On several occasions this year, we have discussed illnesses made worse by obesity and urged weight loss as part of the management of patients with gastrointestinal reflux,1 osteoarthritis2 and coronary heart disease.3 In this article, we turn to problems associated with being underweight. In a recent study, 40% of adults admitted to a UK general hospital were undernourished and in a quarter of these their undernutrition was probably severe enough to threaten life.4 Here we discuss how undernourished patients can be recognised and review ways in which undernourishment can be tackled, concentrating on gross undernutrition rather than specific deficiencies of, for instance, single vitamins or essential fatty acids.
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