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What causes excessive weight loss?

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Posted on Thu, 22 May 2014
Question: My husband is 66 years old and consumes the following on a daily basis: 2 payday candy bars, 2 bowls of ice cream, 4-6 diet pepsi, 4-6 cookies (for breakfast), one bag of candy (M&Ms, jelly beans); usually some sort of cake; 1-2 sandwich (usually his lunch and/or dinner), and he smokes 1 pack of cigarettes per day, has a defibulator and a pacemaker, has had open heart surgery, goes to the doctor on a regular basis for heart checkup and bloodwork, and has lost 50 pounds in the past few years. What would be making him lose weight with this kind of diet? His doctors don't seem to be concerned.
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Answered by Dr. Binu Parameswaran Pillai (1 hour later)
Brief Answer:
Hello

Detailed Answer:
Hello,
Good day.
Noted your husband's history.
What is his height and weight?

Unfortunately he doesn't seems to be looking after himself well (after having an open heart surgery). I presume his heart's pumping function is low and that is the reason why he is on a defibrillator. None of his medicines which you mentioned increase appetite. In fact , Pramipexole suppress appetite. Why is he on pramipexole? Is he depressed? Depression does make people to eat more.

He is consuming large quantities of calories which is definitely not good for him.
He need to sit with a dietician and he also need a proper diet counseling ( may be multiple times). If he is depressed, we need to treat that as well properly.
This need a team approach.

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Binu Parameswaran Pillai (1 hour later)
He is 5'9" and weighs 150... down from about 225 two years ago. He is totally dependent on the defibulator to keep his heart beating. I do not know why he has the pramipexole. He is not depressed.
doctor
Answered by Dr. Binu Parameswaran Pillai (1 hour later)
Brief Answer:
Few suggestions

Detailed Answer:
Thank you.
150 pounds or 150 kilos ?
If he is 150 pounds, then his weight is okay for his height. But if he is 150 kilos, that is surely high.
You could use your Iphone or Android phone to download an application called carbs and cals and can calculate his total calories. Once you calculate the total calories, he may get convinced about his high calorie and fat intake. MAintan a food diary and write down each item what he eats or drinks over one week period. Retrospective checking of it in his presence may motivate him. He shoud be counselled about the bad effects of consuming high calorie diet.

You could try giving him salads with low fat dressing as snacks. Cucumber is really nice for salad which is low calorie and rich in fiber. Try to repace his jelly beans with a fruit . Avoid mayonnaise or use low fat version for sandwitches. Avoid egg yolks and use egg whites instead. Replace ice creams with low fat fruit yogurt. These will surely help him to lose weight.

I realize that all these changes are difficult. Please introduce these changes one by one.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1435 Questions

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What causes excessive weight loss?

Brief Answer: Hello Detailed Answer: Hello, Good day. Noted your husband's history. What is his height and weight? Unfortunately he doesn't seems to be looking after himself well (after having an open heart surgery). I presume his heart's pumping function is low and that is the reason why he is on a defibrillator. None of his medicines which you mentioned increase appetite. In fact , Pramipexole suppress appetite. Why is he on pramipexole? Is he depressed? Depression does make people to eat more. He is consuming large quantities of calories which is definitely not good for him. He need to sit with a dietician and he also need a proper diet counseling ( may be multiple times). If he is depressed, we need to treat that as well properly. This need a team approach. Regards Binu