The Critical Care Obesity Paradox and Implications for Nutrition Support

Jayshil J. Patel, Martin D. Rosenthal, Keith R. Miller, Panna Codner, Laszlo Kiraly, Robert G. Martindale

Research output: Contribution to journalReview articlepeer-review

27 Scopus citations


Obesity is a leading cause of preventable death worldwide. The prevalence of obesity has been increasing and is associated with an increased risk for other co-morbidities. In the critical care setting, nearly one third of patients are obese. Obese critically ill patients pose significant physical and on-physical challenges to providers, including optimization of nutrition therapy. Intuitively, obese patients would have worse critical care-related outcome. On the contrary, emerging data suggests that critically ill obese patients have improved outcomes, and this phenomenon has been coined “the obesity paradox.” The purposes of this review will be to outline the historical views and pathophysiology of obesity and epidemiology of obesity, describe the challenges associated with obesity in the intensive care unit setting, review critical care outcomes in the obese, define the obesity-critical care paradox, and identify the challenges and role of nutrition support in the critically ill obese patient.

Original languageEnglish (US)
Article number45
JournalCurrent gastroenterology reports
Issue number9
StatePublished - Sep 1 2016


  • Critical care
  • Enteral nutrition
  • Intensive care
  • Nutrition
  • Obesity
  • Parenteral nutrition
  • Permissive underfeeding

ASJC Scopus subject areas

  • Gastroenterology


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