Nutritional support of the obese patient.

Overweight and obesity is the most common chronic disease in the United States and is associated with an increased risk for morbidity and mortality. For the hospitalized patient, the mechanical, metabolic, and inflammatory physiologic changes induced by obesity necessitate additional considerations for care. Calculation of nutritional requirements is problematic and challenging due to difficulty in measuring body composition and energy expenditure. Provision of selective hypocaloric feeding in this population may be particularly beneficial in reducing complications of hyperglycemia, fluid overload, and reduction in fat mass. Clinical care should incorporate a team approach that addresses the special nutritional and metabolic needs of this population.