Under-Recognizing Malnutrition in Hospitalized Obese Populations: The Real Paradox

  • Kavita Sharma
  • Kris M. Mogensen
  • Malcolm K. RobinsonEmail author
Diabetes and Obesity (CB Chan, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Diabetes and Obesity


Purpose of Review

Obesity and malnutrition are frequently encountered in the hospitalized population. Although malnutrition associated with low or normal body mass index (BMI) is easily identified, malnutrition in obese patients goes frequently unrecognized as their fat mass masks underlying muscle mass deterioration. The purpose of this review is to explore if malnutrition has been studied in the obese hospitalized population and if that may be one of the reasons for the variable results in the obesity outcome data.

Recent Findings

Various studies have shown a conflicting association between obesity and outcomes in hospitalized patient population. Most prior studies used BMI alone as an indicator of obesity and although some recent studies have included body fat percentage, muscle mass, and functional status, they still showed variable outcomes. Unfortunately, there are not many studies that looked into nutrition status specifically in obese patients to study the outcomes.


Studies evaluating clinical outcomes in obese patients showed a wide range of outcomes; some showed a protective effect while others were neutral. We explored recent data about obesity, malnutrition, and outcomes, where researchers more precisely defined malnutrition and obesity to determine health outcomes.


Obesity paradox Malnutrition Body mass index (BMI) 


Compliance with Ethical Standards

Conflict of Interest

Kavita Sharma declares that she has no conflict of interest.

Kris M. Mogensen has received consulting fees for serving on the Pfizer Malnutrition Advisory Board.

Malcolm K. Robinson declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Kavita Sharma
    • 1
  • Kris M. Mogensen
    • 2
  • Malcolm K. Robinson
    • 3
    Email author
  1. 1.Department of SurgeryBrigham and Women’s Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Department of NutritionBrigham and Women’s HospitalBostonUSA
  3. 3.Department of SurgeryBrigham and Women’s Hospital, Harvard Medical SchoolBostonUSA

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