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Career Talk: using adjusted body weight
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10/05/08 12:02 PM | Edit ReplyReply   |    using adjusted body weight
RD25
47 Posts

Registered Dietitian

Can we use adjusted body weight for calculating the energy needs of malnourished patients or do we have to use their Ideal body weight. I have a patient who weighs only 90#, and his IBW is 140. I would appreciate your help.

10/05/08 12:22 PM | Edit ReplyReply   |    RE: using adjusted body weight
missy
118 Posts

Registered Dietitian

According to some experts, when evaluating a pt's current weight, the most useful comparison would be Usual Body Weight.

Although adjusted body weight is sometimes used with obese patients but Ideal Body Weight is just not very realistic.

10/06/08 07:07 PM | Edit ReplyReply   |    RE: using adjusted body weight
faye
6 Posts

Registered Dietitian


    Posted by 12345:
    Can we use adjusted body weight for calculating the energy needs of malnourished patients or do we have to use their Ideal body weight. I have a patient who weighs only 90#, and his IBW is 140. I would appreciate your help.

10/08/08 09:37 AM | Edit ReplyReply   |    RE: using adjusted body weight
jbrd
131 Posts

Registered Dietitian


    Posted by missy:
    According to some experts, when evaluating a pt's current weight, the most useful comparison would be Usual Body Weight.

    Although adjusted body weight is sometimes used with obese patients but Ideal Body Weight is just not very realistic.


When I worked in the hospital setting this past summer, Dr. Ireton-Jones presented some information consistent with this. She suggested a lower kcal per kg for obese.

10/08/08 05:37 PM | Edit ReplyReply   |    IBW
SEMINOLERD
331 Posts

Registered Dietitian

Please do not confuse malnourished with underweight as someone can be malnourished and overweight. I use current body weight and increase kcal needs 30-35 or 35-40. If someone has not been eating (anorexia) then you want to gradually increase feeding to avoid refeeding syndrome.

10/12/08 10:56 PM | Edit ReplyReply   |    RE: using adjusted body weight
CNM02
121 Posts

Registered Dietitian


    Posted by 12345:
    Can we use adjusted body weight for calculating the energy needs of malnourished patients or do we have to use their Ideal body weight. I have a patient who weighs only 90#, and his IBW is 140. I would appreciate your help.

Generally the recommendation is to use the person's actual weight and adjust the calories. The National Kidney Foundation, though, recommends the use of an adjusted weight in the person who is below their ideal body weight. I would look at your ideal weight also because Hamwii (or the rule of thumb) is also not recommended. Look in the professionsl section of the National Kidney Foundation. It will give you information on adjusting the weight for the underweight. Whatever you choose to do needs to be done consistently by all professionals in your organization. With all patients be careful with refeeding syndrome. It affects not only those that are underweight, but also those that just have been NPO several days even if obese. It is critical that potassium, phosphorus and magnesium be checked and replaced prior to advancing support.

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