Selecting appropriate weight parameters for nutritional prescription during nutrition support: a scoping review

Nutritional Support (NS) is essential for preserving or restoring nutritional status in clinical settings. Accurate nutritional prescription depends on selecting an appropriate Body Weight (BW), yet clinical factors such as edema, ascites, inflammation, immobility, and obesity can compromise the reliability of Current Body Weight (CBW). Although multiple guidelines exist for NS implementation, there is no clear consensus on which BW should be used across different clinical conditions. To map and summarize evidence regarding the types of BW recommended for nutritional prescription in adults receiving NS. A scoping review was conducted according to PRISMA-ScR guidelines. Four databases (PubMed, Embase, Scopus, Web of Science) were searched without date or language restrictions. Eligible documents included guidelines, consensus statements, reviews, and primary studies reporting BW types used to guide caloric or protein prescriptions for adult patients receiving enteral or parenteral nutrition. Four reviewers independently screened, selected, and extracted data, resolving disagreements through discussion. A total of 16 772 papers were identified and 41 publications met the inclusion criteria. Studies were most frequently conducted in Europe and North America. Ideal body weight (IBW) was the most frequently reported BW parameter (73.2%), especially for patients with obesity, fluid overload, or limited mobility. CBW was recommended primarily for individuals with normal weight and no edema or ascites. Considerable variability exists in BW selection for nutritional prescription. Standardized, pathology-specific guidance is needed to minimize heterogeneity in clinical practice and reduce the risk of inappropriate nutrient delivery.