Loss of appetite and cachexia

Loss of appetite and subsequent weight loss are a concern when caring for palliative care patients. Vigano et al. (2000) found a lower survival level with cancer patients with poor nutrition and weight loss. The palliative conditions in which cachexia and anorexia occur most frequently are progressive malignancy, HIV/AIDS, end-stage cardiac failure, end-stage respiratory failure, chronic renal failure, chronic liver disease, and advanced dementia. https://www.caresearch.com.au/caresearch/tabid/182/Default.aspx

The validated Patient-Generated Subjective Global Assessment tool is recommended for nutritional assessment for patients with cancer-related cachexia (Jager-Wittenaar et al., 2017).

The main components of that assessment tool include the following:

Nutritional counseling, removal of eating impediments, appetite stimulants, and tube feedings, depending upon the patient's condition and acceptability, have been recommended (Holmes, 2009; Zhang et al., 2018).
Potentially reversible contributors to appetite problems should be sought and treated as appropriate. These may include:

Instant Feedback:

Which of the following conditions can result in loss of appetite and weight loss?

Progressive malignancy
End-stage cardiac failure
Chronic renal failure
All of the above


Albert, R.H. (2017). End-of-life care: Managing common symptoms.  American Family Physician. 95(6), 356-361.

Holms, S. A (2009). A difficult clinical problem: diagnosis, impact and clinical management of cachexia in palliative care. Int J Palliat Nurs. 15(7),320, 322-6.

Jager-Wittenaar, H. & Ottery, F. D. (2017). Assessing nutritional status in cancer, Current Opinion in Clinical Nutrition and Metabolic Care. 20(5). 322-29.

Vigano, A., Dorgan, M., Buckingham, J., Bruera, E. & Suarez-Almazor, M.E. (2000). Survival prediction in terminal cancer patients: a systematic review of the medical literature. Palliat Med. 14(5),363-74.

Zhang, F., Shen, A., Jin, Y. & Qiang, W. (2018).The management strategies of cancer-associated anorexia: a critical appraisal of systematic reviews. BMC Complement Altern Med. 18(1), 236.