Malnutrition: Symptoms, Causes, Treatment

Weight loss is not the only feature: protein or specific nutrient deficiencies can affect function. Children require age-appropriate growth assessment; adult thresholds should not be applied to them.

Related reading: Tube feeding when indicated.

Signs include unintentional weight loss, weakness, fatigue, reduced activity and delayed wound healing. Frequent infections or poor childhood growth may occur. Lack of obvious thinness does not exclude nutritional problems.

Reduced appetite, chewing or swallowing problems, poor absorption or increased illness-related needs can contribute. Isolation, difficulty obtaining or preparing food, medicines and psychological factors may also play a part.

Chronic disease, older age, frailty, oral or swallowing problems and social barriers increase risk. Eating disorders require appropriate nonjudgmental care. A high BMI does not exclude important nutrient deficiencies.

Assessment considers weight trajectory, intake, illness, swallowing and function, using an appropriate screening tool. Targeted tests may help, but albumin alone neither diagnoses malnutrition nor determines its treatment.

The team treats the cause and individualizes meals, fortification and supplements when indicated. Alternative nutrition support may be needed if oral intake is inadequate or unsafe. After severe depletion or prolonged minimal intake, restart cautiously with clinical monitoring to avoid electrolyte disturbances.

Undernutrition can impair immunity, muscle strength, balance and wound healing and prolong recovery. Unmonitored refeeding after severe depletion can dangerously disturb electrolytes, fluids and heart function.

Monitor appetite, weight and the ability to shop and cook, and seek support early. Address dental pain and swallowing difficulties and provide suitable meals. Avoid imposing a restrictive diet on someone losing weight without assessment.