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At any given moment, it is estimated that 20 million Americans are trying to lose weight, and an equal number consider themselves too fat and are planning to go on a diet. Their concern is echoed in the 1989 Surgeon General's Report on Nutrition and Health, which asserts that a third of all adults in the United States are overweight.

With this emphasis on excessive weight, many people forget that excessive or unexplained weight loss can also be a threat to health. Any unexplained loss of more than 10 pounds is a warning to see a doctor.

Causes of weight loss

Anemia
Weight loss accompanied by fatigue, shortness of breath, rapid heartbeat, pallor, and general malaise suggest possible anemia. The anemia may be due to poor nutrition, or it may be a component of some other disease, such as chronic bleeding or infection.

Cancer
Excessive weight loss or wasting is a common symptom of cancer, especially in its advanced stages. Depending upon the type of cancer, the weight loss may be accompanied by lack of appetite and taste disorders, in which even favorite foods no longer taste good. In addition, some cancer treatments may make eating more difficult. Chemo­therapy and radiation therapy can cause nausea and vomiting; surgery for head or neck cancer can make chewing and swallowing difficult.

Depression
Loss of appetite and weight loss are common signs of depression. Other symptoms include changes in sleeping habits, feelings of hopelessness, thoughts of suicide, and unexplained loss of interest in pleasurable activities.

Diabetes
In diabetes, the body is unable to utilize glucose, its main source of fuel. An early symptom is weight loss despite increased hunger and intake of food. Other symptoms include frequent and abundant urination, thirst, and fatigue.

Digestive disorders
Malabsorption syndromes,

enzyme deficiencies, and other digestive diseases that prevent the proper metabolism of foods can cause weight loss. Many of these diseases, especially those that are inherited, show up early in life and are accompanied by a failure to grow properly.

Eating disorders
Unexplained weight loss in a young woman may be due to an eating disorder, such as anorexia nervosa, a disease marked by self-starvation, or bulimia, a disease characterized by binging and then purging by induced vomiting.

Infection
Many chronic infections cause weight loss. The wasting is particularly serious in AIDS. Tuberculosis, intestinal infections, and parasitic disorders can also result in weight loss.

Intestinal disorders
Chronic diarrhea and intestinal inflammation can result in weight loss due to the body's inability to absorb food. Weight loss can be particularly severe in ulcerative conditions such as colitis.

Liver and/or pancreatic disorders
Both the liver and pancreas are essential in the proper digestion of foods, and diseases of these organs can cause weight loss.

Thyroid disorders
Weight loss accompanied by fatigue, excessive sweating, weakness or trembling, jittery nerves, palpitations, and other symptoms may be due to an overactive thyroid (hyperthyroidism).