While the consequences of malnutrition are well accepted, the condition remains under-diagnosed and under-recognized in many populations and settings. Due to many factors, malnutrition is particularly challenging to recognize, diagnose, and treat in patients with obesity. Research suggests that patients with obesity may benefit from hypo-caloric, high protein nutrition strategies during periods of critical illness. This, along with an assumption that patients with obesity have adequate nutritional stores to support them through critical illness, contributes to under-nutrition in these patients during acute illness. Many interprofessional providers remain unfamiliar with the consequences of underfeeding the patient with obesity. Identifying malnutrition in the population presents unique challenges as physical exams may be insufficient to assess underlying musculature.

Learning Objectives

Evaluate the implications of inadequate feeding in patients with obesity.
Describe the assessment techniques for body composition evaluation in patients with obesity.
Apply approaches to diagnosing malnutrition in patients with obesity via a case study.

Topics and Faculty
Implications of Inadequate Feeding in Patients with Obesity
Carolyn Newberry, MD, Assistant Professor of Medicine; Director of GI Nutrition, Innovative Center for Health and Nutrition in Gastroenterology (ICHANGE), Weill Cornell Medical Center, New York, NY

Body Composition Assessment Tools for the Diagnosis of Malnutrition in People with Obesity
Carrie Earthman, PhD, RDN, Professor, Nutrition, Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE

Case Applications: Approaches for Diagnosing Malnutrition in Obesity
Stacy Pelekhaty, MS, RD, Senior Clinical Nutrition Specialist, Department of Clinical Nutrition, University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, Baltimore, MD

Moderator
Malcom Robinson, MD, Surgical Director, Perioperative services; Vice Chair for Clinical Operations, Department of Surgery; Director, Nutrition Support Service; Bringham and Women’s Hospital, Boston, MA