Nutrition Diet: How to get rid of marasmus effectively

October 6, 2025 •

4 min read

According to UNICEF, nearly half of all deaths in children under five are linked to malnutrition. When addressing severe undernutrition, understanding how to get rid of marasmus? is critical for safe and effective recovery through a carefully managed nutrition diet plan.

Quick Summary

Recovery from marasmus requires a structured, multi-phase dietary and medical intervention to correct severe calorie and protein deficiencies, prevent complications like refeeding syndrome, and restore health. This guide outlines the essential steps.

Key Points

Phased Treatment: Recovery from marasmus requires a medically supervised, multi-phase approach beginning with stabilization before moving to nutritional rehabilitation.
Refeeding Syndrome Risk: Initial refeeding must be done slowly and carefully to prevent refeeding syndrome, a potentially fatal complication from rapid electrolyte shifts.
Nutrient-Dense Diet: Recovery relies on a high-energy, high-protein diet, often using specialized formulas like F-75 and F-100 or RUTFs, to facilitate catch-up growth.
Treating Infections: Given the compromised immune system, infections must be addressed with antibiotics to provide the best chance of recovery.
Crucial Micronutrients: Supplementation with vitamins and minerals like potassium, magnesium, and zinc is essential, with iron introduced only after the initial stabilization phase.
Long-Term Follow-up: Post-recovery follow-up is necessary to monitor for relapse and ensure sustained nutritional health.

Understanding Marasmus and Its Dangers

Marasmus is a severe form of protein-energy malnutrition (PEM) resulting from an overall lack of calories and other macronutrients like carbohydrates, fats, and protein. It is characterized by extreme emaciation, visible muscle wasting, and loss of subcutaneous fat. The body, in survival mode, begins to break down its own tissues for energy. This life-threatening condition disproportionately affects infants and young children in developing countries, though it can occur in anyone with severe, prolonged nutritional deficits. Left untreated, marasmus can lead to organ failure, a compromised immune system, developmental delays, and death.

The Three-Phase Medical Approach to Marasmus Recovery

Treating marasmus is a delicate and complex process that should be conducted under strict medical supervision to avoid the potentially fatal complication of refeeding syndrome. The World Health Organization (WHO) outlines a phased treatment plan to ensure a gradual and safe return to health.

Phase 1: Stabilization and Rehydration

The initial focus is not on rapid weight gain but on stabilizing the patient and correcting life-threatening conditions.

Rehydration: Dehydration is common due to chronic diarrhea. ReSoMal (Rehydration Solution for Malnutrition) is often used orally or via a nasogastric tube to correct electrolyte imbalances slowly. Standard oral rehydration solutions are unsuitable due to their high sodium content.
Treating Infections: A broad-spectrum antibiotic is typically administered, as severely malnourished individuals have a suppressed immune system.
Correcting Deficiencies: Micronutrient deficiencies, such as potassium, magnesium, and zinc, are addressed. However, iron is withheld during this initial phase as it can worsen infections.
Hypoglycemia/Hypothermia: Small, frequent feeds and warmth are necessary to prevent low blood sugar and body temperature.

Phase 2: Nutritional Rehabilitation (Catch-up Feeding)

Once the patient is stable, the focus shifts to restoring nutritional status and promoting growth. This phase can last several weeks.

Gradual Increase in Calories: Feeding begins slowly with therapeutic formulas, like F-75, which are low in protein and calories to prevent refeeding syndrome. The formula is then transitioned to a higher-energy version, such as F-100, or a Ready-to-Use Therapeutic Food (RUTF) like Plumpy'Nut.
High Energy, High Protein Diet: The aim is to achieve rapid weight gain. Calorie intake may increase significantly to help the child make up for lost growth.
Micronutrient Supplementation: Iron supplementation is introduced during this phase once the risk of infection is under control.

Phase 3: Follow-up and Prevention

After discharge from inpatient care, ongoing support is crucial to prevent relapse.

Dietary Education: Caregivers are educated on proper nutrition, food preparation, and hygiene practices.
Immunizations: Ensuring the child is up-to-date on vaccinations helps prevent infectious diseases.
Ongoing Monitoring: Regular follow-up checks are needed to monitor weight, growth, and overall health status.

Comparison of Nutritional Phases for Marasmus Recovery


Feature	Phase 1: Stabilization	Phase 2: Rehabilitation	Phase 3: Follow-up
Primary Goal	Treat life-threatening complications	Restore nutritional status, promote weight gain	Prevent relapse, ensure continued growth
Energy Intake	Low (approx. 70 kcal/kg/day) to prevent refeeding syndrome	High (up to 140 kcal/kg/day) for catch-up growth	Transition to adequate, balanced home diet
Formula Type	Low-osmolarity, low-lactose formulas like F-75	High-energy formulas like F-100 or RUTF	Balanced, nutrient-dense home foods
Feeding Method	Small, frequent feeds (e.g., every 2 hours); may use nasogastric tube	Larger, less frequent feeds (e.g., every 4 hours); oral feeding encouraged	Regular home-cooked meals
Iron Supplementation	Withheld due to infection risk	Started after stabilization (around day 8)	Continued as necessary
Key Risk	Refeeding syndrome, electrolyte imbalances	Food intolerance, continued illness	Relapse due to poor diet, hygiene

Key Foods for Marasmus Recovery

During the rehabilitation phase, a transition to nutrient-dense, calorie-rich foods is essential for sustained recovery.

Milk Products: Skim milk powder mixed with vegetable oil and sugar is a common component of therapeutic formulas. Later, whole milk, eggs, and cheese can be introduced.
Protein Sources: Fish, eggs, and nuts provide crucial protein for muscle rebuilding. In a home setting, incorporating protein-rich legumes, poultry, and meat is important.
Energy-Dense Foods: Carbohydrates from cereals, breads, and grains are vital energy sources. Healthy fats from vegetable oils, avocado, and nuts further increase calorie density.
Fortified Foods: Nutrient-dense foods like Ready-to-Use Therapeutic Foods (RUTFs) provide a balanced mix of high-quality protein, energy, and micronutrients.
Fruits and Vegetables: These provide essential vitamins and minerals, helping to prevent micronutrient deficiencies that often accompany marasmus.

Prevention as the Ultimate Cure

Preventing marasmus is far more effective than treating it, and involves a multi-pronged approach that addresses underlying socioeconomic and health factors. This includes promoting exclusive breastfeeding for the first six months, followed by safe and nutritionally adequate complementary feeding practices. Ensuring access to clean water, sanitation, and basic healthcare can significantly reduce the incidence of infectious diseases that worsen malnutrition. Nutritional education for mothers and families is also critical. Interventions to combat poverty and food insecurity are essential at a community level.

Conclusion

Effectively addressing how to get rid of marasmus? requires a medically supervised, step-by-step process of nutritional recovery. From initial stabilization and careful refeeding to long-term follow-up, the focus is on rebuilding the body safely while preventing dangerous complications like refeeding syndrome. A balanced, calorie- and nutrient-rich diet, along with treating underlying infections, is fundamental to recovery. Crucially, addressing the root causes of malnutrition through public health and educational initiatives is the most powerful tool for prevention.

Learn more about community-based severe acute malnutrition management from authoritative sources such as the Community-Based Management of SAM by WHO and UNICEF.

Frequently Asked Questions

Marasmus is primarily caused by a severe, prolonged deficiency in both protein and calories, leading to the body consuming its own fat and muscle tissues for energy.

Refeeding syndrome is prevented by slowly and cautiously reintroducing food, using low-calorie, low-osmolarity formulas initially while monitoring and correcting electrolyte imbalances under close medical supervision.

Yes, while more common in children, adults can develop marasmus due to starvation, chronic illness, eating disorders, or inadequate nutrient intake over a long period.

Long-term effects can include stunted growth, intellectual disability, compromised immunity, and metabolic issues if the period of severe malnutrition was extensive during crucial developmental years.

Marasmus results from a general deficiency of all macronutrients, leading to a wasted and emaciated appearance. Kwashiorkor, in contrast, is primarily a protein deficiency that can cause edema (swelling) and a distended belly.

Prevention includes ensuring a balanced diet with adequate protein and calories, promoting exclusive breastfeeding, providing clean water and sanitation, and educating communities on nutrition.

Recovery time varies depending on severity and individual response, often taking weeks to months. The average time spent in treatment for complicated cases can be over 40 days.

Special therapeutic foods like RUTFs (Ready-to-Use Therapeutic Foods) are energy-dense, fortified, and safe for use at home, providing the crucial protein, energy, and micronutrients needed for rapid weight gain and recovery.