In pediatric oncology, cachexia is characterized by which of the following?

• A. Maintenance of lean body mass at the expense of body fat
• B. Progressive wasting of lean tissue and body fat
• C. Gradual weight loss
• D. Decrease in energy expenditure

Answer: (B)

Cachexia is a catabolic state driven by cancer and inflammation that leads to progressive loss of both lean body mass (muscle) and adipose tissue. It reflects ongoing tissue wasting from metabolic changes, not just simple weight loss from reduced intake. This combination of muscle and fat loss distinguishes cachexia from other forms of weight change.

The option describing gradual weight loss alone doesn’t capture the active loss of lean tissue and fat that characterizes cachexia, and the idea of maintaining lean mass with fat loss would imply a different pattern of wasting. Decreased energy expenditure is not typical of cachexia, which often involves increased metabolic rate driven by inflammatory mediators.