Table of ContentsView AllTable of ContentsAnorexia vs. CachexiaCausesTreatmentRemediesWhen to See a Provider
Table of ContentsView All
View All
Table of Contents
Anorexia vs. Cachexia
Causes
Treatment
Remedies
When to See a Provider
Decreased appetite and its resulting weight loss is common with many life-threatening illnesses. It’s a symptom that some patients say is just as distressing, if not more so, than pain. Sick patients know they need to eat but sometimes can’t bring themselves to do it.
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You may find yourself wondering how you can help get your loved one to eat and stop or even reverse the weight loss. But before intervening, it’s important to understand what is happening in your loved one’s body and why they may be having a hard time eating.
This article goes over the causes of appetite loss in life-threatening conditions. It also discusses the difference between anorexia andcachexia.
Anorexia-cachexia syndrome (ACS) describes the condition of being unable to eat and experiencing weight loss and muscle wasting as a result.
What Are the Causes of ACS?
Anorexia-cachexia syndrome can have causes that range from the medical condition itself to the therapies used to treat the condition.
Metabolic Alterations
Physical Symptoms
Symptoms of the disease can cause decreased appetite and thus weight loss. Common symptoms that can result in anorexia include:
Medication Side Effects
Medications used to treat illnesses or increase comfort can have side effects that cause anorexia. Many of the side effects are similar to the physical symptoms listed above.
Psychological or Spiritual Distress
Emotional, psychological, or spiritual distress can play a role in anorexia. The effects of the illness and the treatment, coupled with psychological responses such as anxiety or depression and spiritual reactions such as hopelessness, may result in diminished enthusiasm for food and/or a lack of energy to prepare and eat it.
Other Causes
Other causes of anorexia can easily be missed but may be significant. Examples include poorly-fitting dentures and infections of the mouth or esophagus.
How Is ACS Treated?
The first thing you should do is discuss the problem with your nurse or physician. They will help you develop a plan of care to address the contributing factors.
The approach will usually be multidimensional, focusing on:
It’s important to remember that approaches to treating anorexia and cachexia in advanced diseases don’t always work.
Symptom Management
If there are symptoms of illness that are contributing to decreased appetite and weight loss, those should be addressed first. Pain, nausea, fatigue, and depression are the most common anorexia-inducing symptoms and they are usually easy to treat.
If symptoms are a side effect of medication, the person’s physician may want to stop the medication (if it’s not necessary) or try a different one.
Nutritional Support
There are two schools of thought regarding eating towards the end of life: One believes the ill person should only be eating nutritiously dense foods and the other believes the ill person should eat whatever he wants.
Many people will hover in the middle, offering nutritious foods and snacks but allowing indulgences from time to time. This is probably the most prudent approach. If your loved one is losing weight and has no interest in eating meals but loves chocolate pudding, for example, there is no reason to deprive them of it.
You can purchase highly nutritious supplements that also taste good. (Ensure and Boost are probably the most popular.) Adding supplements to your loved one’s diet can increase their overall calorie intake and help make up for any nutritional deficiencies.
Artificial nutrition in the form of tube feedings is a controversial treatment for ACS. As noted above, once a patient is cachexic, nutritional supplementation, including tube feeding, does not reverse it. Tube feedings can also have unpleasant or dangerous side effects and often increase a dying patient’s discomfort.
Medications
Several medications may help patients with ACS increase their appetite and gain weight.Common ones include:
Ask your loved one’s physician if any of these medications could help. Physicians will usually try one or more of these medications for a time and discontinue them if they are ineffective. It’s important to note here that the smoked form of marijuana is still illegal in some states.
Psychosocial and Spiritual Support
Anxiety, depression, family stressors, and other emotional and spiritual factors may contribute to ACS.Decreased appetite can also lead to a patient feeling isolated from loved ones as meals are times for socialization.
A medical social worker (MSW), chaplain, or psychotherapist may be able to help your loved one work through such feelings.
Home Remedies
It’s important to keep in mind that your efforts at increasing appetite may not work, but it’s equally as important to not give up hope.
There are a few things you can do at home to help support your loved one and encourage them to eat. Some of these include:
Working together with your loved one’s healthcare provider will prove the most effective way of rescuing a fading appetite.
Tips for Caregivers
Loss of appetite is normal and to be expected at the end of life. As the body begins to shut down, it can no longer absorb the nutrients from food.
If your loved one is approaching the end of life, they will no longer need to eat nor will they have any interest in eating. Though you may worry that the person is starving, this is not an accurate way to describe what is happening. Starvation happens when a person is deprived of food despite feeling intense hunger. People at the end of life do not feel hunger.
When to See a Healthcare Provider
If you’re concerned about your loved one’s food intake or you believe it is too soon for them to be experiencing end-of-life loss of appetite, contact their healthcare provider. They can discuss strategies to help them continue to get the nutrients they need. These may include suggestions for providing supplemental nutrition or medication changes or additions.
Summary
Treatment strategies for ACS include symptom management, nutritional support, medications, and different types of therapy. It is also important to remember that as someone nears the end of life, it is normal for them to stop eating.
6 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.
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Wickham RJ.Managing Constipation in Adults With Cancer.J Adv Pract Oncol. 2017;8(2):149-161.
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