Patients caused by protein-energy malnutrition disease, the clinical manifestation is wasting type, which is characterized by wasting, loss of subcutaneous fat, dry and loose skin and loss of elasticity and luster, wasting severe cases are “skin and bones” like (skin and bones). It is one of the clinical symptoms of protein-energy malnutrition. So, what diseases should be differentially diagnosed in patients with severe emaciation “skin and bones”? The following is a brief introduction: 1, generalized wasting type: generalized wasting type refers to the human body weight loss due to disease or some factors, less than 10% of the standard weight is wasting (some authors believe that where the weight is more than 10% lower than the standard weight is thin, less than 20% is called wasting). 2. Palpitations with wasting and diarrhea: Hyperthyroidism in the elderly has an insidious onset and is not the same as the typical symptoms of hyperthyroidism in young people, with cardiovascular and gastrointestinal symptoms such as arrhythmia, hypertension, loss of appetite, diarrhea and wasting being the main symptoms. Therefore, if 60-year olds have palpitations, diarrhea, weight loss but good mental status, they should be alert to the onslaught of hyperthyroidism. 3, progressive wasting: Progressive wasting refers to short-term progressive, with weight loss before and after the measured weight value control, and there are obvious clothes become wider, the belt becomes loose, shoes become larger, as well as subcutaneous fat reduction, muscle thinning, skin relaxation, bone protrusion and other side evidence.