Obesity, which is characterized as having a body mass index (BMI) equal to, or greater than 30, is a serious and growing epidemic worldwide. According to a study conducted by the World Health Organization (WHO) in 2014, worldwide obesity has more than doubled since 1980 with more than 600 million adults classifying as obese. The study also concluded that over 42 million children under the age of 5 were overweight or obese. The serious health risks of obesity are numerous and include heart disease, high blood pressure, diabetes, sleep disorders and even some cancers. But obese patients face a unique set of challenges when it comes to healthcare because they are nearly 12 times more likely to face complications during surgery than their normal-weight peers.
Data suggests that for obese patients, the complications of laparoscopic surgery compared with open surgery are signiﬁcantly lower, but there are still major risks involved in any surgery type. Those risks include, longer surgery times, increased blood loss and increased analgesic requirements. Poor visibility during surgery due to excessive fat is also an issue that some surgeons face when operating on an obese patient. Because the fat tissue is harder to retract, exposing the surgical target becomes much more diﬃcult. In particular, obese women undergoing abdominal hysterectomies maintain a higher risk of wound complications, surgical site infections and venous thromboembolism (blood clots), a major source of morbidity according to the American Congress of Obstetricians and Gynecologists (ACOG).
Studies show that obese people risk a myriad of post-operative complications. According to a four year long study by the University of Michigan on more than 6,000 patients, obese patients had much higher rates of complications after surgery than non-obese patients such as:
• Five times higher rate of heart attack
• Four times higher rate of peripheral nerve injury
• 1.7 times higher rate of wound infection
• 1.5 times higher rate of urinary tract infection
The study also found that the mortality rate was nearly twice as high among morbidly obese patients versus non-obese patients. Postoperative recovery times are also prolonged due to reduced blood ﬂow in fat tissue. (WebMD) .
Because of the increased risk of complications during and after surgery to obese patients, it is important that any preexisting health conditions, (hypertension, high cholesterol, GERD, diabetes, sleep apnea etc), be carefully managed by doctors before undergoing procedures. The obese patient should also be suﬃciently educated about the risks involved and steps should be taken to become as healthy as possible before surgery.
Article Sources: Severe obesity increases risks of health problems during surgery sciencedaily.com ; Obese patients create big problems for surgeons orlandosentinel.com ; Surgery decreases longterm mortality, morbidity, and health care use in morbidly obese patients www.ncbi.nim.nih.gov ; Surgery risks higher for obese webmd.com ; Gynecologic Surgery in the obese woman www.acog.org ; How does obesity affect the procedure of surgery? www.reddit.com ; Obesity and overweight www.who.int .