The ongoing unprecedented shift in body weight paradigms is however posing larger dramatic individual, family, socio-economic and healthcare challenges [
7]. Obesity is indeed a strong risk factor for metabolic diseases such as metabolic syndrome and type 2 diabetes as well as atherosclerosis and cardiovascular events, whose prevalence is accordingly rapidly increasing in the general population [
15‐
18]. In addition, obese individuals have higher risk of developing several chronic diseases leading to end-stage organ failure as well as higher risk of cancer and infections [
6,
9]. All of the above conditions may lead to acute complications and hospitalizations, and it is therefore all but surprising that obese patients are increasingly common in intensive care units (ICUs), where according to recent epidemiological data up to one-third of admissions may indeed involve obese individuals [
19,
20]. Most importantly, chronic and acute diseases have a general negative impact on nutritional state, and disease-related malnutrition is recognized as a relevant cause of undernutrition in all clinical settings [
21], largely through its negative impact on skeletal muscle protein-anabolic pathways and function that may be combined with variable degrees of anorexia and reduced volitional food intake [
22‐
24]. Sarcopenia, defined as reduction of skeletal muscle mass and function, is indeed common in many disease conditions, and may be associated with excess body fat in persons with obesity, thereby introducing the concept of sarcopenic obesity [
25]. Although its clinical relevance is emerging as a potential important risk factor for negative outcomes, the concept of sarcopenic obesity and, more generally, of malnutrition in obesity still needs research efforts and consensus initiatives aimed at better clarifying its definition, diagnostic criteria and treatment options [
25].