[When the intestine swallows the pounds].

The case of an 88-year-old male patient with progressive, unintentional weight loss is reported. The condition was subjectively asymptomatic and subsequently completely reversible. Following a comprehensive internal medicine examination, chronic mesenteric ischemia due to arteriosclerosis was identified as the cause and treated interventionally. Over time, the patient experienced significant weight gain, a comparatively rare phenomenon in very old geriatric patients. Broad and targeted investigation of the cause and interventional therapies are safe and feasible even in old age.