Sugar-free sweets linked to extreme weight loss
High consumption of sugar-free products sweetened with sorbitol can lead to severe weight loss, as evidenced by two case reports in the British Medical Journal for January 12.
The cases are described by Dr. Juergen Bauditz and colleagues at Charite Universitatsmedizin in Berlin, Germany. The first case was a 21-year-old woman with an 8-month history of 4 to 12 watery bowel movements per day, resulting in weight loss of 11 kg. The second patient was a 46-year-old man who had lost 22 kg within the previous year, associated with 7 to 10 daily episodes of diarrhoea.
In both cases, laboratory tests of antibody titers, stool pancreatic elastase, and stool cultures were normal, and endoscopic, radiologic, and histologic examinations revealed nothing out of the ordinary. However, stool electrolyte measurements indicated a large osmotic gap.
Detailed analysis of the patients' eating habits determined that they consumed 20 g to 30 g of sorbitol daily in the form of chewing gum and other sweets. Once they started a sorbitol-free diet, the diarrhoea subsided and they gained back the weight they had lost.
"The investigation of unexplained weight loss," the authors conclude, "should include detailed dietary history with regard to foods containing sorbitol."