不正常體重下降的定義為：在非刻意減重的情況下，體重於6-12個月減少平常體重的5%。常見的因素可歸納為下表(引用UptoDate: Approach to the patient with unintentional weight loss)
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Major causes
of unintentional weight loss
|
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Malignancy
(eg, gastrointestinal, lung, lymphoma, renal, and prostate cancers)
|
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Nonmalignant
gastrointestinal diseases (eg, peptic ulcer disease, celiac disease,
inflammatory bowel disease)
|
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Psychiatric
disorders (particularly depression), also eating disorders, food-related
delusional manifestations of other psychiatric disorders
|
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Endocrinopathies
(eg, hyperthyroidism, diabetes, adrenal insufficiency)
|
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Infectious
diseases (eg, HIV, viral hepatitis, tuberculosis, chronic fungal or bacterial
disease, chronic helminth infection)
|
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Advanced
chronic disease (eg, cardiac cachexia from heart failure, pulmonary cachexia,
renal failure)
|
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Neurologic
diseases (eg, stroke, dementia, Parkinson disease, amyotrophic lateral
sclerosis)
|
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Medications/substances
|
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Rheumatologic
diseases (eg, severe rheumatoid arthritis, giant cell vasculitis)
|
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Chronic
vigorous exercise (eg, distance running, ballet dancing, gymnastics)
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Medication/substances
associated with weight loss
|
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Alcohol
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Cocaine
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Amphetamines
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Drug
withdrawal syndromes (withdrawal after chronic high-dose psychotropic
medications or cannabis)
|
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Tobacco
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Adverse
effects of prescription drugs (eg, anticonvulsants diabetes medications,
thyroid medication)*
|
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Herbal and
other nonprescription drugs (5-hydroxytryptophan, aloe, caffeine, cascara,
chitosan, chromium, dandelion, ephedra, garcinia, glucomannan, guarana, guar
gum, herbal diuretics, nicotine, pyruvate, St. John's wort)
|
UptoDate也有整理為簡單的口訣版本
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Medications (eg, digoxin,
theophylline, SSRIs, antibiotics)
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Emotional (eg, depression,
anxiety)
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Alcoholism, older
adult abuse
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Late-life paranoia or
bereavement
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Swallowing problems
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Oral factors (tooth loss,
xerostomia)
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Nosocomial infections (eg,
tuberculosis, pneumonia)
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Wandering and other
dementia-related factors
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Hyperthyroidism,
hypercalcemia, hypoadrenalism
|
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Enteral problems (eg,
esophageal stricture, gluten enteropathy)
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Eating problems
|
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Low salt, low cholesterol,
and other therapeutic diets
|
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Social isolation, stones
(chronic cholecystitis)
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