Overfeeding usually results from overestimation of caloric needs. Overestimation occurs when actual body weight is used, such as in critically ill patients with significant fluid overload and in obese patients. Indirect calorimetry can be used to quantify energy requirements. Estimated dry weight should be obtained from preinjury records or family members. Adjusted lean body weight can also be calculated. Clinically, increased oxygen consumption, increased carbon dioxide production, fatty liver, suppression of leukocyte function, and increased infectious risks have been documented with overfeeding.

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