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2021 | OriginalPaper | Hoofdstuk

8. Gewichtsverlies

Auteurs : Prof. dr. H. de Vries, Drs. J. F. Bastiaans, Prof. dr. F. J. van Ittersum

Gepubliceerd in: Diagnostiek van alledaagse klachten

Uitgeverij: Bohn Stafleu van Loghum

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Samenvatting

Onbedoeld gewichtsverlies wordt veelal als pathologisch beschouwd indien het meer dan 5 % van het uitgangsgewicht betreft, ontstaan in 6 maanden of kortere tijd. De oorzaken variëren van ernstige organische aandoeningen tot psychiatrische stoornissen. Depressie wordt het vaakst gevonden als oorzaak bij ouderen in de huisartsenpraktijk. Soms wordt een anorexia nervosa vastgesteld. Een systematische anamnese gericht op de factoren die van invloed zijn op het lichaamsgewicht (inname, opname, verbruik, verlies) levert de belangrijkste bijdrage aan de diagnostiek. Er zijn aanwijzingen dat een algeheel lichamelijk onderzoek zinvol is. De meeste auteurs bevelen verder screenend bloed- en urineonderzoek aan. Wat aanvullend onderzoek betreft, zijn er argumenten om bij ouderen een X-thorax aan te vragen. Als de anamnese en het lichamelijk onderzoek geen aanwijzingen geven, kan er een afwachtend beleid worden gevoerd. Daarbij is herbeoordeling na 3–6 maanden aangewezen. Aan specifieke oorzaken van gewichtsverlies bij ouderen (o.a. onvoldoende zorg, dementie, slikproblemen, maligniteiten, ernstige orgaandisfunctie en medicatie/polyfarmacie) dient aandacht besteed te worden.
Literatuur
1.
go back to reference Meltzer AA, Everhart JE. Unintentional weight loss in the United States. Am J Epidemiol. 1995;142:1039–46.PubMedCrossRef Meltzer AA, Everhart JE. Unintentional weight loss in the United States. Am J Epidemiol. 1995;142:1039–46.PubMedCrossRef
2.
go back to reference French SA, Jeffery RW, Folson AR, et al. History of intentional and unintentional weight loss in a population-based sample of women aged 55 to 69 years. Obes Res. 1995;3:163–70.PubMedCrossRef French SA, Jeffery RW, Folson AR, et al. History of intentional and unintentional weight loss in a population-based sample of women aged 55 to 69 years. Obes Res. 1995;3:163–70.PubMedCrossRef
3.
go back to reference Wannamathee SG, Shaper AG, Whincup PH, et al. Characteristics of older men who lose weight intentionally or unintentionally. Am J Epidemiol. 2000;151:667–75.CrossRef Wannamathee SG, Shaper AG, Whincup PH, et al. Characteristics of older men who lose weight intentionally or unintentionally. Am J Epidemiol. 2000;151:667–75.CrossRef
4.
go back to reference Reife CM. Weight loss. In: Fauci AS, Braunwald E, Kasper DL, et al., redacteuren. Harrison’s principles of internal medicine. 17e druk. New York: McGraw-Hill; 2007. Reife CM. Weight loss. In: Fauci AS, Braunwald E, Kasper DL, et al., redacteuren. Harrison’s principles of internal medicine. 17e druk. New York: McGraw-Hill; 2007.
5.
go back to reference Bouras EP, Lange SM, Scolapio JS. Rational approach to patients with unintentional weight loss. Mayo Clin Proc. 2001;76:923–9.PubMedCrossRef Bouras EP, Lange SM, Scolapio JS. Rational approach to patients with unintentional weight loss. Mayo Clin Proc. 2001;76:923–9.PubMedCrossRef
6.
go back to reference Drossman DA. Approach to the patient with unexplained weight loss. In: Podolsky DK, Camilleri M, Fitz JG, et al., redacteuren. Yamada’s textbook of gastroenterology. 6e druk. Hoboken: Wiley-Blackwell; 2015. Drossman DA. Approach to the patient with unexplained weight loss. In: Podolsky DK, Camilleri M, Fitz JG, et al., redacteuren. Yamada’s textbook of gastroenterology. 6e druk. Hoboken: Wiley-Blackwell; 2015.
7.
go back to reference Marton KI, Sox HC Jr, Krupp JR. Involuntary weight loss: diagnostic and prognostic significance. Ann Intern Med. 1981;95:568–74.PubMedCrossRef Marton KI, Sox HC Jr, Krupp JR. Involuntary weight loss: diagnostic and prognostic significance. Ann Intern Med. 1981;95:568–74.PubMedCrossRef
8.
go back to reference Rabinovitz M, Pitlik SD, Leifer M, et al. Unintentional weight loss: a retrospective analysis of 154 cases. Arch Intern Med. 1986;146:186–7.PubMedCrossRef Rabinovitz M, Pitlik SD, Leifer M, et al. Unintentional weight loss: a retrospective analysis of 154 cases. Arch Intern Med. 1986;146:186–7.PubMedCrossRef
9.
go back to reference Fischer J, Johnson MA. Low body weight and weight loss in the aged. J Am Diet Assoc. 1990;90:1697–706.PubMed Fischer J, Johnson MA. Low body weight and weight loss in the aged. J Am Diet Assoc. 1990;90:1697–706.PubMed
10.
go back to reference Wannamathee SG, Shaper AG. Weight change, perceived health status and mortality in middle-aged British men. Postgrad Med J. 1990;66:910–3.CrossRef Wannamathee SG, Shaper AG. Weight change, perceived health status and mortality in middle-aged British men. Postgrad Med J. 1990;66:910–3.CrossRef
11.
go back to reference Thompson MP, Morris LK. Unexplained weight loss in the ambulatory elderly. J Am Geriatr Soc. 1991;39:497–500.PubMedCrossRef Thompson MP, Morris LK. Unexplained weight loss in the ambulatory elderly. J Am Geriatr Soc. 1991;39:497–500.PubMedCrossRef
13.
go back to reference Muris JWM, Starmans R, Fijten GH, et al. Nonacute abdominal complaints in general practice: diagnostic value of signs and symptoms. Br J Gen Pract. 1995;45:313–6.PubMedPubMedCentral Muris JWM, Starmans R, Fijten GH, et al. Nonacute abdominal complaints in general practice: diagnostic value of signs and symptoms. Br J Gen Pract. 1995;45:313–6.PubMedPubMedCentral
14.
go back to reference Wallace JI, Schwartz RS, LaCroix AZ, et al. Involuntary weight loss in older outpatients: incidence and clinical significance. J Am Geriatr Soc. 1995;432:329–37.CrossRef Wallace JI, Schwartz RS, LaCroix AZ, et al. Involuntary weight loss in older outpatients: incidence and clinical significance. J Am Geriatr Soc. 1995;432:329–37.CrossRef
15.
go back to reference Beck ER, Francis JL, Souhami RL. Tutorials in differential diagnosis. 3e druk. Edinburgh: Churchill Livingstone; 1992. Beck ER, Francis JL, Souhami RL. Tutorials in differential diagnosis. 3e druk. Edinburgh: Churchill Livingstone; 1992.
17.
go back to reference Landelijke Eerstelijns Samenwerkings Afspraak Ondervoeding. Huisarts Wet. 2010;53(7):S7–10. Landelijke Eerstelijns Samenwerkings Afspraak Ondervoeding. Huisarts Wet. 2010;53(7):S7–10.
18.
go back to reference Williamson DF. Descriptive epidemiology of body weight and weight change in U.S. adults. Ann Intern Med. 1993;119:646–9. Williamson DF. Descriptive epidemiology of body weight and weight change in U.S. adults. Ann Intern Med. 1993;119:646–9.
19.
20.
go back to reference Pamuk ER, Williamson DF, Serdula MK, et al. Weight loss and subsequent death in a cohort of U.S. adults. Ann Intern Med. 1993;119:744–8. Pamuk ER, Williamson DF, Serdula MK, et al. Weight loss and subsequent death in a cohort of U.S. adults. Ann Intern Med. 1993;119:744–8.
21.
go back to reference Yaari S, Goldbourt U. Voluntary and involuntary weight loss: associations with long term mortality in 9,228 middle-aged and elderly men. Am J Epidemiol. 1998;148:546–55.PubMedCrossRef Yaari S, Goldbourt U. Voluntary and involuntary weight loss: associations with long term mortality in 9,228 middle-aged and elderly men. Am J Epidemiol. 1998;148:546–55.PubMedCrossRef
23.
go back to reference Bauer DC, Browner W, Cauley JA, et al. Factors associated with appendicular bone mass in older women. Ann Intern Med. 1993;118:657–65.PubMedCrossRef Bauer DC, Browner W, Cauley JA, et al. Factors associated with appendicular bone mass in older women. Ann Intern Med. 1993;118:657–65.PubMedCrossRef
24.
go back to reference Langlois JA, Harris T, Looker AC, et al. Weight change between age 50 years and old age is associated with risk of hip fracture in white women aged 67 years and older. Arch Intern Med. 1997;156:989–94.CrossRef Langlois JA, Harris T, Looker AC, et al. Weight change between age 50 years and old age is associated with risk of hip fracture in white women aged 67 years and older. Arch Intern Med. 1997;156:989–94.CrossRef
25.
go back to reference Ensrud KE, Cauley J, Lipschutz R, et al. Weight change and fractures in older women. Study of Osteoporotic Fractures Research Group. Arch Intern Med. 1997;157:857–63. Ensrud KE, Cauley J, Lipschutz R, et al. Weight change and fractures in older women. Study of Osteoporotic Fractures Research Group. Arch Intern Med. 1997;157:857–63.
26.
go back to reference Launer LJ, Harris T, Rumpel C, et al. Body mass index, weight change, and risk of mobility disability in middle-aged and older women: the epidemiologic follow-up study of NHANES I. J Am Med Assoc. 1994;271:1093–8.CrossRef Launer LJ, Harris T, Rumpel C, et al. Body mass index, weight change, and risk of mobility disability in middle-aged and older women: the epidemiologic follow-up study of NHANES I. J Am Med Assoc. 1994;271:1093–8.CrossRef
27.
go back to reference Sullivan DH, Walls RC, Bopp MM. Protein-energy undernutrition and the risk of mortality within one year of hospital discharge: a follow-up study. J Am Geriatr Soc. 1995;43:509–12. Sullivan DH, Walls RC, Bopp MM. Protein-energy undernutrition and the risk of mortality within one year of hospital discharge: a follow-up study. J Am Geriatr Soc. 1995;43:509–12.
29.
go back to reference Evans AT, Gupta R. Approach to the patient with weight loss. www.uptodate.com. Laatste update mei 2019. Geraadpleegd 27 augustus 2020. Evans AT, Gupta R. Approach to the patient with weight loss. www.uptodate.com. Laatste update mei 2019. Geraadpleegd 27 augustus 2020.
30.
go back to reference Davis C, Fattore L, Kaplan AS, et al. The supression of appetite and food consumption by methylfhenidate: the moderating effects of gender and weight status in healthy adults. Int J Neuropsychopharmacol. 2012;15:181–7.PubMedCrossRef Davis C, Fattore L, Kaplan AS, et al. The supression of appetite and food consumption by methylfhenidate: the moderating effects of gender and weight status in healthy adults. Int J Neuropsychopharmacol. 2012;15:181–7.PubMedCrossRef
31.
go back to reference Sullivan DH, Martin W, Flaxman N, et al. Oral health problems and involuntary weight loss in a population of frail elderly. J Am Geriatr Soc. 1993;41:725–31.PubMedCrossRef Sullivan DH, Martin W, Flaxman N, et al. Oral health problems and involuntary weight loss in a population of frail elderly. J Am Geriatr Soc. 1993;41:725–31.PubMedCrossRef
32.
go back to reference American Psychiatric Association. Handboek voor de classificatie van psychische stoornissen (DSM-5). Amsterdam: Boom; 2013. American Psychiatric Association. Handboek voor de classificatie van psychische stoornissen (DSM-5). Amsterdam: Boom; 2013.
33.
go back to reference Hoek HW, Furth EF van. Anorexia nervosa en boulimia nervosa. I Diagnostiek en behandeling. Ned Tijdschr Geneeskd. 1998;142:1859–63. Hoek HW, Furth EF van. Anorexia nervosa en boulimia nervosa. I Diagnostiek en behandeling. Ned Tijdschr Geneeskd. 1998;142:1859–63.
35.
go back to reference Nielsen S, Moller-Madsen S, Isager T, et al. Standardized mortality in eating disorders – a quantitative summary of previously published and new evidence. J Psychosom Res. 1998;44:413–34.PubMedCrossRef Nielsen S, Moller-Madsen S, Isager T, et al. Standardized mortality in eating disorders – a quantitative summary of previously published and new evidence. J Psychosom Res. 1998;44:413–34.PubMedCrossRef
36.
go back to reference Rijn CA van. Anorexia nervosa en boulimia nervosa. II Somatische gevolgen van ondervoeding. Ned Tijdschr Geneeskd. 1998;142:1863–6. Rijn CA van. Anorexia nervosa en boulimia nervosa. II Somatische gevolgen van ondervoeding. Ned Tijdschr Geneeskd. 1998;142:1863–6.
37.
38.
go back to reference Hippisley-Cox J, Coupland C. Symptoms and risk factors to identify women with suspected cancer in primary care: derivation and validation of an algorithm. Br J Gen Pract. 2013;63(606):e11–21.PubMedCrossRef Hippisley-Cox J, Coupland C. Symptoms and risk factors to identify women with suspected cancer in primary care: derivation and validation of an algorithm. Br J Gen Pract. 2013;63(606):e11–21.PubMedCrossRef
39.
go back to reference Hippisley-Cox J, Coupland C. Symptoms and risk factors to identify men with suspected cancer in primary care: derivation and validation of an algorithm. Br J Gen Pract. 2013;63(606):e1–10.PubMedCrossRef Hippisley-Cox J, Coupland C. Symptoms and risk factors to identify men with suspected cancer in primary care: derivation and validation of an algorithm. Br J Gen Pract. 2013;63(606):e1–10.PubMedCrossRef
40.
go back to reference Leduc D, Rouge PE, Rousset H, et al. Clinical study of 105 cases of isolated weight loss in internal medicine. Rev Med Interne. 1988;9:480–6.PubMedCrossRef Leduc D, Rouge PE, Rousset H, et al. Clinical study of 105 cases of isolated weight loss in internal medicine. Rev Med Interne. 1988;9:480–6.PubMedCrossRef
41.
go back to reference Huerta G, Viniegra L. Involuntary weight loss as a clinical problem. Rev Invest Clin. 1989;41:5–9.PubMed Huerta G, Viniegra L. Involuntary weight loss as a clinical problem. Rev Invest Clin. 1989;41:5–9.PubMed
42.
go back to reference Lankisch P, Gerzmann M, Gerzmann JF, et al. Unintentional weight loss: diagnosis and prognosis. The first prospective follow-up study from a secondary referral centre. J Intern Med. 2001;249:41–6. Lankisch P, Gerzmann M, Gerzmann JF, et al. Unintentional weight loss: diagnosis and prognosis. The first prospective follow-up study from a secondary referral centre. J Intern Med. 2001;249:41–6.
43.
go back to reference Bosch X, Monclús E, Escoda O, et al. Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients. PLoS One. 2017;12:PubMedPubMedCentralCrossRef Bosch X, Monclús E, Escoda O, et al. Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients. PLoS One. 2017;12:PubMedPubMedCentralCrossRef
44.
go back to reference Morley JE, Kraenzle D. Causes of weight loss in a community nursing home. J Am Geriatr Soc. 1994;42:583–5.PubMedCrossRef Morley JE, Kraenzle D. Causes of weight loss in a community nursing home. J Am Geriatr Soc. 1994;42:583–5.PubMedCrossRef
45.
46.
go back to reference Wallace JI, Schwartz RS. Involuntary weight loss in elderly outpatients. Clin Geriatr. 1997;13:717–35.CrossRef Wallace JI, Schwartz RS. Involuntary weight loss in elderly outpatients. Clin Geriatr. 1997;13:717–35.CrossRef
47.
go back to reference Gazewood JD, Mehr DR. Diagnosis and management of weight loss in the elderly. J Fam Pract. 1998;47:19–25.PubMed Gazewood JD, Mehr DR. Diagnosis and management of weight loss in the elderly. J Fam Pract. 1998;47:19–25.PubMed
48.
go back to reference Moriguti JC, Moriguti EK, Ferriolli E, et al. Involuntary weight loss in elderly individuals: assessment and treatment. Sao Paulo Med J. 2001;119:72–7.PubMedCrossRef Moriguti JC, Moriguti EK, Ferriolli E, et al. Involuntary weight loss in elderly individuals: assessment and treatment. Sao Paulo Med J. 2001;119:72–7.PubMedCrossRef
49.
go back to reference Holdcroft C. Evaluating involuntary weight loss in older adults. Nurse Pract. 1988;13(9–11):14–5. Holdcroft C. Evaluating involuntary weight loss in older adults. Nurse Pract. 1988;13(9–11):14–5.
50.
go back to reference Robbins LJ. Evaluation of weight loss in the elderly. Geriatrics. 1989;44(31):4, 37. Robbins LJ. Evaluation of weight loss in the elderly. Geriatrics. 1989;44(31):4, 37.
51.
go back to reference Gaddey HL, Holder K. Unintentional Weight Loss in Older Adults. Am Fam Physician. 2014;89:718–22.PubMed Gaddey HL, Holder K. Unintentional Weight Loss in Older Adults. Am Fam Physician. 2014;89:718–22.PubMed
52.
go back to reference Schwenk A. Was ist zu tun bei unklarem Gewichtsverlust? Med Klin. 1998;93:719–25.CrossRef Schwenk A. Was ist zu tun bei unklarem Gewichtsverlust? Med Klin. 1998;93:719–25.CrossRef
53.
go back to reference Wise GR, Craig D. Evaluation of involuntary weight loss. Where do you start? Postgrad Med. 1994;95:143–50. Wise GR, Craig D. Evaluation of involuntary weight loss. Where do you start? Postgrad Med. 1994;95:143–50.
54.
go back to reference Hernandez JL, Riancho JA, Matorras P, et al. Clinical evaluation for cancer in patients with involuntary weight loss without specific symptoms. Am J Med. 2003;114:631–7.PubMedCrossRef Hernandez JL, Riancho JA, Matorras P, et al. Clinical evaluation for cancer in patients with involuntary weight loss without specific symptoms. Am J Med. 2003;114:631–7.PubMedCrossRef
56.
go back to reference Kaandorp CJE, redacteur. Klinische probleemstellingen. 2e druk Houten: Prelum uitgevers; 2012 (is opvolger van Diagnostisch kompas 2003). Kaandorp CJE, redacteur. Klinische probleemstellingen. 2e druk Houten: Prelum uitgevers; 2012 (is opvolger van Diagnostisch kompas 2003).
57.
go back to reference Hayabuchi N, Russell WJ, Murakami J, et al. Screening for lung cancer in a fixed population by biennial chest radiography. Radiology. 1983;148:369–73.PubMedCrossRef Hayabuchi N, Russell WJ, Murakami J, et al. Screening for lung cancer in a fixed population by biennial chest radiography. Radiology. 1983;148:369–73.PubMedCrossRef
58.
go back to reference Muhm JR, Miller WE, Fontana RS, et al. Lung cancer detected during a screening program using four-month chest radiographs. Radiology. 1983;148:609–15.PubMedCrossRef Muhm JR, Miller WE, Fontana RS, et al. Lung cancer detected during a screening program using four-month chest radiographs. Radiology. 1983;148:609–15.PubMedCrossRef
Metagegevens
Titel
Gewichtsverlies
Auteurs
Prof. dr. H. de Vries
Drs. J. F. Bastiaans
Prof. dr. F. J. van Ittersum
Copyright
2021
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/978-90-368-2620-4_8