What are the differential diagnoses for poor weight gain in an adolescent?

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Last updated: February 18, 2025 • View editorial policy

Differential Diagnosis for Poor Weight Gain in Adolescent

Single Most Likely Diagnosis

  • Psychological or behavioral issues: Eating disorders such as anorexia nervosa, bulimia nervosa, or other mental health conditions like depression or anxiety can lead to poor appetite and weight gain. This is a common issue in adolescents due to body image concerns, peer pressure, and emotional struggles.

Other Likely Diagnoses

  • Gastrointestinal issues: Conditions like inflammatory bowel disease (Crohn's disease or ulcerative colitis), celiac disease, or gastroesophageal reflux disease (GERD) can cause malabsorption, leading to poor weight gain.
  • Hormonal imbalances: Thyroid disorders (hypothyroidism or hyperthyroidism), growth hormone deficiency, or other endocrine issues can affect appetite, metabolism, and weight gain.
  • Chronic illnesses: Conditions like diabetes, cystic fibrosis, or chronic infections (e.g., tuberculosis) can lead to poor weight gain due to increased energy expenditure, malabsorption, or decreased appetite.
  • Nutritional deficiencies: Inadequate caloric intake, poor diet, or deficiencies in essential nutrients like vitamin D, iron, or zinc can hinder weight gain.

Do Not Miss Diagnoses

  • Cancer: Although rare, certain types of cancer (e.g., leukemia, lymphoma, or brain tumors) can cause weight loss and poor weight gain in adolescents.
  • Infectious diseases: Conditions like HIV/AIDS, tuberculosis, or parasitic infections (e.g., giardiasis) can lead to malabsorption, weight loss, and poor weight gain.
  • Genetic disorders: Certain genetic conditions, such as Turner syndrome or Prader-Willi syndrome, can affect growth and weight gain.

Rare Diagnoses

  • Mitochondrial disorders: Conditions like Kearns-Sayre syndrome or Pearson syndrome can affect energy production, leading to poor weight gain and other systemic symptoms.
  • Congenital heart disease: Certain heart defects can increase energy expenditure, leading to poor weight gain.
  • Neurological disorders: Conditions like muscular dystrophy or spinal muscular atrophy can affect appetite, swallowing, and weight gain.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.