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Cachexia is a severe muscle wasting syndrome that affects people with a variety of chronic conditions including diabetes, cancer and infectious disease. It is highly debilitating, and associated with reduced responsiveness to therapy and poor prognosis. Our understanding of the disease process has increased substantially over the past decade. We know that it is associated with a complicated mix of immune, metabolic and inflammatory pathways, but we still don’t know the cause nor can we prevent the process once it has begun. As a result, there is currently no cure or treatment for cachexia.