Screening and Diagnosis of Malnutrition in Individuals With Obesity: A Scoping Review of Current Methods

The global rise in obesity presents a major public health challenge, commonly associated with an increased risk of noncommunicable diseases. Paradoxically, individuals with obesity, particularly older adults and those with comorbidities, are also at risk of malnutrition. This coexistence, driven by inadequate nutritional intake, chronic inflammation, and immune dysfunction, highlights the need to understand these overlapping health risks. Obesity complicates the identification and management of malnutrition. This review examines current screening and diagnostic methods for malnutrition in individuals with obesity.

A systematic scoping review was conducted following the Joanna Briggs Institute guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Literature was searched using a comprehensive strategy across the EBSCOhost database.

From 2097 search results, 41 studies with 420,498 participants met the inclusion criteria. Three main methods for assessing malnutrition risk/nutritional status emerged: blood markers, malnutrition screening tools, and physical/etiologic assessments. The diagnostic criteria described were typically based on healthy weight reference values, lacking obesity-specific cutoff values. Only two studies introduced tools tailored to individuals with obesity: the Nutrition Health Outcomes Questionnaire and the Just a Nutritional Screening Tool.

Current malnutrition screening and diagnostic methods lack reliability, validity, and appropriate reference values for individuals with obesity. This limits their effectiveness in accurately identifying malnutrition risk in this population. Adjusting cutoff values for key indicators such as weight loss and muscle mass is vital to improve the accuracy of malnutrition diagnosis and ensure appropriate clinical management for individuals with obesity.