Managing weight loss and appetite issues

Loss of weight (cachexia) and appetite (anorexia) are common issues for many palliative care patients.

Key points

  • Anorexia (loss of appetite / early satiety) and cachexia occur commonly together in cancer and other advanced diseases, and affect performance status.
  • Cachexia and anorexia are strong independent prognostic predictors.
  • Once fully established, or in late disease, cachexia is not reversible by nutritional interventions.
  • Cachexia affects the person’s ability to tolerate treatment of cancer.
  • Clinicians need to recognise the profound social, cultural and emotional importance of food and provide individualised support to patients and families.


  • Consider potentially reversible causes - including nausea, depression, medication side effects, mouth problems.
  • Consider overall prognosis and stage of disease in deciding a management approach.

Approach to management

  • Multidisciplinary intervention (nutrition, exercise, occupational therapy and pharmacological intervention) may help selected patients.
  • Assist with adaptation to the symptom – including dietary modification, appropriate nutritional support, and psychological support.
  • When prognosis is getting short: encourage transition to eating for comfort.

Last updated 24 August 2021