Disease of aging
Muscle Wasting (Cachexia)
Last updated 2026-07-02· Last reviewed 2026-07-02· 1 min read
Reviewed by the Ultimate Longevity Bible editorial team. Educational reference — not medical advice. See disclaimer.
Distinguishing from related entities
- Sarcopenia: age-related muscle mass and function decline.
- Starvation: reversible with feeding.
- Cachexia: multi-mechanism metabolic derangement resistant to nutritional support alone; inflammatory catabolic drive predominates.
Pathophysiology
- Systemic inflammation: IL-6, TNF-α, IL-1β.
- Increased proteolysis (ubiquitin-proteasome system).
- Insulin and IGF-1 resistance.
- Reduced protein synthesis and disrupted anabolic hormones.
- Anorexia (mediated by hypothalamic pro-inflammatory signalling).
Assessment
Weight loss > 5% over 6 months (or > 2% with BMI < 20 or sarcopenia) in the context of underlying disease. FAACT scale for symptom burden.
Management
- Underlying disease treatment where possible.
- Nutritional support — necessary but insufficient alone.
- Resistance exercise — evidenced improvement in muscle mass and function even in cancer cachexia.
- Ghrelin agonists (anamorelin) — approved in some jurisdictions for cancer cachexia.
- Anti-inflammatory strategies and enobosarm (SARM) — under investigation.
- Emerging: activin/myostatin antagonists.
- Gait Speed — Biomarker.
- Grip Strength — Biomarker.
- Creatine Monohydrate — Intervention.
- Protein Intake & mTOR — Nutrition entry.
- Norman Lazarus — Researcher.