1 Prevalence and Documentation Rates of Obesity in Hospitalized Patients : Results of a 2 Retrospective Cohort Study . 3

1 Prevalence and Documentation Rates of Obesity in Hospitalized Patients: Results of a 2 Retrospective Cohort Study. 3 Mohammad A. Hossain MD1, Ami Amin MD1, Anju Paul MD1, Huzaif Qaisar MD1, Monika Akula 4 MD1, Alireza Amirpour MD1, Shreya Gor MD1, Sofi Giglio1, Jennifer Cheng DO1, Roy Mathew 5 MD2, Tushar Vachharajani MD3, Mohamed Bakr MD1, Arif Asif MD, MHCM1 6 1Department of Medicine, Jersey Shore University Medical Center, Neptune, Hackensack Meridian 7 Health, NJ 07753; mohammad.hossain@hackensackmeridian.org, ami.amin@hackensackmeridian.org, 8 anjuapaul@gmail.com, huzaif.qaisar@hackensackmeridian.org, monika.akula@hackensackmeridian.org, 9 alireza.amirpour@hackensackmeridian.org, shreya.gor@hackensackmeridian.org, sofigiglio16@gmail.com, 10 jennifers.cheng@hackensackmeridian.org, mohamed.bakr@hackensackmeridian.org, 11 arif.asif@hackensackmeridian.org, 12 2 Department of Medicine, WJB Dorn VA Medical Center, Columbia, SC; roy.mathew@va.gov. 13 3 3Division of Nephrology, Salisbury VA Health Care System, and University of NC, Chapel Hill, 14 NC, USA. tvachh@gmail.com. 15 * Correspondence: arif.asif@hackensackmeridian.org. ; Tel.: 732-776-4420 16 17 18 Abstract: While obesity is a serious chronic condition, its prevalence and documentation as a 19 diagnosis has not been extensively studied in hospitalized patients. We conducted a retrospective 20 chart review to investigate the prevalence and documentation of obesity as a diagnosis among 21 patients admitted to our medical center. IRB approval was obtained for this retrospective study. 22 Body mass index as per CDC, admission and discharge diagnosis of obesity and common 23 comorbidities including hypertension, diabetes, hyperlipidemia and others, were recorded. Length 24 of hospital stay was calculated. We also investigated whether counselling for weight loss was 25 provided to obese patients. A total of 540 consecutive patients with mean age of 66 ± 6 years, were 26 investigated, of which 182(34%) had normal weight, 188(35%) patients were overweight and 27 170(31%) patients were obese. Obese group included 55% female and 45% male. 100 (59%) had class I 28 obesity, 43(25%) had class II obesity and 27(16%) class III obesity. Of the obese patients 40/170(23.5%) 29 patients had obesity documented on the admission problem list and only 21(12%) had obesity 30 documented as a discharge diagnosis. Only 3(2%) patients received appropriate counseling and 31 referral for obesity management during the hospitalization. Comorbidities included hypertension 32 (68%), diabetes (35%), hyperlipidemia (36%), coronary artery disease (18%), chronic kidney disease 33 (17%), congestive heart failure (18%) and COPD (24%). The average length of stay in normal weight, 34 overweight and obese patients was similar (4.5 ± 0.5 days). An overwhelming percentage never had 35 weight status documented despite significant prevalence of obesity. Hospitalization offers health 36 care providers a window of opportunity to identify obesity, communicate risks and initiate weight 37 management interventions. 38