The importance of preventing unintentional weight loss

Whether intentional, progressive, supervised, or accompanied by physical activity, weight loss is often perceived as a positive experience. However, there are situations where weight loss can have negative consequences and lead to malnutrition. That is why it is important to identify and address these situations when necessary.

Losing weight when ill, of a certain age or in a fragile state is not without consequences. In fact, weight loss results from an imbalance between energy and protein intake in the diet and the body’s needs. This imbalance would lead to a decrease in muscle mass, followed by a loss of fat mass and could eventually result in malnutrition.

Every country in the world is affected by one or more forms of malnutrition. Current global estimates are that around a quarter of older adults (65 years and older) are malnourished or at risk of malnutrition. Malnutrition often develops quietly and only becomes apparent through the complications it causes.

Moreover, a person could be malnourished despite being obese or overweight, which makes weight loss difficult to identify.

What explains weight loss?

Several factors, sometimes combined, can lead to weight loss. These include:

• Decreased food intake, related to:
  • Loss of appetite
  • Depression
  • Loneliness
  • Pain
  • Dementia
  • Poor oral health
  • Nausea, for example, following chemotherapy
  • Refusal to eat
• Increased energy expenditure
• Increased bowel movement (such as diarrhea) due to illness.

At which point is weight loss considered a criterion for malnutrition?

The diagnosis of malnutrition is based on combined criteria, such as unintentional weight loss. If the weight loss is > 5% within 6 months, BMI <20 kg/m2 in older adults compared to the usual weight before the onset of illness, it is a sign of malnutrition. The doctor diagnoses malnutrition after clinical evaluation and identification of the associated diagnostic criteria.

For example, if a person weighed 70 kg in January and their weight is 66 kg in August, this means they have lost 4 kg unintentionally, which is 5.71% of their original weight. This weight loss fits de criteria for malnutrition.

The BMI (Body Mass Index) is also an indicator used to diagnose malnutrition. It is calculated as follows: BMI = weight in kg / height² in m

The BMI indicates malnutrition if: 

• BMI <20 kg/m2 in older adults
• BMI < 22 kg/m² for people over 70

Example: If a person weighs 60 kg and is 1.82 m tall, their BMI is 60 / (1.82 x 1.82) = 18.1.This BMI indicates malnutrition.

What are the consequences of malnutrition?

Malnutrition could have significant consequences. It increases the risk of getting sick and can cause more falls and dependence on others. It can also weaken the immune system, making it easier to catch infections. Malnutrition can slow down recovery from illness or surgery and lead to weaker muscles.

Weight, a simple parameter to monitor

If you notice that you or the person you care for is losing weight unintentionally, such as needing smaller clothing sizes, having pants, shirts, or dresses that are noticeably baggy or require a belt to stay up, experiencing noticeable changes in body shape or muscle tone, having decreased energy levels, showing changes in eating habits such as skipping meals, having a more sunken appearance in the face, or having a decreased appetite, please contact a healthcare professional for help.

Solutions to combat weight loss

Nutritional support could help prevent or limit weight loss and even assist in regaining weight. 
It includes dietary guidance to diversify food intake and may involve the use of energy- and protein-enriched products, such as oral nutritional supplements, if regular food intake is insufficient.

Healthcare professionals support the implementation of nutritional solutions to combat malnutrition.