Irregularities in metabolism associated with both increased and decreased body weight may result in pathophysiologic changes that lead to poorer outcomes in patients with burn injuries, according to findings published in the Journal of Burn Care & Research. Philip D. Tolley, MD, and colleagues examined outcomes after burn injury across the spectrum of BMI among adults with burn injuries from 2007-2015. Of 116,008 encounters, 7,243 patients with burn injuries had at least one operation for wound closure. Mortality rates were lowest in the overweight (P=0.039) and obese I cohorts (BMI, 25-29.9 and 30.0-34.9, respectively) at 2.9% and rose in both directions on the BMI continuum to 4.1% in the underweight (P=0.032) and 5.1% in the morbidly obese (class III) groups (P=0.042). Time to final wound closure was longest for the two BMI extremes. A BMI equal to or greater than 40 was associated with more ICU days, ventilator days, and renal and cardiac complications, while a BMI of than less than 18.5 correlated with more hospital days and rates of sepsis.