Registered dietitians (RDs) subjectively assess muscle loss as part of the nutrition-focused physical examination (NFPE), using standardized malnutrition guidelines. Computed tomography (CT) scans provide an objective measure of skeletal muscle mass and adipose tissue, which can then be used to determine skeletal muscle loss and level of adiposity. The objective of this study was to evaluate the relationship between muscle assessment through the NFPE with muscle assessment through CT imaging, and how excess adiposity impacts this relationship. This study supports the use of the NFPE for muscle assessment, and suggests that excess adiposity may influence the accuracy of the NFPE.