Lupus is a chronic autoimmune disease where the immune system mistakenly attacks healthy tissues, causing widespread inflammation. While lupus presents with diverse symptoms, unintended weight loss can occur. Understanding the reasons behind this can help in managing the condition.
How Lupus Activity Can Lead to Weight Loss
Active lupus can cause unintended weight loss. Chronic inflammation, a hallmark of lupus, increases the body’s metabolic rate, burning more calories even at rest. This elevated energy expenditure reduces body mass over time.
The immune system’s activity can also lead to cachexia, or body wasting. This occurs when the body utilizes its own fat and muscle stores to combat ongoing disease activity, especially during severe flares. Inflammation can also disrupt appetite-regulating hormones, decreasing the desire to eat. A general feeling of being unwell, or malaise, common during flares, also contributes to reduced food intake.
Medications and Other Lupus Symptoms Affecting Weight
Certain lupus medications can cause weight loss by interfering with eating and nutrient absorption. Immunosuppressants and some pain relievers may lead to nausea, vomiting, or diarrhea. These gastrointestinal disturbances make it challenging to consume and retain adequate calories.
Beyond medication, many lupus symptoms indirectly impact weight. Severe fatigue can make meal preparation and eating feel overwhelming. Mouth sores, or oral ulcers, and difficulty swallowing (dysphagia) can make eating painful or challenging. Gastrointestinal issues like malabsorption, inflammation of the intestines (lupus enteritis), peptic ulcers, or irritable bowel syndrome can also reduce nutrient uptake or food intake. Mental health conditions such as depression and anxiety, which frequently occur alongside lupus, can significantly suppress appetite.
When to Consult a Healthcare Provider
Communicate any unintended or significant weight loss to a healthcare provider. Clinically important weight loss is defined as losing more than 5% of one’s body weight over 6 to 12 months without intentionally trying to do so. For example, a 160-pound person losing 8 pounds over this timeframe indicates significant weight loss.
Reporting accompanying symptoms, such as persistent nausea, vomiting, severe fatigue, or changes in appetite, is also important. Unexplained weight loss can signal increased disease activity, side effects from medications, or other underlying health issues that require medical evaluation. Ignoring such changes can delay necessary adjustments to a treatment plan or the diagnosis of a new condition.
Approaches to Managing Weight Changes
Managing weight changes in lupus often requires a collaborative effort with healthcare professionals. Consulting with a dietitian or nutritionist can be beneficial in developing an individualized nutritional plan that focuses on nutrient-dense foods and smaller, more frequent meals. This approach can help ensure adequate caloric intake even when appetite is reduced.
Addressing symptoms that interfere with eating, such as treating mouth sores or managing pain before meals, can improve a person’s ability to consume food comfortably. Since mental health influences appetite, addressing depression or anxiety through support or therapy is important for comprehensive management. Ongoing communication with the medical team allows for adjustments to treatment plans and nutritional strategies to support overall health and weight stability.