DIAGNOSING MALNUTRITION IN PATIENTS WITH OBESITY

Understanding the challenges and implications

The prevailing misconception that individuals with obesity cannot be malnourished is being challenged by nutrition specialists. Stacy Pelekhaty from the University of Maryland Medical Center highlights the issue of malnutrition not being recognized in patients with obesity, potentially leading to suboptimal care. Experts from Weill Cornell Medical Center stress the importance of screening obese patients for malnutrition, akin to those with lower BMI ranges, to improve outcomes through nutritional support interventions.

A 2022 study highlighted that malnourished individuals with obesity were less frequently diagnosed with malnutrition compared to those who were malnourished but had a normal or below-normal body mass index. In a separate 2014 study involving more than 3,200 patients, it was found that obese patients in intensive care units experienced delays in receiving nutritional support when compared to patients who were underweight, of normal weight, or slightly overweight

The issue of sarcopenic obesity — loss of lean muscle mass amidst excess fat — highlights the complex interplay between fat and muscle loss, underscoring the need for accurate nutritional assessment and strategy formulation. Guidelines suggest immediate nutritional evaluation and plan development to mitigate the increased risk of complications in individuals with higher BMI, advocating for ongoing nutritional assessments and support plans.