Cachexia is a form of undernutrition which consists of a consequent slimming and weakening of the body, associated with a situation of chronic inflammation.

Undernutrition is a state of nutritional imbalance in the body. The body is not receiving enough energy and / or protein to meet these needs. There is an imbalance between inputs and expenses which can have three distinct or combined origins:

• insufficient food intake;
• an increase in expenditure of the body or an increase in losses.

This results in a decrease in lean body mass and cell mass in the body, leading to significant weight loss and weakness.

There are different forms of undernutrition:

• marasmus: isolated weight loss;
• kwashiorkor: weight loss accompanied by edemas which mainly affects malnourished children;
• sarcopenia: loss of muscle mass which may be associated with loss of muscle function;
• fragility: association of vulnerability and poor adaptability of the body to low energy and protein reserves;
• cachexia: involuntary loss of muscle mass, with or without loss of fat mass, accompanied by chronic inflammation. It is a state of chronic undernutrition. Weight loss is usually caused by a disease such as cancer or heart failure.

Various causes

It can be caused by illness, insufficient and / or unbalanced nutrition or old age. Cachexia can be the consequence of a chronic pulmonary, renal, hepatic or cardiac pathology. On average, 40% of chronically ill suffer from undernutrition. It is linked to the possible occurrence of complications, hospitalizations and the increased risk of mortality.

In case of cancer

Cachexia can be a consequence of cancer. Indeed, the presence of a tumor or the treatment against it can have effects on the metabolism and on the energy balance of the body. Cancer cachexia most often associates variable weight loss, progressive destruction of muscles and possible loss of fat mass. This is because the disease and its treatment disrupt the body’s energy and / or hormonal metabolism. They can also increase the expenses of the body. As cancer and its treatments often have nausea, vomiting and taste and smell disorders as side effects, this also disrupts the patient’s nutritional intake. The severity of cachexia is not related to the size of the tumor but rather to the type of tumor.

In case of obesity

It can also affect overweight or obese people. It can, in this case, be the consequence of an eating disorder, a diet, an unbalanced diet, surgery related to obesity.

Significant and rapid weight loss can have a very deleterious effect on the body. It causes a decrease in the effectiveness of the immune system, a reduction in muscle strength, difficulty for certain organs to function normally and a general state of weakness.

In the case of an illness, cachexia can make treatment more difficult to endure. In oncology, it results in an increase in mortality and complications from treatments and possible surgeries. In addition, since most treatments are calculated based on the patient’s weight, the loss of muscle mass can affect the effectiveness of the drugs.

The first step is to screen for cachexia and identify patients who can benefit from nutritional support: define the current situation, its possible stability, its possible evolution, the context (is cachexia associated with a disease).

The possible treatments are as follows, in order of installation:

• enriched diet: the patient’s diet is enriched with proteins and adapted according to his tastes (which may change in the event of chemotherapy, for example);
• oral food supplements: they are added to the normal diet to try to compensate for any deficiencies;
• Enteral Nutrition: When the digestive tract is functioning properly and is able to absorb nutrients, enteral nutrition is the first artificial nutrition method that can be implemented. It consists of administering the nutrients contained in a bag in liquid form directly into the stomach or intestine using a probe;
• Parenteral nutrition: When natural feeding is no longer possible and the digestive tract is damaged, parenteral nutrition is used to provide for the nutritional needs of the body. The term parenteral means “bypassing the digestive tract”. With this method, the nutrients do not pass through the digestive tract at all but directly into the bloodstream.

In the event of significant, rapid and involuntary weight loss, it is advisable to consult your doctor.