What causes weight loss despite healthy diet in the elderly?

Question

Hello doctor,

I am a 64-year-old male. In the past three years, body weight has decreased from 163 pounds to 134 pounds. Height is 172 cm (centimeters), with a medium build. There are no known underlying health issues. My diet is healthy and balanced, and includes fish, seafood, vegetables, fruits, grains, and occasional dairy products and eggs. However, alcohol intake is higher than medically recommended, with around five bottles of white wine consumed each week.

Walking was previously a regular form of exercise, but my activity has reduced recently due to caring for an elderly dog. Overall, my health feels good, though there are occasional episodes of light-headedness. Should there be any concern about this weight loss? What could be the likely cause?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Reduced physical activity can lead to some muscle loss, even if your overall body weight appears stable. Alcohol intake, such as five bottles of wine per week, can interfere with nutrient absorption (especially B vitamins and folate), stress the liver, suppress appetite, or lead to changes in metabolism.

Some possible medical or metabolic reasons for weight loss include thyroid disease, diabetes, and conditions that prevent the proper absorption of nutrients, such as celiac disease or reduced pancreatic function. Chronic infections like Helicobacter pylori or mild chronic kidney or liver disease may also be responsible.

Unintentional weight loss may be an early sign of certain cancers, especially those in the stomach, colon, pancreas, blood (such as lymphoma), or lungs.

Depression and mild cognitive changes can quietly affect appetite and eating habits without you noticing a clear emotional or mental health problem.

You are not in immediate danger, but it is important to request the following basic tests and investigations:

Complete blood count (CBC).
Erythrocyte sedimentation rate or C-reactive protein (ESR or CRP).
Thyroid-stimulating hormone and free thyroxine (TSH and free T4).
Liver function tests and gamma-glutamyl transferase (LFT and GGT).
Hemoglobin A1c (glycated hemoglobin).
Urea, electrolytes(U&E), and creatinine.
Calcium and albumin (serum calcium and serum albumin).
Vitamin B12 and folate (cobalamin and folate).
Fecal occult blood test (FOBT).
Chest X-ray.
Abdominal ultrasound or computed tomography scan (ultrasound abdomen or CT abdomen).
Upper gastrointestinal endoscopy and colonoscopy (UGI and colonoscopy).

In the meantime, monitor your weight weekly, as rapid or continuous drops may need more urgent attention. Try to reduce your alcohol intake or stop drinking entirely if possible. Reintroduce physical activity, such as light bodyweight exercises or resistance band training, to help maintain muscle mass. Also, track your daily intake of protein and total calories to ensure you are meeting your body’s nutritional needs.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.