Patient information · General health
Unexplained weight loss
the symptom least worth waiting on
Losing weight without trying is one of the few symptoms that is almost never nothing. It has a long list of causes, many of them entirely treatable — but the list also includes conditions where early diagnosis matters a great deal, which is why this is a symptom to act on rather than monitor.
Arrange prompt assessment, and urgently if there is also
- difficulty swallowing, or food sticking
- bleeding — coughing blood, blood in stool or urine, or vomiting blood
- a new lump anywhere, or swollen glands persisting more than three weeks
- drenching night sweats, or persistent fever
- a persistent change in bowel habit, or persistent abdominal pain
- a persistent cough or hoarse voice lasting more than three weeks
Unintentional weight loss combined with any of these meets NICE criteria for urgent investigation. This is not a symptom to review in a few months to see how it goes.
How much counts
Clothes becoming loose, a belt needing tightening, or someone else commenting are often the first signs — many people do not weigh themselves. If you have old weights recorded anywhere, bring them; the trend matters more than a single figure.
Causes worth excluding
- Diabetes — particularly with thirst and frequent urination. Weight loss can be the presenting feature.
- Overactive thyroid — with palpitations, tremor, heat intolerance and anxiety.
- Cancer — the reason for urgency. Bowel, stomach, oesophageal, pancreatic, lung, kidney and lymphoma all present this way.
- Coeliac disease and inflammatory bowel disease.
- Chronic infection — tuberculosis in particular, which is more common in East London than nationally, and HIV.
- Depression, anxiety and eating disorders — common causes, and eating disorders occur at every age and body size.
- Heart, lung, liver or kidney disease, and dementia in older people.
- Medicines, dental problems making eating painful, and simply reduced food intake for social or financial reasons.
Ask yourself two things
Is your appetite up or down? Weight loss with a good or increased appetite points strongly towards diabetes, an overactive thyroid or malabsorption. Weight loss with a poor appetite points more towards cancer, chronic infection, depression or organ disease. And is anything making eating difficult? Painful swallowing, mouth problems, early fullness or nausea each direct the investigation differently.
What investigation involves
- Documented weight, and comparison with any previous records
- Blood tests — full blood count, inflammatory markers, kidney and liver function, calcium, glucose or HbA1c, thyroid function, coeliac screening, and often ferritin, B12 and folate
- Urine testing, and a stool test for blood or calprotectin where relevant
- Chest X-ray, particularly in smokers or with any cough
- Further imaging or endoscopy guided by the findings
- HIV and TB testing where risk factors are present — both are treatable and both are missed
If everything comes back normal
That is a good result and it is not the end of it. Persistent unexplained weight loss with normal initial tests warrants a period of documented monitoring with repeat assessment rather than discharge, because some conditions declare themselves over weeks. Meanwhile, nutritional support matters — continuing to lose weight causes muscle loss, falls and poorer outcomes from whatever is eventually found.
Why come to us. This is a symptom where waiting for appointments has a real cost. We can see you within days, take the full investigation panel in-house — blood count, inflammatory markers, kidney, liver, calcium, HbA1c, thyroid, coeliac, and HIV or TB testing where relevant — with results explained face to face, usually in the same visit. Chest X-ray, CT and endoscopy are arranged rapidly through our CQC-registered partners, and we refer on the same day where anything needs it.
Seen within days, full panel in-house
Results the same visit, imaging arranged rapidly. Seven days a week.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.