Wellness & Fitness

Why am I Losing Weight?

weight

Q: I am a 42-year-old woman and over the past one year, I have lost close to 20 kilogrammes. (I have not changed my diet or started on an exercise plan). My hair is falling out and despite my best attempts at personal hygiene, I constantly smell of sweat. I am an emotional rollercoaster and my family steers out of my way due to my persistent foul mood. Initially, I thought that I had tuberculosis because my previous house help had a persistent cough, (we had lived with her for six months before the diagnosis was made). I went for several tests that turned out to be negative. My family thinks that I am stressed and my husband even took me on holiday, but I am still unhappy. I visited a doctor last month and he suggested that I take some anti-depressants to improve my mood. Could all these symptoms be because of stress? Please help.

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Well, from a medical point of view, ‘stress’ is usually a diagnosis of omission and you cannot say that a patient has stress related symptoms until you have ruled out all other medical conditions. In your case, I would suggest that you go for a full medical check-up.

Concerning symptoms:

In your case, these are the symptoms that have raised a red flag: Unexplained weight loss, excessive sweating, unexplained mood swings and hair loss. Important additional information that you need to tell you doctor on review include:

• Have you noticed any changes in your menstrual cycle? • Do you have changes in your skin? • Are you on any medication? • Any changes in your mental function (concentration, memory etc.)? • Do you have unusual tremors in your hands? • Any changes in your bowel habits (constipation or diarrhoea) or abdominal pain? • Any persistent cough? Any persistent headaches or change in vision? • Do you smoke, drink, or use other social or illegal drugs?

Possible causes of your symptoms

Thyroid abnormalities:If your thyroid is overactive, you can have symptoms very similar to what you are describing. It is important to note that your thyroid does not have to be enlarged (goitre) for you to have these symptoms.

Initial assessment for thyroid problems is usually a blood test. This should guide your doctor as to whether or not you need further investigations (scans).

Infections: Although there are a number of infections that could lead to the symptoms that you are describing. In our local set up, the most common causes are tuberculosis and HIV.

It is important to know that tuberculosis does not just affect the lungs; it can affect any part of the body. Your doctor would need to do a series of tests to evaluate for infectious causes of your symptoms.

Cancer: Cancer can cause generalised symptoms (medically known as constitutional symptoms). These are usually fever and weight loss and in some cases mood changes.

Since cancers are many, your doctor would use your physical examination and symptoms to guide him/her on the need for further investigation. Some cancers also produce hormones, which can account for symptoms similar to what you have described.

Autoimmune diseases: these are medical conditions in which the body’s immunity wrongfully attacks itself as opposed to attacking harmful organisms. Autoimmune conditions are more common in women aged over 40 years than the rest of the population. An example of an autoimmune condition is lupus.

DIGESTIVE PROBLEMS: Conditions that prevent your body from digesting food properly can result in you losing weight despite not changing your feeding pattern. Usually, digestive problems are accompanied by changes in your toilet habits and sometimes may give abdominal pain.

Hormonal irregularities:In addition to the thyroid, hormonal irregularities caused by an organ known as the adrenal and the part of the brain known as the pituitary gland can also cause the symptoms you have described.

Substance abuse:Most illicit drugs result in some form of weight changes. Although cannabis can give you excessive hunger and some weight gain, most of the other substances cause weight loss (this includes alcohol abuse).

Medication:Some medication can cause reduction in the amount of the water in the body (diuretics), which can ultimately lead to some weight loss. You need to carry any medication you are using to the doctor for review.

Diabetes: Diabetes can cause weight loss and some skin and hair changes. It is, however, commonly associated with excessive peeing and an increased appetite. Your doctor will need to know if there is a family history of diabetes.

Organ dysfunction:Your doctor will need to assess you and make sure that all your internal organs are functioning properly – this includes liver, lungs, pancreas and kidney.

Mental health problems:Clinical depression has been associated with some of the symptoms that you have described. Your doctor, however, needs to carry out a full mental evaluation before diagnosing you with clinical depression. Remember, clinical depression is not stress. Stress is a temporary state of mind, whereas clinical depression is a mental health problem, which can be lifelong.

Moral support

In addition to getting a full physical examination, it would probably be in your best interest to get some counselling – especially if your current status is affecting the relationships with those close to you.

If need be, involve your spouse and family in the counselling. Your employer might also need to know that you are going for medical review if you are missing work or underperforming. This will help avoid unfair dismissal.