Cachessia: Causes, Types, Symptoms, Complications and Treatment

It is a condition characterized by strong weight loss and muscle weakness.

The term derives from the union of two Greek words: »kakos«, which means evil and »exis«, which means condition.

Cachessia can also be a symptom of a more serious chronic disease , such as cancer, type 1 diabetes, HIV, and multiple sclerosis.

Compared to other conditions characterized by strong weight loss, such as marasmus, a person with cachessia loses weight even if they continue to eat regularly. This weight loss affects both the fat component and the muscle mass.

What are the causes that can produce cachessia?

People with cachessia have abnormal levels of some substances in the body. This imbalance causes weight loss and sarcopenia. Among the substances considered responsible for the cachectic state, we have testosterone and a similar insulin growth factor (IGF-1).

Weight loss is also caused by high levels of cytokines, inflammatory substances that contribute to weight loss. High levels of cytokines in the body could be related to a chronic disease associated with cachessia.


Depending on the conditions associated with cachessia, it is possible to distinguish different types:

  • Senile Cachessia : This extremely malnourished condition affects elderly people often forced to go to bed by other illnesses such as senile dementia and Alzheimer’s disease.
  • Cardiac cachessia : The progressive loss of weight and muscle mass is linked to serious heart diseases, such as chronic heart failure.
  • Cancer Cachessia : A large number of cancer patients suffer from loss of weight and muscle mass. This condition is related both to increased cytokine production in cancer patients and to chemotherapies that reduce the sensation of appetite.

Tumor cachessia mainly affects patients who are in the terminal phase, in whom normal therapies aimed at contrasting the tumor are suspended and palliative care is carried out, with the aim of minimizing the suffering of the patient.

In this case, we speak of terminal cachessia.

What are the symptoms?

Not always a person with cachessia appears undernourished, so doctors have established precise criteria to establish that it is actually cachexia. People with cachexia should have the following characteristics:

  • Having lost more than 5% of body weight.
  • Having a body mass index of less than 20 in a person under 65, or a BMI of less than 22 in a person over 65.
  • Have less than 10% body fat.
  • Have high levels of cytokines in the body.

What are the complications associated with cachessia?

The loss of fat and muscle mass can be severe enough to cause death. One study found that losing 66% of body weight can quickly lead to death, regardless of the trigger.

Some complications of cachessia include:

  • Worsening quality of life
  • Insufficient response to cancer treatment.
  • Low immune defenses.
  • General worsening of symptoms of the triggering disease.

What are the remedies and treatment for cachessia?

Treatment or management of cachessia depends on the causes, general prognosis, and other factors related to the patient.

There is insufficient evidence to support the use of fish oil for the treatment of late stage cancer cachessia.

Progestins such as megestrol acetate are an option for the treatment of refractory cachessia that presents with anorexia as an important symptom.

In addition, a comorbidity of cachessia is observed in patients with one of the diseases classified as chronic obstructive pulmonary diseases.

Steroid intake may be helpful in cancer cachessia, but use is recommended for up to 2 weeks to avoid side effects.

Non-pharmacological therapies that have been shown to be effective in cancer-induced cachessia include nutritional counseling, psychotherapeutic interventions, and physical training.

Treatment for cachessia may include drugs aimed at lowering cytokine levels in the body, stimulating appetite, or blocking hormones related to this condition.