible first set of blood tests and scans
  • Treat diabetes, thyroid, low mood and many other causes
  • Arrange a specialist test, such as an endoscopy, when it is needed

Needs a visit in person

  • Blood tests, at a laboratory or by home collection
  • An examination of the belly, glands and breasts
  • Endoscopy, colonoscopy and scans
  • Any sign in the red box: that is an emergency

Talk it through with Dr. Arya.

Bring your reports and medicines to a video consultation. He goes through them with you, in plain words, and says clearly if you need to be seen in person.

Book a video consultation

Dr. Prabhat Arya · MBBS, MD (Internal Medicine) · Delhi Medical Council Reg. No. DMC-83759