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Table of Contents
Definition
Causes
Diagnosis
Treatment
Unexplained or unintentional weight loss may seem a welcome change for some people, but looking into the potential causes is important. Unintentional weight loss may be a sign of a medical condition, such as thyroid problems, lupus, diabetes, orcancer.
With medical evaluation, anunderlying conditionis found in at least 72% of people who lose weight unexpectedly.That’s why unexplained weight loss should always be a reason to talk to your healthcare provider.
This article looks at weight loss you don’t expect to see, some reasons why people experience it, and how your healthcare provider will determine and treat the cause.
Verywell / Ellen Lindner
Unintentional Weight Loss: Definition
Unexplained weight loss isdefined as the unintentional loss of at least 5% of body weight over a period of six to 12 months.This would mean a 10-pound loss in a 200-pound man, or losing between 6 and 7 pounds for a 130-pound woman.
Unintentional weight loss occurs without any attempt to lose weight, such as cutting the calories you eat or starting to exercise.
Unexplained weight loss can happen to anyone, but it is most common in people over the age of 65. In older adults, the annual incidence of unintentional weight loss is around 13%.
Unintentional weight loss is important because it indicates there is a need to look for an underlying cause. It also has significance to overall health. Unexplained and unintentional weight loss can complicate treatment and recovery in other conditions, includingcoronary artery disease.
It is important to see your healthcare provider if you are losing 5% to 10% of your weight without trying, even if you think there is an explanation for your weight loss. And don’t be afraid to ask for a second opinion if needed.
What Can Cause Unexplained Weight Loss?
There are many reasons for unexplained weight loss, some of which are serious. For adults not living in a nursing home or other care setting, the main causes of unexplained weight loss are cancer, digestive tract disorders such asinflammatory bowel disease, and mental health-related causes like depression.
In a study of 2,677 people with unexplained weight loss whose average age was 64, cancer was most often responsible.A similar study of people 65 and older homed in on nonmalignant causes, including diminished sense of taste andappetitedue to medication.Still, other research has found up to a quarter of cases of unintentional weight loss can’t be explained.
How often is unexplained weight loss due to cancer?Around 40% of people with cancer said they had experienced weight loss at the time of diagnosis. A 2018 study found this weight loss was the second-strongest predictor of some types of cancer.
How often is unexplained weight loss due to cancer?
Around 40% of people with cancer said they had experienced weight loss at the time of diagnosis. A 2018 study found this weight loss was the second-strongest predictor of some types of cancer.
Cancer
Weight loss may be the first sign of blood-related cancers such asleukemiasandlymphomas, or solid tumors such as lung cancer (especiallyadenocarcinomaof the lung), colon cancer, ovarian cancer, and pancreatic cancer. Weight loss can also occur when an early-stage tumor (such as breast cancer) comes back.
Gastrointestinal Conditions
Problems with your gastrointestinal (GI) system can cause weight loss, including conditions such as:
Celiac disease is an example of a GI disease that can lead to weight loss. This autoimmune condition causes your body to attack the cells in your small intestine in the presence of gluten, a protein found in wheat and other grains. This can interfere with your body’s ability to absorb nutrients.
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Diabetes
People with diabetes usually fall into two categories: Type 1, which is an autoimmune disease, and Type 2, which often develops later in life when the body can’t make or process insulin properly. (A third type, called gestational diabetes, is temporary and occurs only during pregnancy.)
Unexplained weight losscan occur with both types but is more common in Type 1 diabetes.
Hyperthyroidism
There are several conditions that causehyperthyroidism, a condition in which the thyroid gland in the neck is overactive. They includeautoimmune disorderssuch as Graves' disease, the most common cause of hyperthyroidism in the United States.Iodine exposure, medication error, and even pregnancy also may cause an overactive thyroid.
Hyperthyroidism speeds up your metabolism, which can lead to weight loss.
Muscle Loss
Weight loss may be linked to the loss of comparatively heavy muscle tissue, sometimes calledmuscle atrophyor muscle wasting. That’s especially true in cancer and in people diagnosed withHIV/AIDSand is known ascachexiain these groups. This muscle loss can prove fatal and is the underlying cause of roughly 25% of cancer deaths.
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Depression
Depression can cause changes in eating habits that can lead to weight loss or weight gain. Depression affects many people from all walks of life, and roughly one in every six people will experience depression at some point in their lives.
Addison’s Disease
Addison’s disease is anendocrine disorderthat is related to problems with the adrenal glands found atop each kidney. These glands produce key hormones, or chemical messengers, like cortisol. The lack of these hormones in Addison’s disease may be the cause of weight loss, fatigue, and other symptoms.
Rheumatoid Arthritis
Rheumatoid arthritis(RA) is best known for causing joint pain and damage, but it also can bring on muscle wasting and weight loss known as rheumatoid cachexia.RA may be related to inflammation of the digestive system andgastrointestinal disease, which may contribute to unintentional and unexplained weight loss.
Lupus
Lupus is an autoimmune condition that causes your body’s immune system to mistakenly attack healthy cells. Lupus can cause problems with your digestive system and interfere with your body’s ability to absorb nutrients.
Loss of appetite is also a common symptom of lupus. Between 17% and 15% of people with this condition experience unintentional weight loss. Most of the time, the weight loss will be noticed before diagnosis.
Stress
Stressful life events such as divorce, the death of a family member, or financial difficulties can cause you to have a poor appetite, skip meals, or eat less than usual overall. This can lead to unintentional weight loss.If you find that stress is interfering with your quality of life, reach out to family or friends for support or speak to a mental healthcare provider.
Infections
Infections with viruses, bacteria, and parasites are not uncommon causes and include infections such as:
Chronic Diarrhea
Alcohol and Substance Use Disorder
The use of street drugs such as methamphetamine, prescription medications like Adderall, and over-the-counter drugs like laxatives can cause weight loss.
People with alcohol use disorder may have weight loss associated with reduced appetite, nausea, vomiting, or mental health and lifestyle factors.
People who have had alcohol use disorder for a long time may also experience malnutrition as a consequence of advanced liver disease. Chronic liver disease is associated with a number of nutritional problems such as nutrient malabsorption and decreased appetite.
Chronic Obstructive Pulmonary Disease (COPD)
People with COPD often have protein imbalances and other nutritional imbalances along with changes in the way the body turns nutrients into energy. This can cause unintentional weight loss and malnutrition.
Chronic obstructive pulmonary diseaseincludes conditions such as emphysema,bronchiectasis, and chronic bronchitis.
Kidney Failure
Poor appetite and nausea may contribute to weight loss, but so does a change in fluid retention in a person whose kidneys aren’t working properly.
Neurological conditions
Early weight loss is a common symptom of neurodegenerative disorders such asParkinson’s disease,Alzheimer’s disease, and Huntington’s disease. Some researchers believe that weight loss in these conditions may be related to changes in protein metabolism in the brain that lead to increased energy requirements.
Medication
Nearly any medication may have weight loss as a consideration or side effect. Medications may cause weight loss directly, or cause nausea and loss of appetite leading to weight loss. Some of the most common include:
Some of the underlying causes that contribute to unintentional weight loss are serious conditions in their own right. Seeing a healthcare provider and having the necessary tests will help determine the best course of action and hopefully better outcomes. Weight loss itself is linked with higher mortality (death rate) and a lower quality of life for people who have these illnesses.
Less Common Causes
Sex Differences in Weight Loss CausesBoth men and women may have unintended or unexplained weight loss. Some autoimmune disorders, like RA and Graves' disease, occur more often in women. Depression also occurs more frequently in women.Men face risks due to cancer cachexia, digestive problems, and infections like endocarditis.
Sex Differences in Weight Loss Causes
Both men and women may have unintended or unexplained weight loss. Some autoimmune disorders, like RA and Graves' disease, occur more often in women. Depression also occurs more frequently in women.Men face risks due to cancer cachexia, digestive problems, and infections like endocarditis.
If you have unintentional weight loss, be ready to give your healthcare team a complete and careful medical history. Along with the physical exam, your healthcare provider will use this information to determine your risk factors and narrow the possibilities for underlying medical conditions.
Questions Your Healthcare Provider May Ask
Be prepared to answer questions including:
Tests and Labs
Many conditions that lead to unintentional weight loss are difficult to diagnose in the early stages, and sometimes a number of blood tests or imaging studies (such as X-rays) are needed to find the cause.
Theblood teststhat your healthcare provider orders will depend on many factors, including any symptoms. Tests that are commonly done include:
Procedures
Endoscopy procedures such as an upper GIendoscopyor colonoscopy can look for evidence of gastrointestinal causes of weight loss.
Anechocardiogramis an ultrasound of the heart, and it is helpful in diagnosing many conditions, including infections present on the heart valves (infectious endocarditis).
Imaging Studies
Imaging tests that may be helpful include:
The treatment of unintentional weight loss will depend upon the underlying cause or causes, and it’s highly likely there is one. Some of the causes of unintentional weight loss are fairly uncommon, and it may require several visits to determine a cause.
When the exam, blood tests, and other procedures lead to a specific cause, it’s easy to focus on that treatment while the weight loss itself is set aside. Make sure to talk to your healthcare provider about how you should treat the weight loss.
For those who are diagnosed with cancer, apalliative careconsultation should be considered. Palliative care teams do an excellent job of addressing concerns not directly related to cancer (for example, chemotherapy or radiation therapy) such as unintentional weight loss.
Summary
Unexplained weight loss may not seem a cause for concern, and it’s easy to ignore. But this kind of weight loss likely is a clue to an illness that needs to be diagnosed and treated. Your healthcare provider can help find the cause, and treat both the underlying condition and the weight loss.
19 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gaddey HL, Holder KK.Unintentional Weight Loss in Older Adults.Am Fam Physician. 2021 Jul 1;104(1):34-40. PMID: 34264616.Freha NA.Unintentional weight loss. In: Lobera IJ, ed.Weight Loss. IntechOpen; 2018.Perera LAM, Chopra A, Shaw AL.Approach to patients with unintentional weight loss.Med Clin North Am. 2021;105(1):175-186. doi:10.1016/j.mcna.2020.08.019Bosch X, Monclús E, Escoda O, et al.Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients.PLoS One. 2017;12(4):e0175125. doi:10.1371/journal.pone.0175125Gaddey HL, Holder KK.Unintentional weight loss in older adults.Am Fam Physician. 2021;104(1):34-40.Nicholson B, Hamilton W, O’Sullivan J, Aveyard P, Hobbs F.Weight loss as a predictor of cancer in primary care: A systematic review and meta-analysis.Br J Gen Pract. 2018;68(670):e311-e322. doi:10.3399/bjgp18X695801Freeman HJ.Endocrine manifestations in celiac disease.World J Gastroenterol.2016;22(38):8472-8479. doi:10.3748/wjg.v22.i38.8472American Thyroid Association.Graves' disease.Siddiqui JA, Pothuraju R, Jain M, Batra SK, Nasser MW.Advances in cancer cachexia: Intersection between affected organs, mediators, and pharmacological interventions.Biochimica et Biophysica Acta (BBA) - Reviews on Cancer. 2020;1873(2):188359. doi: 10.1016/j.bbcan.2020.188359American Psychiatric Association.What Is Depression?National Institute of Diabetes and Digestive and Kidney Diseases.Adrenal insufficiency & Addison’s disease.Lemmey AB.Rheumatoid cachexia: the undiagnosed, untreated key to restoring physical function in rheumatoid arthritis patients?Rheumatology. 2016;55(7):1149-1150. doi: 10.1093/rheumatology/kev412Stojan G, Li J, Wittmaack A, Petri M.Cachexia in systemic lupus erythematosus: Risk factors and relation to disease activity and damage.Arthritis Care Res (Hoboken). 2021;73(11):1577-1582. doi:10.1002/acr.24395National Library of Medicine.Weight loss - unintentional.Burgers K, Lindberg B, Bevis ZJ.Chronic diarrhea in adults: Evaluation and differential diagnosis.Am Fam Physician. 2020;101(8):472-480.Boulhosa RSSB, Lourenço RP, Côrtes DM, Oliveira LPM, Lyra AC, de Jesus RP.Comparison between criteria for diagnosing malnutrition in patients with advanced chronic liver disease: GLIM group proposal versus different nutritional screening tools.J Hum Nutr Diet. 2020;33(6):862-868. doi:10.1111/jhn.12759Collins PF, Yang IA, Chang YC, Vaughan A.Nutritional support in chronic obstructive pulmonary disease (COPD): an evidence update.J Thorac Dis. 2019;11(Suppl 17):S2230-S2237. doi:10.21037/jtd.2019.10.41Marinelli L.Early weight loss in neurodegenerative disorders could be related to increased protein metabolism in the brain. Neurology.Domecq JP, Prutsky G, Leppin A, et al.Clinical review: Drugs commonly associated with weight change: A systematic review and meta-analysis.J Clin Endocrinol Metab. 2015;100(2):363-70. doi:10.1210/jc.2014-3421Additional ReadingBosch X, Monclús E, Escoda O, et al.Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients. Wu W-CH, ed.PLoS ONE. 2017;12(4):e0175125. doi: 10.1371/journal.pone.0175125
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gaddey HL, Holder KK.Unintentional Weight Loss in Older Adults.Am Fam Physician. 2021 Jul 1;104(1):34-40. PMID: 34264616.Freha NA.Unintentional weight loss. In: Lobera IJ, ed.Weight Loss. IntechOpen; 2018.Perera LAM, Chopra A, Shaw AL.Approach to patients with unintentional weight loss.Med Clin North Am. 2021;105(1):175-186. doi:10.1016/j.mcna.2020.08.019Bosch X, Monclús E, Escoda O, et al.Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients.PLoS One. 2017;12(4):e0175125. doi:10.1371/journal.pone.0175125Gaddey HL, Holder KK.Unintentional weight loss in older adults.Am Fam Physician. 2021;104(1):34-40.Nicholson B, Hamilton W, O’Sullivan J, Aveyard P, Hobbs F.Weight loss as a predictor of cancer in primary care: A systematic review and meta-analysis.Br J Gen Pract. 2018;68(670):e311-e322. doi:10.3399/bjgp18X695801Freeman HJ.Endocrine manifestations in celiac disease.World J Gastroenterol.2016;22(38):8472-8479. doi:10.3748/wjg.v22.i38.8472American Thyroid Association.Graves' disease.Siddiqui JA, Pothuraju R, Jain M, Batra SK, Nasser MW.Advances in cancer cachexia: Intersection between affected organs, mediators, and pharmacological interventions.Biochimica et Biophysica Acta (BBA) - Reviews on Cancer. 2020;1873(2):188359. doi: 10.1016/j.bbcan.2020.188359American Psychiatric Association.What Is Depression?National Institute of Diabetes and Digestive and Kidney Diseases.Adrenal insufficiency & Addison’s disease.Lemmey AB.Rheumatoid cachexia: the undiagnosed, untreated key to restoring physical function in rheumatoid arthritis patients?Rheumatology. 2016;55(7):1149-1150. doi: 10.1093/rheumatology/kev412Stojan G, Li J, Wittmaack A, Petri M.Cachexia in systemic lupus erythematosus: Risk factors and relation to disease activity and damage.Arthritis Care Res (Hoboken). 2021;73(11):1577-1582. doi:10.1002/acr.24395National Library of Medicine.Weight loss - unintentional.Burgers K, Lindberg B, Bevis ZJ.Chronic diarrhea in adults: Evaluation and differential diagnosis.Am Fam Physician. 2020;101(8):472-480.Boulhosa RSSB, Lourenço RP, Côrtes DM, Oliveira LPM, Lyra AC, de Jesus RP.Comparison between criteria for diagnosing malnutrition in patients with advanced chronic liver disease: GLIM group proposal versus different nutritional screening tools.J Hum Nutr Diet. 2020;33(6):862-868. doi:10.1111/jhn.12759Collins PF, Yang IA, Chang YC, Vaughan A.Nutritional support in chronic obstructive pulmonary disease (COPD): an evidence update.J Thorac Dis. 2019;11(Suppl 17):S2230-S2237. doi:10.21037/jtd.2019.10.41Marinelli L.Early weight loss in neurodegenerative disorders could be related to increased protein metabolism in the brain. Neurology.Domecq JP, Prutsky G, Leppin A, et al.Clinical review: Drugs commonly associated with weight change: A systematic review and meta-analysis.J Clin Endocrinol Metab. 2015;100(2):363-70. doi:10.1210/jc.2014-3421Additional ReadingBosch X, Monclús E, Escoda O, et al.Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients. Wu W-CH, ed.PLoS ONE. 2017;12(4):e0175125. doi: 10.1371/journal.pone.0175125
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Gaddey HL, Holder KK.Unintentional Weight Loss in Older Adults.Am Fam Physician. 2021 Jul 1;104(1):34-40. PMID: 34264616.Freha NA.Unintentional weight loss. In: Lobera IJ, ed.Weight Loss. IntechOpen; 2018.Perera LAM, Chopra A, Shaw AL.Approach to patients with unintentional weight loss.Med Clin North Am. 2021;105(1):175-186. doi:10.1016/j.mcna.2020.08.019Bosch X, Monclús E, Escoda O, et al.Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients.PLoS One. 2017;12(4):e0175125. doi:10.1371/journal.pone.0175125Gaddey HL, Holder KK.Unintentional weight loss in older adults.Am Fam Physician. 2021;104(1):34-40.Nicholson B, Hamilton W, O’Sullivan J, Aveyard P, Hobbs F.Weight loss as a predictor of cancer in primary care: A systematic review and meta-analysis.Br J Gen Pract. 2018;68(670):e311-e322. doi:10.3399/bjgp18X695801Freeman HJ.Endocrine manifestations in celiac disease.World J Gastroenterol.2016;22(38):8472-8479. doi:10.3748/wjg.v22.i38.8472American Thyroid Association.Graves' disease.Siddiqui JA, Pothuraju R, Jain M, Batra SK, Nasser MW.Advances in cancer cachexia: Intersection between affected organs, mediators, and pharmacological interventions.Biochimica et Biophysica Acta (BBA) - Reviews on Cancer. 2020;1873(2):188359. doi: 10.1016/j.bbcan.2020.188359American Psychiatric Association.What Is Depression?National Institute of Diabetes and Digestive and Kidney Diseases.Adrenal insufficiency & Addison’s disease.Lemmey AB.Rheumatoid cachexia: the undiagnosed, untreated key to restoring physical function in rheumatoid arthritis patients?Rheumatology. 2016;55(7):1149-1150. doi: 10.1093/rheumatology/kev412Stojan G, Li J, Wittmaack A, Petri M.Cachexia in systemic lupus erythematosus: Risk factors and relation to disease activity and damage.Arthritis Care Res (Hoboken). 2021;73(11):1577-1582. doi:10.1002/acr.24395National Library of Medicine.Weight loss - unintentional.Burgers K, Lindberg B, Bevis ZJ.Chronic diarrhea in adults: Evaluation and differential diagnosis.Am Fam Physician. 2020;101(8):472-480.Boulhosa RSSB, Lourenço RP, Côrtes DM, Oliveira LPM, Lyra AC, de Jesus RP.Comparison between criteria for diagnosing malnutrition in patients with advanced chronic liver disease: GLIM group proposal versus different nutritional screening tools.J Hum Nutr Diet. 2020;33(6):862-868. doi:10.1111/jhn.12759Collins PF, Yang IA, Chang YC, Vaughan A.Nutritional support in chronic obstructive pulmonary disease (COPD): an evidence update.J Thorac Dis. 2019;11(Suppl 17):S2230-S2237. doi:10.21037/jtd.2019.10.41Marinelli L.Early weight loss in neurodegenerative disorders could be related to increased protein metabolism in the brain. Neurology.Domecq JP, Prutsky G, Leppin A, et al.Clinical review: Drugs commonly associated with weight change: A systematic review and meta-analysis.J Clin Endocrinol Metab. 2015;100(2):363-70. doi:10.1210/jc.2014-3421
Gaddey HL, Holder KK.Unintentional Weight Loss in Older Adults.Am Fam Physician. 2021 Jul 1;104(1):34-40. PMID: 34264616.
Freha NA.Unintentional weight loss. In: Lobera IJ, ed.Weight Loss. IntechOpen; 2018.
Perera LAM, Chopra A, Shaw AL.Approach to patients with unintentional weight loss.Med Clin North Am. 2021;105(1):175-186. doi:10.1016/j.mcna.2020.08.019
Bosch X, Monclús E, Escoda O, et al.Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients.PLoS One. 2017;12(4):e0175125. doi:10.1371/journal.pone.0175125
Gaddey HL, Holder KK.Unintentional weight loss in older adults.Am Fam Physician. 2021;104(1):34-40.
Nicholson B, Hamilton W, O’Sullivan J, Aveyard P, Hobbs F.Weight loss as a predictor of cancer in primary care: A systematic review and meta-analysis.Br J Gen Pract. 2018;68(670):e311-e322. doi:10.3399/bjgp18X695801
Freeman HJ.Endocrine manifestations in celiac disease.World J Gastroenterol.2016;22(38):8472-8479. doi:10.3748/wjg.v22.i38.8472
American Thyroid Association.Graves' disease.
Siddiqui JA, Pothuraju R, Jain M, Batra SK, Nasser MW.Advances in cancer cachexia: Intersection between affected organs, mediators, and pharmacological interventions.Biochimica et Biophysica Acta (BBA) - Reviews on Cancer. 2020;1873(2):188359. doi: 10.1016/j.bbcan.2020.188359
American Psychiatric Association.What Is Depression?
National Institute of Diabetes and Digestive and Kidney Diseases.Adrenal insufficiency & Addison’s disease.
Lemmey AB.Rheumatoid cachexia: the undiagnosed, untreated key to restoring physical function in rheumatoid arthritis patients?Rheumatology. 2016;55(7):1149-1150. doi: 10.1093/rheumatology/kev412
Stojan G, Li J, Wittmaack A, Petri M.Cachexia in systemic lupus erythematosus: Risk factors and relation to disease activity and damage.Arthritis Care Res (Hoboken). 2021;73(11):1577-1582. doi:10.1002/acr.24395
National Library of Medicine.Weight loss - unintentional.
Burgers K, Lindberg B, Bevis ZJ.Chronic diarrhea in adults: Evaluation and differential diagnosis.Am Fam Physician. 2020;101(8):472-480.
Boulhosa RSSB, Lourenço RP, Côrtes DM, Oliveira LPM, Lyra AC, de Jesus RP.Comparison between criteria for diagnosing malnutrition in patients with advanced chronic liver disease: GLIM group proposal versus different nutritional screening tools.J Hum Nutr Diet. 2020;33(6):862-868. doi:10.1111/jhn.12759
Collins PF, Yang IA, Chang YC, Vaughan A.Nutritional support in chronic obstructive pulmonary disease (COPD): an evidence update.J Thorac Dis. 2019;11(Suppl 17):S2230-S2237. doi:10.21037/jtd.2019.10.41
Marinelli L.Early weight loss in neurodegenerative disorders could be related to increased protein metabolism in the brain. Neurology.
Domecq JP, Prutsky G, Leppin A, et al.Clinical review: Drugs commonly associated with weight change: A systematic review and meta-analysis.J Clin Endocrinol Metab. 2015;100(2):363-70. doi:10.1210/jc.2014-3421
Bosch X, Monclús E, Escoda O, et al.Unintentional weight loss: Clinical characteristics and outcomes in a prospective cohort of 2677 patients. Wu W-CH, ed.PLoS ONE. 2017;12(4):e0175125. doi: 10.1371/journal.pone.0175125
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