Marasmus is a form of malnutrition. It happens when the intake of nutrients and energy is too low for a person's needs. It leads to wasting, or the loss of body fat and muscle. A child with marasmus may not grow as children usually do.
When an individual does not get the right nutrients, it is harder for their body to carry out routine processes that enable them to grow new cells or fight disease. More serious health problems can then result.
Marasmus is a severe form of protein-energy malnutrition that results when a person does not consume enough protein and calories. Without these vital nutrients, energy levels become dangerously low and vital functions begin to stop.
Both adults and children can have marasmus, but it most often affects young children in developing countries.
Causes of marasmus include:
- not having enough nutrition or having too little food
- consuming the wrong nutrients or too much of one and not enough of another
- having a health condition that makes it difficult to absorb or process nutrients correctly
Older adults who live alone and find it difficult to prepare food and care for themselves may be at risk. Sometimes marasmus can affect an older adult who has not eaten healthfully over a period of some months or years, say the University of Kansas Landon Center on Aging.
While consuming the wrong nutrients and having a health condition can contribute to marasmus, each of these alone would probably not be enough to cause it, as long as calories are available.
In places where food can be scarce, breastfeeding infants for as long as possible may help reduce the risk of malnutrition.
However, if breastfeeding continues for longer than 6 months without an infant receiving solid food, the risk of marasmus can also increase, especially if the mother is malnourished herself.
Those born preterm or with low birth weight may also have a predisposition to malnutrition afterward.
Appropriate support and nutrition during pregnancy and in a child's early years are essential for preventing malnutrition.
In a child, the main symptom of marasmus is a failure to grow, known as stunted growth.
In adults and older children, the main symptom may be wasting, or a loss of body tissue and fat. An older child with wasting may have standard height for their age.
A child with marasmus may also be very hungry and suck on their clothes or hands as if looking for something to eat.
But some people with marasmus will have anorexia, and they will not want or be able to eat.
Over time, a person with marasmus will lose body tissue and fat in their face. Similarly, their bones become visible under their skin, and folds of skin develop from the loss of body mass. Their eyes may appear sunken.
Other symptoms include:
- persistent dizziness
- lack of energy
- dry skin
- brittle hair
Apart from weight loss, long-term effects of marasmus in children include slow growth and repeated infections.
Marasmus is not the only syndrome that results from severe malnutrition.
Kwashiorkor is another severe form of protein-energy malnutrition where the main deficiency is protein.
Severe cases of malnutrition can lead to kwashiorkor. Unlike marasmus, kwashiorkor causes the body to retain fluid in the lower legs, feet, arms, hands, and face, leading to a swollen appearance.
Kwashiorkor may also result in a person having a distended or bulging abdomen. But, someone with kwashiorkor may not have a particularly low weight, because the fluid buildup makes up for the loss in body fat and muscle tissue.
According to the United Nations (UN) Food and Agriculture Organization (FAO), a child with kwashiorkor will have a weight that is 60 to 80 percent of the standard weight for their age.
Other symptoms of kwashiorkor include:
- loss of appetite
- lack of energy
- changes in hair color to yellow or orange
Skin problems are a complication of kwashiorkor. These can include:
- patches of skin turning unusually light or dark
- skin shedding
- skin ulcers developing
- lesions beginning to leak or bleed
Liver problems can occur with kwashiorkor, but they are rare with marasmus.
Kwashiorkor needs immediate diagnosis and treatment, as it can quickly become life-threatening.
Marasmic kwashiorkor is the third form of protein-energy malnutrition that combines features and symptoms of both marasmus and kwashiorkor.
A person with marasmic kwashiorkor may:
- be extremely thin
- show signs of wasting in areas of the body
- have excessive fluid buildup in other parts
In children with marasmus kwashiorkor, the weight will be less than 60 percent of the standard weight for their age.
Immediate medical treatment is essential. As the condition progresses, recovery becomes more difficult, and the chances of survival reduce.
According to the FAO, it remains unclear why some people develop marasmus, and others develop kwashiorkor.
Marasmus is a life-threatening medical emergency. When symptoms appear, the person needs treatment straight away.
Rapid weight loss, infections, and sudden changes in behavior or appetite could be signs of an underlying problem, such as an eating disorder or a chronic health condition.
A medical professional will need to prepare a specific eating plan for anyone with a diagnosis of marasmus.
If the person has anorexia nervosa, a team of professionals may be involved.
It is critical for a person with marasmus to receive a diet treatment that is rich in nutrients, carbohydrates, and calories. They will need more calories than is usual for their age. However, their body may find it hard to tolerate or digest food after losing so much fat and body tissue.
One solution is for doctors to provide food in small amounts and possibly through tubes to the veins and stomach. These tubes allow for food and fluid to be delivered quickly and directly to the body.
A full recovery can still take months, even with the right treatment plan. An individual may also need treatment for the complications, such as infections and dehydration.
If marasmus results from an eating disorder, a person is also likely to need mental health treatment and support.
The best way to prevent marasmus is to have an adequate intake of calories and protein, preferably from a healthful, well-balanced diet.
Foods rich in protein, such as skimmed milk, fish, eggs, and nuts are ideal for energy and growth, though any protein and calorie-rich food can be used to prevent marasmus, depending on what is available.
Vegetables and fruits are essential for providing other nutrients and minerals and for preventing vitamin deficiencies. People can also take supplements, but they may be less effective than foods in delivering nutrients.
A person who has recovered or is recovering from marasmus should take care to avoid complications, including dehydration and diarrhea.
Sanitation and hygiene
Good sanitation and hygiene can play a role in marasmus, especially in places where there is not a regular supply of healthful food and clean water.
Poor sanitation and hygiene can lead to infections that can worsen the symptoms of marasmus and other types of malnutrition and make it harder to recover.
Cooking foods at high heat to destroy bacteria can help, as can freezing food and reheating it before eating.
Boiling water before drinking, cooking, or bathing in areas where clean water is difficult to access is essential to prevent spreading waterborne diseases.
Breastfeeding infants for 6 months can help protect them from nutritional difficulties, especially in places where food is short.