Resistance or strength training is defined by resisting, lifting, and lowering weights. Resistance exercise training for a period of 8-12 weeks results in significant increases in muscle mass, muscle strength, and muscle function. Even in cases where dietary protein intake falls below recommended daily allowances, the anabolic effect of resistance training appears to improve energy intake and protein use, allowing nitrogen retention (Castaneda 1998). Resistance training has been shown to improve muscle strength and functioning in people with disease-causing muscle wasting and in healthy, but frail elderly people (Fielding 1995). Resistance exercise training is cost-effective, noninvasive, and a means to improve the quality of life – and as such, should be considered as an adjunct treatment modality.
Appetite stimulants have been used in both HIV and cancer patients with wasting syndrome.
Marinol (dronabinol) is a synthetic version of the active ingredient in marijuana, 9-tetrahydro-cannibol (THC). Marinol can be prescribed by a physician and taken orally. Results have been mixed as a treatment for nausea and vomiting due to chemotherapy. As an appetite stimulant, however, results are more encouraging. In a study of 139 people with HIV, Marinol significantly improved appetite, body weight, mood, and decreased nausea and vomiting compared to those on placebo (Beal 1995). Side effects from Marinol may include heightened awareness, a sense of well-being, and elation. Dizziness, drowsiness, muddled thinking, and anxiety are also possible side effects.
Megace is a synthetic progesterone used to stimulate appetite in people with wasting syndrome caused by HIV or advanced stages of cancer. It is also used as a therapy in women with breast cancer, interfering with the action of estrogen on cancer cell receptor sites. Although an increase or stabilization of weight may be seen after 6 weeks at the therapeutic dose of 800 mg daily, most of the gain will be in fat. A lower therapeutic dose along with resistance training will help to promote more muscle mass. Megace has a low incidence of adverse side effects when taken as directed.