Loss of appetite: managing unwanted weight loss in the older patient

Loss of appetite, regardless of cause, is a significant symptom that may cause extreme weight loss in older patients. The consequences of anorexia include muscle wasting, weakness, depression, increased susceptibility to disease complications, and decreased immunocompetence. In the older population, the major causes of anorexia are pulmonary and cardiac diseases, cancer, dementia, alcoholism, depression, and medications. The diagnosis is based on the physical exam, a history of weight loss, and a review of dietary intake. Treatment strategies include managing GI disturbances, encouraging physical activity and socialization, reducing fatigue and food aversions, and adding high-calorie supplements to the diet.