According to evidence, what nutrition support plan should be used for critically ill obese patients?

• A. Hypercaloric, high protein
• B. Hypocaloric, high protein
• C. Hypocaloric, low protein
• D. Eucaloric, moderate carbohydrate

Answer: (B)

In critically ill patients who are obese, the goal is to avoid overfeeding while preserving lean body mass and supporting recovery. The best approach is to provide a hypocaloric amount of calories paired with high protein. This means delivering energy at roughly 60–70% of estimated needs to prevent the complications of overfeeding, while supplying enough protein (often about 1.2–2.0 g per kg of actual body weight per day) to maintain nitrogen balance, support immune function, and aid wound healing. Overly generous calories can worsen hyperglycemia and CO2 production, while too little protein risks rapid loss of lean mass. The other plans either overprovide calories, underprovide protein, or don’t emphasize the protein needed to protect lean mass in this population.