Why am I losing weight?

Ask the doctor

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Q. I'm an 87-year-old man. Over the past year I've lost considerable weight, and I didn't have that much to lose. My doctor can't find any reason for my weight loss and is advising me to eat ice cream. But isn't that risky for my heart?

A. I smiled when I read your letter, because I've occasionally said that if I were to develop a terminal condition, the silver lining on that cloud would be that I could finally eat all the hot fudge sundaes I wanted.

Assuming that you've lost a significant amount (like 10% of your original weight) over the course of six to 12 months, your doctor was right to test you for various diseases that can cause weight loss. When weight loss is caused by a disease (such as cancer or a chronic infection) it's usually because the disease has reduced the person's appetite. One exception is an overactive thyroid (hyperthyroidism): that condition increases both appetite and weight loss. Fortunately, your doctor has found no evidence of a serious disease in you. If your weight loss continues, your doctor probably will repeat some of the tests.

As for the ice cream, here's the way I'd think about it, if I were you. At 87, you've already outlived most men who were born the same year you were. On one hand, many decades of a diet that is high in saturated fats (ice cream contains such fats) does increase the risk for heart disease and stroke.

On the other, if you don't have heart disease or past strokes, and if you have maintained a healthy diet most of your life, your risk from ice cream is low. So, I recommend that you follow your doctor's advice: I would. Then again, I've already confessed to a weakness for ice cream.

— by Anthony L. Komaroff, M.D.
Editor in Chief, Harvard Health Letter