Unintentional weight loss: diagnosis and prognosis. The first prospective follow-up study from a secondary referral centre

J Intern Med. 2001 Jan;249(1):41-6. doi: 10.1046/j.1365-2796.2001.00771.x.


Objectives: To establish the incidence and causes of unintentional weight loss and to compare prognoses.

Design: Prospective.

Setting: Secondary referral centre.

Subjects: 158 patients (89 female, 56%; 69 male, 44%) referred by general physicians for unexplained weight loss or for other reasons. In the latter case, weight loss was established after admission to hospital. Follow-up lasted for up to 3 years.

Main outcome measure: Determining the course of weight loss in patients with diagnosed and undiagnosed causes.

Results: The cause of weight loss was established in 132 (84%) patients and remained unclear in 26 (16%). Reasons were non-malignant (60% of patients) and malignant (24%) diseases. Psychological disorders represented 11% of the non-malignant group. A gastrointestinal disease caused weight loss in 50 (30%) patients. Of malignant disorders, 53% (20 of 38 patients) were gastrointestinal. Amongst the non-malignant group, 39% (30 of 77 patients) had somatic disorders. The prognosis for unknown causes of weight loss was the same as for non-malignant causes.

Conclusion: Contrary to common belief, weight loss is not usually due to a malignant disease. A gastrointestinal tract disorder accounts for weight loss in every third patient. If minimal diagnostic procedures cannot establish a diagnosis, then endoscopic investigation of the upper and lower gastrointestinal tract and function tests should be performed to exclude malabsorption.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cause of Death
  • Chronic Disease
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Germany / epidemiology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / diagnosis
  • Prognosis
  • Prospective Studies
  • Referral and Consultation
  • Weight Loss*