* Marasmus is a presentation of severe acute malnutrition (SAM). * There is a severe deficiency of calories in the diet * Child body weight is less than 60% normal for age, sex and height * There is growth retardation and loss of muscle mass * Visceral protein compartment (liver) is preserved as the muscles are used as an energy source. * There is multivitamin deficiencies, anemia and immuno-suppression RC 10th Ed. p 434