Is it true that ALS patients have particularly high energy needs?

In fact, some ALS patients experience significant weight loss early in the course of the disease. In some cases, unwanted weight loss of 10–20 kilograms may occur. Studies on metabolism in ALS have shown that ALS patients have an increased resting energy expenditure, which can be understood as an elevated metabolism and increased energy consumption. Further studies have demonstrated that the hormonal regulation of metabolism in the brain is altered in ALS patients.

These changes in the central nervous system are discussed as one of several possible factors contributing to an ALS-related increase in resting energy expenditure. The exact mechanism underlying the described metabolic abnormalities is not yet known. Another factor contributing to increased energy requirements is respiratory dysfunction. Weakness of the diaphragm and trunk muscles leads to increased respiratory effort (usually accompanied by an increased respiratory rate), which in turn can result in increased energy requirements.

Due to increased energy requirements, the use of a high-calorie nutritional supplement (liquid nutrition) is often necessary and advisable in cases of respiratory dysfunction.