Nutrition in Clinical Practice Volume XX Number X Month 201X 1 –4 © 2014 American Society for Parenteral and Enteral

ncp.sagepub.com hosted at online.sagepub.com Invited Review Obesity is a complex disease state most readily characterized by the presence of excess adipose tissue and is among the most pressing worldwide public health issues of the 21st century. Worldwide, there are>500 million obese adults,1 with most of these individuals in the developed world. However, overall, obesity rates have been steadily increasing in recent years, even in second- and third-world economies.1 There are a vari-ety of methods for determining one’s level of body fat, but from the standpoint of simplicity (and hence usability in epide-miologic research), body mass index (BMI) has gained the widest acceptance. BMI is calculated by a simple formula (Table 1), and the World Health Organization1 classifies indi-viduals as obese once BMI reaches 30 kg/m2. As obesity rates increase, the impact on the healthcare system is broad, and in no setting is an understanding of the unique pathophysiology and characteristics of the obese patient more important than the realm of critical care. This article will review some of the sig-nificant features of obesity that affect management in the inten-sive care unit and some potential ways that these conditions might be managed in the future