What is Cachexia: Causes, Symptoms, Treatment, Prevention

Cachexia is a condition in which there is extreme weight loss and muscle wasting and is a symptom of many chronic conditions including cancer, chronic renal failure, and multiple sclerosis. It affects people in the later stage of these illnesses.

According to the Society on Sarcopenia, Cachexia, and Wasting disease; cachexia is defined as a multifactorial syndrome characterized by an ongoing loss of skeletal muscles that cannot be fully reversed by nutritional support and that can further lead to progressive functional impairment.⁽¹⁾

Cachexia leads to weight loss that is involuntary, muscle wasting, and a decrease in body fat. It is estimated that around 160,000 people in the United States are hospitalized for cachexia.⁽²⁾

The cause of cachexia depends on the physiology of a person and the underlying illness.

There are a few factors that can lead to cachexia, these include:

• Increased metabolic rate
• Reduce in the intake or availability of nutrients
• Prevention of muscle growth
• Increase in muscle breakdown

There are various chronic conditions that lead to cachexia when they reach their end-stage. These include:

• Cancer
• Congestive heart disease
• Congestive renal failure
• Chronic obstructive pulmonary disease
• Crohn’s disease
• Cystic fibrosis
• Rheumatoid arthritis
• HIV

The symptoms of cachexia are as follows:

1. Involuntary Weight Loss: In this condition, a person loses weight despite consuming adequate nutrients and a good amount of calories.
2. Loss of Appetite: The person with cachexia may not feel like eating food at all.
3. Muscle Wasting: There may be muscle wasting, but not all people with cachexia appear malnourished. Those overweight despite losing a good amount of weight may not appear weak.
4. Reduction in Functional Ability: The person may experience malaise, fatigue, and low energy levels. This may lead to discomfort, extreme tiredness, and lack of motivation.
5. Edema: Due to a decrease in protein level the fluid may move into the tissues and lead to swelling or edema.

Fat and muscle wasting can be serious and increase morbidity. Cachexia is the main factor in around 1/5th of death due to cancer.⁽³⁾

Cachexia may complicate and lead to:

• Low quality of life and loss of ability to live
• Reduced immunity
• Impaired response to treatments
• Reduced life expectancy

Treatment of cachexia depends on the underlying condition responsible for its occurrence. A proper medical plan is needed to treat the disease, it cannot just be improved by increasing calorie consumption as it is a complex nature disease.

It is observed that medical professionals pay greater attention to behavioral and psychological factors while assessing and treating cachexia.⁽⁴⁾ A few steps taken with a person with cachexia include:

• Focusing on social aspects of eating. People have pleasure in sitting together and eating even if there are not in a good mood. Social eating is emphasized as it may reposition their emotional relation to eating.
• Eat small and frequent meals. This way they can tolerate what is being eaten. Also, taking nutritional supplemental drinks is important to increase calorie intake.
• Emotional support. It is important for the friends and the family to understand that as the disease has progressed to its end-stage the patient may not want or feel like eating. It is all right, not to force the person as muscle wasting would occur whether he eats or not.
• Use of appetite stimulants. There are a few medications that may stimulate appetite in certain conditions and diseases. These medications may increase appetite and this would help the person in socializing ad participating in family and social meetings.
• Encouraging exercise may be helpful in building muscle mass. However, it depends on whether or not a person is able to exercise.

Cachexia is due to an underlying condition, therefore, focusing on keeping the underlying condition at bay is important.

Having an active lifestyle and eating a balanced diet is an important step in preventing any illness.

Cachexia is mostly an irreversible condition that occurs as the related chronic illnesses reach their end-stage. The best way to prevent cachexia is to reduce the chances of occurrence of such illnesses.