Nutritional state has profound actions at all levels of the GH/IGF-I axis and growth hormone has potent effects on nutritional state. The growth promoting effects of GH on linear height in children has long been recognised and, more recently, the important action of GH in maintaining adult body composition have been appreciated. The strong anabolic actions of GH have made it a drug of abuse among athletes and, of interest, clinicians, as a potent anti-catabolic therapy. In this review we consider the effects of nutrition on the GH/IGF-I axis and then discuss its potential use as an anti-catabolic agent. We also note the recent study in critically ill patients which has been associated with a poor outcome using high dose GH therapy.