Anorexia and cachexia

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Cachexia is a very serious, complex condition that occurs with anorexia nervosa (AN) and other disorders. Also called a “wasting disorder,” cachexia involves body mass loss, muscle loss, extreme fatigue, weakness, and lack of appetite. It can be caused by systemic inflammation from an underlying disease, such as cancer, heart failure, kidney disease, COPD, and AIDS, and is a result of the disease process itself, not intentional efforts to lose weight.

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Cachexia results from a combination of many factors, including inflammation and not getting enough energy and nutrients from food, as part of the body’s response to fighting the associated disease. (1) There is a change in metabolism that causes the body to break down muscle and fat tissues, and it affects all organs, as well. (2) It can be life-threatening if prolonged. 

Weight loss, extreme fatigue, weakness, and loss of appetite are warning signs of cachexia. And blood tests will usually show low levels of white blood cells, serum albumin, and total protein, altered levels of uric acid, and elevated levels of C-reactive protein and inflammatory markers.

Does anorexia cause cachexia?

Yes, anorexia nervosa can cause cachexia. People who have AN don’t consume enough food to keep the body operating normally. This puts the body in a state of distress, and results in overproduction of certain proteins that regulate the immune system’s response and control inflammation. These then turn against the body and attack essential tissues, breaking down muscle, fat, and even organ tissue. (4)

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Treatment of anorexia cachexia?

A comprehensive, multidisciplinary treatment approach must be taken in order to stop the process before anorexia cachexia does permanent damage to the body and becomes potentially life threatening. While outcomes have been mixed, a combination of nutritional counseling, supplements, medical treatment of GI symptoms, psychotherapy, and medications have had some positive results. (3,5)

Seeking help from a team of highly qualified practitioners who specialize in eating disorders is the first step. At Within Health, we offer virtual treatment programs for anyone looking for help treating, and recovering from an eating disorder. Our clinical care team will work with you to create a customized plan attuned to your specific needs. To learn more about what we do, including our commitment to inclusive care, or to start treatment today, talk with our admissions team.

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Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Resources

  1. Ohnuma, T., Ali, M.A., Adigun, R. Anorexia and Cachexia. StatPearls Publishing; 2022 Jan 2021 Sep 19. Accessed online Jan. 31, 2022. https://pubmed.ncbi.nlm.nih.gov/28613696/
  2. Reuter, S.E., Martin, J.H. Pharmacokinetics of cannabis in cancer cachexia-anorexia syndrome. Clin Pharmacokinet. 2016 Jul;55(7):808-812. Accessed online Jan. 31, 2022. https://pubmed.ncbi.nlm.nih.gov/26883879/  
  3. Esposito, A., Criscitiello, C., Gelao, L., Pravettoni, G., Lacatelli, M., Minchella, I., Di Leo, M., Liuzzi, R., Milani, A., Massaro, M., Curigliano, G. Mechanisms of anorexia-cachexia syndrome and rationale for treatment with selective ghrelin receptor agonist. Cancer Treat Rev. 2015 Nov;41(9):797-7. Accessed Jan. 31, 2022. https://pubmed.ncbi.nlm.nih.gov/26386985/ 
  4. Holden, R.J., Pakula, S. The role of tumor necrosis factor-alpha in the pathogenesis of anorexia and bulimia nervosa, cancer cachexia and obesity. Med Hypotheses. 1996 Dec;47(6):423-438. Accessed online on Jan. 31, 2022. https://pubmed.ncbi.nlm.nih.gov/8961238/ 
  5. Suzuki, H., Asakawa, A., Li, J.B., Tsai, M., Amitani, H., Ohinata, K., Komai, M., Inui, A. Zinc as an appetite stimulator – the possible role of zinc in the progression of diseases such as cachexia and sarcopenia. Recent Pat Food Nutr Agric. 2011 Sep; 3(3): 226-31. Accessed Jan. 31, 2022. https://pubmed.ncbi.nlm.nih.gov/21846317/

FAQs

Further reading

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