Weight loss must be investigated

Dear Dr. Roach: I am a 72-year-old man in good health. I have lost about 12 pounds in the past year. I’m 5 feet, 9 1⁄2 inches tall, and my morning weight has dropped from 166-168 pounds to 154-156 pounds.

I eat well. I’ve had on-andoff atrial fibrillation for 14 years, with two ablations, but since I began flecainide two years ago, no more episodes. I also take 10 mg simvastatin and 1,000 mg vitamin D3 daily.

My doctor did bloodwork and ordered a full CT scan, but found nothing. I’ve been walking 3 miles every other day, alternating with my days on the stationary bike at home. The doctor thinks I may be burning more calories than I’m eating, but I doubt it.

Would you have any ideas? — D.S.

Unexplained weight loss should be taken seriously. Getting bloodwork and a CT scan is a reasonable start.

Your doctor is right to think about energy intake as well as energy expenditure. The first to do is to see how many calories you are eating. A careful food diary can accomplish this. People with major depression and other neurologic and psychiatric illnesses sometimes eat little.

Sometimes, the body cannot absorb calories properly. Celiac disease and inflammatory bowel disease are the most common, but there are others. The body may lose calories; diabetes causes sugar to come out through the urine. Some infections can cause profound weight loss.

Medications are an uncommon cause of weight loss. Some supplements can cause weight loss, too.

Cancer leaps to the mind for many when they hear about weight loss. Colon cancer and prostate cancer should be considered. .

Since your weight loss continues, it’s time for a more thorough re-evaluation.