Marasmus – Causes, Symptoms & Treatment


Marasmus is a very common disease, especially in developing countries, and is the result of chronic malnutrition. The state of nutrition is disturbed by long-lasting malnutrition. What are the consequences of this disease and how can it be combated?+

What is marasmus?

Marasmus occurs primarily in children from infancy to five years of age living in developing countries. In developed countries, marasmus is a consequence of eating disorders . Protein-energy deficiency syndrome is caused by a persistently insufficient intake of calories. The body gradually reduces its energy and protein reserves . The lack of protein and energy can lead to death if the affected people’s diet does not change.

Two types of marasmus can be distinguished. Nutritional marasmus is severe malnutrition. If the person concerned suffers from an energy and protein malnutrition, this is referred to as kwashiorkor marasmus.


If the body is permanently undersupplied with food, not enough calories, vitamins , fats and trace elements can get into the organism. In developing countries, the disease only occurs more frequently when the children are no longer receiving breast milk and are dependent on normal food intake. As a result of malnutrition, the digestion process of the ingested food is also disturbed.The affected children suffer from a lack of digestive enzymes and bile acids, which impedes the absorption of fats through the intestines. Other causes of marasmus can be tumor diseases , diseases of the digestive system or consumptive infectious diseases such as tuberculosis .

Symptoms, Ailments & Signs

The most common and visible sign of malnutrition is reflected in weight loss . The body does not have sufficient fat reserves from which energy could be obtained. Muscle mass is broken down faster because the body needs protein to survive. The children’s bloated stomachs and sunken faces, which appear older, are striking. Those affected suffer from diarrhea and anal prolapse (the anal mucosa comes before the sphincter).

Diagnosis & course of disease

The lack of energy seriously affects the metabolic processes and digestive juices, urine and hormones cannot be produced sufficiently. Due to the lack of food, the immune system is not as resilient and performance is greatly reduced. The patient is more susceptible to numerous infections, which can also be fatal. The brain becomes less efficient and hallucinations can occur.

Man becomes apathetic and tends to lose consciousness. Cardiac arrhythmias , which are a consequence of the heart’s lack of energy, lead to electromechanical decoupling. This is a common cause of death. Symptoms of the kwashiorkor are brittle hair and hair loss as well as reduced performance and impaired fertility. Fluid deposits ( edema ) appear in the tissue.


First and foremost, the marasmus leads to a very strong weight loss. In any case, weight loss is a very unhealthy condition for the patient’s body and should therefore be avoided at all costs. In the long term, this can lead to irreversible damage to the internal organs and ultimately, in the worst case, to the death of the patient.

Those affected suffer primarily from a bloated stomach and also from diarrhea. The quality of life is significantly reduced by the marasmus. Likewise, the resilience of those affected decreases and there is severe tiredness and exhaustion. Children can also suffer from developmental disorders due to marasmus, which can lead to complications in adulthood.

Malnutrition also has a negative effect on the heart, which can lead to cardiac death. Not infrequently, patients also suffer from hair loss and hallucinations. Marasmus is treated with therapy and is not always successful. The success of the treatment usually depends on the duration of the malnutrition and the damage present. It is not uncommon for this disease to significantly reduce the life expectancy of the patient.

When should you go to the doctor?

People who have eaten too little food over a long period of time, either consciously or because of the circumstances, must be subjected to an intensive medical examination. The low intake of food causes damage to the organism, which must be controlled and evaluated. If there are various deficiency symptoms, a feeling of illness or an inner weakness, a doctor is needed. If the BMI is below the recommended guidelines, a doctor should be consulted. A low body weight with a strongly arched abdomen are indications of existing irregularities that need to be examined and treated.

If food intake after a long period of abstinence causes immediate vomiting or severe diarrhea, medical attention is required. In the event of exhaustion, severe tiredness and a loss of strength, a doctor should be consulted. Irregularities in the anus should be examined and treated by a doctor. If the affected person notices that the anal mucosa is outside the sphincter, he should consult a doctor immediately. Chronic malnutrition is often reflected in severely aged facial features and sunken skin. Below the upper layer of skin, no layer of fat can be felt on the entire body. Medical care is necessary, as otherwise complications and premature death may occur.

Treatment & Therapy

If marasmus is diagnosed, treatment is carried out in ten steps according to the scheme developed by the WHO: Due to the high loss of fatty tissue, the patients are severely hypothermic. It is therefore important to warm up and monitor your body temperature. Low blood sugar levels are brought back into balance by giving a sugar solution (glucose) by mouth or intravenously. The child is fed the glucose solution every two hours for at least a day. This therapy prevents further hypoglycaemia.

Dehydration is the only symptom that cannot be treated according to the standard WHO scheme. The affected children have severe cardiac insufficiency due to inadequate nutrition . When given an oral rehydration solution, the amount of sodium is very high. Too much sodium would put too much strain on the heart. Therefore, a modified rehydration solution that is low in sodium but high in potassium is given.

Furthermore, important vitamins and trace elements must be supplied to the patient. The immune system is so weakened that infections are very difficult to recognize as such. By administering a broad-spectrum antibiotic, even invisible infections are treated.

The dose of trace elements is increased daily until iron is also administered in the second week of treatment. In the second week of therapy, the protein and calorie intake must be increased to such an extent that a correspondingly normal height for the corresponding age can be achieved. Children suffering from marasmus show a reduction in growth and it also negatively affects their intelligence in adulthood.

To diagnose marasmus, a self-test can be performed by the appropriate person. Has the person recently unintentionally lost weight or eaten less food? At the first signs, a doctor should be consulted, who will clarify the symptoms in a conversation. If an examination takes place, a suspicion can be confirmed with the help of the Nutritional Risk Screening (NRS 2002).

The doctor then determines the severity of the disease and clarifies the cause of the malnutrition. The life expectancy of malnourished people is severely limited. If the person is not treated in time, the body’s organs change, which in the worst case can lead to death.

Outlook & Forecast

Marasmus mostly affects children under the age of five. Most of them live in poor conditions. Risk areas are in Asia, Africa and Latin America. International organizations put the annual death toll at five million. Marasmus is rare in western industrialized nations. There it is usually due to other serious illnesses and mental disorders.

There are actually sufficient therapeutic approaches to combat marasmus. However, cases in which the disease has been present unnoticed for years appear to be problematic. The normalization of the body balance through therapies can then take a long time. Development deficits cannot always be completely eliminated. Severe organic disturbances may be irreparable. Insufficient supply systems are in place, especially in countries where malnutrition is caused by food shortages. The prospects there are poor, as can be seen from the high number of deaths.

Malnutrition can also be triggered by infections or tumors . The chances of recovery then depend on the extent to which doctors can eliminate the original disease. Eating disorders also lead to marasmus. In this case, the success of the treatment justifies the willingness to reorganize your life. Left untreated, marasmus leads to a greatly reduced life expectancy.


In order to avoid marasmus outbreaks, it is important to inform and educate people, especially in industrialized countries. Malnutrition is not just a problem that exists in the developing world. People must have access to a balanced and sufficient diet. For people who cannot feed themselves, more attention must be paid to nutrition, because malnutrition is a widespread problem, especially in old age or in seriously ill patients.


Marasmus primarily leads to rapid and severe weight loss in those affected. With weight loss, the body is in an overall unhealthy state. For this reason, those affected should try to compensate for the weight loss and strengthen their general resilience during follow-up care with the doctor treating them. The quality of life of those affected is significantly reduced. The help of relatives and friends in everyday life is indispensable. Those affected suffer from fatigue and exhaustion. A balanced diet and a healthy lifestyle promote recovery. Treating marasmus does not always improve or cure the condition. The improvement depends on the severity of the damage and the duration of the malnutrition.

You can do that yourself

If there is marasmus, the affected person must be taken to a doctor immediately. The treatment developed by the World Health Organization can be supported by various measures.

First, any dehydration must be compensated for by the patient drinking enough. A nutrient deficiency can be compensated for by the administration of food supplements, but also by a wholesome diet , which must be fed to the affected person very slowly. Since the immune system is usually severely weakened during the disease, the affected person must take it easy. A few days of bed rest is ideal , supported by regular visits to the doctor.

A balanced and nutritious diet can prevent renewed malnutrition. The prerequisite for this is that the circumstances for the marasmus are recognized and corrected. In Germany, organizations such as the Tafel or the parish churches offer free or cheap food. Those affected can also contact the authorities and apply for support. If malnutrition occurs due to other circumstances, such as during a trip or an illness, a doctor must be consulted in any case. The nutrient deficiency must be compensated for as quickly as possible to prevent long-term consequences.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.