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Serious weight loss may reduce quality of life, impair treatment effectiveness or recovery, worsen disease processes and be a risk factor for earlier mortality.[1][6] Malnutrition can affect every function of the human body, from the cells to the most complex functions, including:[5]

    immune response;
    wound healing;
    muscle strength (including respiratory muscles);
    renal capacity and depletion leading to water and electrolyte disturbances;
    thermoregulation; and
    menstruation.

In addition, malnutrition can lead to vitamin and other deficiencies and to inactivity, which in turn may pre-dispose to other problems, such as pressure sores.[5]

Unintentional weight loss can be the characteristic leading to diagnosis of diseases such as cancer[1] and type 1 diabetes.[10]

In the UK, up to 5% of the general population is underweight, but more than 10% of those with lung or gastrointestinal diseases and who have recently had surgery.[5] According to data in the UK using the Malnutrition Universal Screening Tool ('MUST'), which incorporates unintentional weight loss, more than 10% of the population over the age of 65 is at risk of malnutrition.[5] A high proportion (10-60%) of hospital patients are also at risk, along with a similar proportion in care homes.

Weight loss issues related to specific diseases include:

    As chronic obstructive pulmonary disease (COPD) advances, about 35% of patients experience severe weight loss called pulmonary cachexia, including diminished muscle mass.[7] Around 25% experience moderate to severe weight loss, and most others have some weight loss.[7] Greater weight loss is associated with poorer prognosis.[7] Theories about contributing factors include appetite loss related to reduced activity, additional energy required for breathing, and the difficulty of eating with dyspnea (labored breathing).[7]
    Cancer, a very common and sometimes fatal cause of unexplained (idiopathic) weight loss. About one-third of unintentional weight loss cases are secondary to malignancy. Cancers to suspect in patients with unexplained weight loss include gastrointestinal, prostate, hepatobillary (hepatocellular carcinoma, pancreatic cancer), ovarian, hematologic or lung malignancies.
    People with HIV often experience weight loss, and it is associated with poorer outcomes.[11] Wasting syndrome is an AIDS-defining condition.[11]
    Gastrointestinal disorders are another common cause of unexplained weight loss – in fact they are the most common non-cancerous cause of idiopathic weight loss.[citation needed] Possible gastrointestinal etiologies of unexplained weight loss include: celiac disease, peptic ulcer disease, inflammatory bowel disease (crohn's disease and ulcerative colitis), pancreatitis, gastritis, diarrhea and many other GI conditions.
    Infection. Some infectious diseases can cause weight loss. Fungal illnesses, endocarditis, many parasitic diseases, AIDS, and some other subacute or occult infections may cause weight loss.
    Renal disease. Patients who have uremia often have poor or absent appetite, vomiting and nausea. This can cause weight loss.
    Cardiac disease. Cardiovascular disease, especially congestive heart failure, may cause unexplained weight loss.
    Connective tissue disease
    Neurologic disease, including dementia[12]
    Oral, taste or dental problems (including infections) can reduce nutrient intake leading to weight loss.[3]

Therapy-related

Medical treatment can directly or indirectly cause weight loss, impairing treatment effectiveness and recovery that can lead to further weight loss in a vicious cycle.[1]

Many patients will be in pain and have a loss of appetite after surgery.[1] Part of the body's response to surgery is to direct energy to wound healing, which increases the body's overall energy requirements.[1] Surgery affects nutritional status indirectly, particularly during the recovery period, as it can interfere with wound healing and other aspects of recovery.[1][5] Surgery directly affects nutritional status if a procedure permanently alters the digestive system.[1] Enteral nutrition (tube feeding) is often needed.[1] However a policy of 'nil by mouth' for all gastrointestinal surgery has not been shown to benefit, with some suggestion it might hinder recovery.[13]

Early post-operative nutrition is a part of Enhanced Recovery After Surgery protocols.[14] These protocols also include carbohydrate loading in the 24 hours before surgery, but earlier nutritional interventions have not been shown to have a significant impact.[14]

Some medications can cause weight loss,[15] while others can cause weight gain.[16][17]
Social conditions

Social conditions such as poverty, social isolation and inability to get or prepare preferred foods can cause unintentional weight loss, and this may be particularly common in older people.[18] Nutrient intake can also be affected by culture, family and belief systems.[3] Ill-fitting dentures and other dental or oral health problems can also affect adequacy of nutrition.[3]

Loss of hope, status or social contact and spiritual distress can cause depression, which may be associated with reduced nutrition, as can fatigue.[3]
Intentional

Intentional weight loss refers to the loss of total body mass as a result of efforts to improve fitness and health, and/or to change appearance.

Weight loss in individuals who are overweight or obese can reduce health risks,[19] increase fitness,[20] and may delay the onset of diabetes.[19] It could reduce pain and increase movement in people with osteoarthritis of the knee.[20] Weight loss can lead to a reduction in hypertension (high blood pressure), however whether this reduces hypertension-related harm is unclear.[19]

Weight loss occurs when an individual is in a state of negative thermodynamic flux: when the body is expending more energy (i.e. in work and metabolism) than it is absorbing (i.e., from food or other nutritional supplements), it will use stored reserves from fat or muscle, gradually leading to weight loss.

It is not uncommon for some people who are at their ideal body weight to seek additional weight loss in order to improve athletic performance or meet required weight classification for participation in a sport. Others may be driven to lose weight to achieve a more attractive appearance. Being underweight is associated with health risks such as difficulty fighting off infection, osteoporosis, decreased muscle strength, trouble regulating body temperature and even increased risk of death.[21]

According to the U.S. Food and Drug Administration (FDA), healthy individuals seeking to maintain their weight should consume 2,000 calories per day.[22]

According to the Dietary Guidelines for Americans those who achieve and manage a healthy weight do so most successfully by being careful to consume just enough calories to meet their needs, and being physically active.[23]

Low-calorie regimen diets are also referred to as balanced percentage diets. Due to their minimal detrimental effects, these types of diets are most commonly recommended by nutritionists. In addition to restricting calorie intake, a balanced diet also regulates macronutrient consumption. From the total number of allotted daily calories, it is recommended that 55% should come from carbohydrates, 15% from protein, and 30% from fats with no more than 10% of total fat coming from saturated forms.[24] For instance, a recommended 1,200 calorie diet would supply about 660 calories from carbohydrates, 180 from protein, and 360 from fat. Some studies suggest that increased consumption of protein can help ease hunger pangs associated with reduced caloric intake by increasing the feeling of satiety.[25] Calorie restriction in this way has many long-term benefits. After reaching the desired body weight, the calories consumed per day may be increased gradually, without exceeding 2,000 net (i.e. derived by subtracting calories burned by physical activity from calories consumed). Combined with increased physical activity, long-term low-calorie diets are thought to be most effective long term, unlike crash diets which can achieve short term results, at best. Physical activity could greatly enhance the efficiency of a diet. The healthiest weight loss regimen, therefore, is one that consists of a balanced diet and moderate physical activity.[citation needed]

Weight gain has been associated with excessive consumption of fats, sugars, carbohydrates in general, and alcohol.[citation needed] Depression, stress or boredom may also contribute to weight increase,[citation needed] and in these cases, individuals are advised to seek medical help. A 2010 study found that dieters who got a full night's sleep lost more than twice as much fat as sleep-deprived dieters.[26][27]

The majority of dieters regain weight over the long term

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