For patients with hepatitis a significant barrier to maintaining an adequate intake of kcal is

I believe the answer is loss of appetite. Patients with hepatitis often have very little appetite, which makes it hard for them to achieve adequate oral intake of nutrients. However, patients with hepatitis do not usually have problems with malabsorption, fat intolerance, or increased metabolic rate. Other symptoms of hepatitis include; fatigue, flu-like symptoms, pale stool, abdominal pain, loss of appetite, unexplained weight loss.