The medical term that describes a severe undernutrition (a deficiency in all macronutrients, including carbohydrates, fats, and protein) is marasmus. This condition usually causes visible wasting of fat and muscle under the skin, giving the body an emaciated appearance.
In other words, marasmus is a severe type of malnutrition in which the body does not have enough macronutrients to function properly. In children, this condition can cause delayed growth. People who experience marasmus for long periods may also experience starvation.
What is The Difference between Marasmus and Kwashiorkor?
These are different types of severe malnutrition. While people with marasmus have a deficiency of macronutrients (including carbohydrates, protein, and fats), kwashiorkor happens in people who may have access to carbohydrates (such as bread, grains, or starches), but they have a lack of protein in their diet. Those who suffer from kwashiorkor often experience edema (fluid buildup in the body), especially in the abdomen and face.
What Happens to The Body in Marasmus Disease?
If the body is deprived of energy people get from food, it begins to feed on its own tissues. First, it uses adipose tissue (body fat) and then muscle. The body may also shut down some of its functions to conserve energy. For instance, cardiac activity slows (slow heart rate), low blood pressure (hypotension), and low body temperature. Sometimes, it may lead to heart failure. Furthermore, people with marasmus also have a weakened immune system that make you more prone to infections and serious health conditions. Usually, people with this condition recover more slowly than a person without it.
This condition can be more problematic in children because they no longer have the physical resources to grow and develop properly. As a result, it may lead to delayed growth and development and intellectual disabilities. Additionally, some parts of the digestive system may begin to atrophy from lack of use. Thus, it may lead to the inability of the body to absorb nutrients despite eating again.
Symptoms
The symptoms are different among people who develop marasmus because they depend on some factors. For example, how long you have experienced this condition, the severity of the disease, your overall health, and your age. Check some examples below:
- Hypotension (low blood pressure)
- Gastrointestinal malabsorption
- Stunted growth
- Slow heart rate
- Electrolyte imbalances
- Dehydration
- Anemia (low red blood cell count)
- Osteomalacia or rickets
- Developmental delays
If you or your child experiences any of the symptoms listed below, immediately contact your healthcare professional. Otherwise, it may lead to permanent damage to certain body systems (such as the digestive system).
External Signs of Marasmus
These include:
- Large head
- Old and wizened face
- Dry and loose skin (also known as skin atrophy)
- Sunken fontanelles in infants
- Lethargy, apathy, and weakness
- Body mass index (BMI) lower than 16
- Weight loss (more than 40%)
- Prominent skeleton
Causes
There are multiple reasons for marasmus. Check some of them below:
- Anorexia
- Infections that cause severe or chronic (long-lasting) diarrhea
- Wasting diseases (such as AIDS)
- Poverty and food scarcity
- Inadequate breastfeeding or early weaning of infants
- Child abuse or neglect
- Dementia
- Elder abuse or neglect
Physicians have also identified some factors that may put you or your child at increased risk of marasmus. Examples include:
- Social isolation
- Physical disability
- Cognitive decline
- Chronic health conditions (such as cancer)
- Underlying diseases – These include cystic fibrosis, congenital heart defects, severe food allergies, and others
- Infections – For example, HIV infection, pneumonia, and others.
- Poor sanitation
- Food insecurity
- Maternal malnutrition
- Inadequate intake (severe and prolonged calorie and protein deficiency)
What Are The Potential Complications of Marasmus?
Those who develop this condition may also experience some complications, especially if malnutrition happens for long periods. Check some complications below:
- Cardiovascular and metabolic failure – These include bradycardia (slow heart rate), low blood pressure, and hypothermia.
- Infections and immune system dysfunction – People with marasmus often have weakened immune systems that make them more prone to infections (such as pneumonia).
- Organ dysfunction – For example, kidney and liver failure, atrophy of the digestive tract, and others.
- Growth and development – These include intellectual disabilities, developmental delays, and others. In more severe cases, it may cause permanent stunting of growth in children.
- Micronutrient deficiencies – For example, reduced levels of vitamins and minerals, including Iron, Zinc, vitamin A, and others.
- Skin and muscle wasting – People with marasmus often experience a severe loss of subcutaneous fat and muscle mass.
- Chronic health risks – Those who suffer from marasmus are also at increased risk of type 2 diabetes, cardiovascular diseases, and others.
How to Prevent Marasmus?
In general, it is possible to prevent this condition. However, in the global community, preventing marasmus means:
- Eliminating food deserts
- Fighting poverty
- Improving sanitation and elder care in developing countries
- Controlling widespread infections
- Improving nutritional education
Diagnosis
Sometimes, doctors diagnose marasmus by performing a physical examination only. Usually, people with marasmus have visible wasting of fat and muscle mass. Beyond different appearances, doctors may also measure the height and length of the person’s body and the circumference of the upper arms. They often use standard charts to measure a child’s or an adult’s weight-to-height ratio. During diagnosis, doctors rely on body measurements, which are then scored according to different scoring systems for children and adults. They may also perform blood tests to check for secondary effects of marasmus, including deficiency of vitamins, minerals, enzymes, and electrolytes. In most cases, doctors perform a complete blood count (CBC) to check for infections or diseases that may contribute to marasmus.
Treatment
People who have marasmus are at increased risk for refeeding syndrome, which is a life-threatening complication that results when the undernourished body tries to reboot too quickly. That’s why the treatment happens in stages. For example:
Rehydration and Stabilization
This is the first part of the treatment that focuses on treating dehydration, electrolyte imbalances, and micronutrient deficiencies. Doctors often recommend a rehydration solution that is given orally or through a nasogastric tube, treatment for infections, and other treatments. Commonly, it takes several hours to days to stabilize enough for refeeding.
Nutritional Rehabilitation
However, refeeding begins slowly with liquid formulas that help balance carbohydrates, proteins, and fats. Doctors may also recommend a feeding tube for gradual and continuous nutrition. The second part of the treatment often lasts up to 6 weeks.
Follow-up and Prevention
This condition may return, and you should finish the treatment exactly as recommended by your doctor. To prevent widespread diseases and infections in developing countries, doctors often recommend safe drinking water, food preparation guidelines, immunizations, education, and breastfeeding support. Moreover, people in these countries may also need the Malnutrition Universal Screening Tool (MUST), which helps identify people who are at risk.
Frequently Asked Questions
Can you recover from marasmus?
The average time people spend in treatment is about 42 days. Most people who return to a caring environment with the resources they need to maintain good health recover completely. After treatment, doctors may also recommend some supplements.
What is the main cause of marasmus?
In most cases, people develop this condition due to a lack of calories. It means a severe deficiency of macronutrients, including carbohydrates, protein, and fats. If you suspect you may have this condition, immediately visit a doctor.
Can marasmus be cured?
People who develop this condition and do not get treatment may also experience some life-threatening complications. However, most people who return to a caring environment after treatment fully recover. If you have additional questions, ask your healthcare provider.
