Alp Ikizler, MD, of Vanderbilt University Medical Center, discusses the issue of obesity in the context of chronic kidney disease (CKD) and dialysis. Dr Ikizler emphasizes the importance of understanding the causes, impacts, and development of obesity, as well as the comorbid conditions associated with it. Obesity is a global problem, being prevalent not only in Western countries but also in Africa and India. The average body mass index of patients receiving dialysis is greater than 32, qualifying them for class II obesity. Currently, there is a lack of reliable nutritional assessment tools that can be used to determine who is truly obese and who has nutritional problems.