Anorexia and weight loss are associated with increased mortality in cachectic patients. The role of caloric supplementation is controversial. The purpose of this review is to examine the role of calorie supplementation in cachexia.Caloric supplementation improves outcomes in malnourished hospital patients and malnourished older persons. It may improve the quality of life in cancer patients and for those persons receiving palliative care. Caloric supplementation should include a balanced essential amino acid supplement given at least twice a day. The role of eicosapentanoic acid as a supplement is controversial. All caloric supplements should be given between and not with meals.Caloric supplementation rich in protein and with adequate vitamin D should be given between meals to all patients with cachexia.