How should I assess the nutritional status of a patient who presents with unintentional weight loss?

Assessing the nutritional status of a patient with unintentional weight loss involves:

• Screening for malnutrition using tools such as the Malnutrition Universal Screening Tool (MUST), which includes measuring body mass index (BMI) and calculating the percentage of unintentional weight loss over time.
• Considering the duration and extent of reduced nutrient intake, including whether the patient has eaten little or nothing for more than 5 days or is likely to continue this pattern.
• Evaluating clinical signs of malnutrition such as fragile skin, poor wound healing, muscle wasting, poor appetite, altered taste sensation, and swallowing difficulties.
• Using specific criteria to identify malnutrition: a BMI less than 18.5 kg/m², unintentional weight loss greater than 10% within the last 3 to 6 months, or a BMI less than 20 kg/m² with unintentional weight loss greater than 5% within the last 3 to 6 months.
• Monitoring anthropometric parameters such as weight, BMI, mid-arm circumference, and triceps skinfold thickness regularly to assess ongoing nutritional status.
• Considering the need for further investigations or referrals if weight loss is unexplained or associated with other symptoms suggestive of serious underlying conditions, including cancer.

These steps ensure a comprehensive assessment of nutritional status and help guide appropriate nutrition support interventions if needed.

References: NICE CG32,NICE NG12