Nutrition Support in the Obese

The epidemic in obesity has changed the demography of hospitalized populations in the USA. Nutrition support used to be aimed at the depleted (“skeleton in the closet”) patient, but now there is increasing demand to recognize and treat nutritional problems in the obese patient who cannot eat, or who has undergone gastric bypass procedures to lose weight. Micronutrient deficiencies can be hidden in the obese patient, and general management plans need to include a careful medical examination, the assessment of blood levels, and clinical manifestations of deficiency states. Bypass patients are at particular risk because of their disturbed digestive anatomy, and need specialized investigation and management as described in this chapter.