Weight loss and sarcopenia are common in some rheumatological conditions. In many of these conditions the prevalence of malnutrition is not recorded. The causes of malnutrition are multi-factorial including factors such as disease activity, hand function and psychosocial factors. Specifically in systemic sclerosis, malnutrition does not correlate well with gastrointestinal involvement which therefore should not be relied upon to signpost who should be screened. Assessment of nutritional status can include patient reported data, food diaries, physician assessment and anthropometric measurements. Body mass index should not be relied upon in isolation since it may mask underlying muscle wasting. When malnutrition is detected, a multidisciplinary approach should be taken to optimise all areas which may be adversely affecting nutrition including psychological assessment and treatment. If feeding is required this should follow a stepwise approach of oral supplements (least invasive), then use of enteral feeding routes (which may be pre- or post-pyloric), with parenteral (intravenous) feeding as a last resort due to associated complications. Further work is needed to confirm the prevalence of malnutrition in these patient groups and evidence of intervention benefits to drive service development and improve patient care.