Parenteral protein-sparing modified fast in an obese adolescent with Prader-Willi syndrome

A ventilator-dependent, extremely obese adolescent patient with Prader-Willi syndrome was nutritionally managed using a parenteral, protein-sparing modified fast. A solution containing only amino acids, electrolytes, vitamins, and macro- and micro-minerals helped create a ketotic state and facilitate weaning from the ventilator. This case demonstrates an unusual strategy for achieving weight loss and the challenge to provide adequate protein intake while limiting fluid intake.