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www.ccmjournal.org Critical Care Medicine • Volume 46 • Number 1 (Supplement) Learning Objectives: Obesity has historically been associated with detrimental outcomes in the critically ill, however its impact is not completely understood. Benzodiazepines (BZDs) are lipophilic compounds with a higher volume of distribution that necessitate larger doses in obese individuals from a pharmacokinetic perspective. Our objective was to study BZD use and outcomes of obese patients in alcohol withdrawal. Methods: A retrospective observational study was performed in the adult ICU at an academic community hospital in an urban setting between January 2014 and December 2016. All patients admitted to the ICU with a diagnosis of alcohol withdrawal were included. The groups were divided based on BMI as follows: BMI≥30 (OBESE) and BMI< 30 (NON-OBESE). Subsets were compared using cumulative BZD use, ICU length of stay (LOS), days of mechanical ventilation and hospital LOS. The total BZD dose was converted and reported in milligrams of lorazepam. The clinical outcomes were compared using t-test, Mann-Whitney U-test & Levene’s test for equality of variances. Results: Study population consisted of predominantly male, African American patients of which 33% were mechanically ventilated. 60% of patients were treated for AWS prior to implementation of symptom-triggered Clinical Institute Withdrawal Assessment for Alcohol (CIWA) BZD protocol and 40% patients were treated after implementation of the protocol. The cumulative BZD dose in OBESE group (n = 30) was 13.9mg when compared to 22.2mg in NON-OBESE group (n = 113) (pvalue=0.42). The ICU LOS was similar among the 2 groups (4.0 days vs 4.2 days, p-value=0.21). Days of mechanical ventilation was also similar among the 2 groups (1.1 days vs 1.75 days, pvalue=0.86).The hospital LOS in OBESE group was 6.4 days when compared to 5.8 days in the NON-OBESE group (p-value=0.127). Conclusions: In our study, the OBESE group did not have worse outcomes for ICU LOS, days of mechanical ventilation and hospital LOS when compared to the NON-OBESE group. We postulate that the larger amount of lipoid tissue in obese patients may actually help better distribution of BZDs, resulting in lower cumulative dosing needs in AWS.