These days, we are surrounded by messages about the diseases associated with Obesity or being fat. Indeed, the campaign against obesity has been so successful that our conception of beauty has changed-- even in Africa. There was a time when a woman in Africa was not considered beautiful unless she had a big front, a big behind, ending in impressive hips and a round face with dimples! In those days, most of those dominating the fashion shows now would have been considered sick.

Unfortunately, many have come to think that if fat/obesity is bad, slimness is good. That is false.

Involuntary or unintended weight loss can be a sign of very serious disease. A weight loss of over 5% of bodyweight in 6 months to a year is considered significant. This will be manifested to the person as clothes getting loose. Sometimes, rings too get loose.

I remember while living in Abidjan, one of my acquaintances, a former model in France, was thin, very thin. When she was persuaded to see a doctor because of a persistent cough, she had tuberculosis. All her acquaintances had to be tested for the disease and quite a few tested positive.

Indeed, weight loss in tuberculosis is so common that in areas where the disease is common, weight loss and persistent cough is considered highly suggestive of TB. Another disease highly associated with weight loss is HIV. In the early days of the disease, weight loss was so common that it was called "Slim disease" in many places. Nearly one in ten HIV patients have weight loss. And when TB and HIV occur together, as they often do, the weight loss can be dramatic.

Depending on age and geography, there are many causes of weight loss. The most common causes are cancer, nearly a third, bowel-related illnesses in one-in-six patients and the same proportion in Depression and other MENTAL health illnesses.

Endocrine diseases like thyroid and diabetic illnesses can also cause weight loss. Nutritional problems are particularly common in children and adolescents.

Indeed, Kwashiokor, which describes one such childhood illness, is a Ghanaian (Ga) word.In about one-in-five cases, no cause can be found.

It is important to get to the doctor as soon as possible. Based on the history, tests and imaging studies can be done that, in most cases, can lead to successful diagnosis and treatment.

So, the lesson here is that weight loss can be a sign of serous illness.

See a doctor if you are losing weight involuntarily.

Encourage family members and friends to get help when they are losing weight.

Merry Xmas and a very rewarding 2018.

Arthur K