(P37) Obesity and Malnutrition: A Recipe for Disaster

Introduction/Objective: The World Health Organization classifies obesity as a chronic complex disease defined by excessive fat deposits that can impair health. NIH data shows that as of 2018, 42.8% of individuals above the age of 60 were considered obese. These increasing trends in obesity are not only observable in the general public, but are also occurring within post-acute long-term care (PALTC) facilities. According to a study published in the Journal of Post-Acute and Long-Term Care Medicine (JAMDA), the prevalence of moderate-to-severe obesity has doubled in the last decade and continues to increase in Nursing Homes. Malnutrition is a medical condition often thought to be associated with only insufficient calories and lacking macronutrients and studies show that malnutrition in patients with obesity may often be overlooked. As more older adults experience obesity, malnutrition should also be considered as these conditions may coexist and can lead to severe health complications which increase morbidity and mortality.
Our intent to focus on obesity and malnutrition in PALTC is driven by the paucity of research and information regarding this topic in the medical literature. The goal of this project is to examine the prevalence of malnutrition in patients with obesity at Budd Terrace, a PALTC facility in Atlanta, GA.

Design/Methodology : We completed a retrospective chart review between 6/1/2021 to 5/31/2024 to determine the number of patients with obesity admitted or living in to Budd Terrace, and of those, how many had malnutrition.

Results: From 6/2021-5/31/2024, 61 patients with obesity were admitted or living at Budd Terrace. Of 61 patients with obesity, 37.7% (23) had class III obesity and (24) 39.3% had malnutrition. Our study results show that malnutrition is prevalent amongst patients with obesity admitted or living in our PALTC facility. In fact, a large percentage (39.3%) of obese patients had malnutrition

Conclusion/Discussion : Acknowledgment of this dichotomy might also spur changes in obesity treatment protocols. Instead of emphasizing pure calorie restriction, healthcare providers may instead consider what types of calories to restrict and what type of calories to maintain or in some cases increase. Obese patients in PALTC facilities are generally already vulnerable due to decreased mobility, multiple chronic conditions, and sometimes lack of social support. Malnutrition could further worsen the deleterious health impacts of obesity on these patients. The coexistence of obesity and malnutrition poses significant health risks for PALTC patients as research shows obesity and malnutrition individually increase morbidity and mortality. Thus, a combination of these two conditions can provoke serious complications and certainly warrants more attention and consideration, especially in the PALTC patient population.