Psychological aspects of anorexia: areas for study.

Anorexia and weight loss are frequently the first manifestations of cancer. Although psychological reasons are frequently included as a partial explanation for loss of appetite and weight in the cancer patient, there have been no systematic studies which establish the nature of this relationship. It is proposed that anorexia and cachexia are at times somatic consequences of the cancer patient's beliefs and attitudes about their disease and its treatments. The inability to overcome a sense of hopelessness leads to an adaptive biological reaction called conservation-withdrawal. The effects of the reaction of disengagement and inactivity in relation to the external world which includes external nutriment may be constructive or destructive depending on when it is experienced and the length of time the reaction continues. How this reaction is initiated and mediated biologically and how it may be related to and can be reversed by a shift in motivation are questions of great importance.