Let’s talk a little bit more in depth about how obesity affects surgical procedures.
In most serious, intensive surgeries, you’re probably going to be under anesthesia, right? And you’re probably going to have medications to take afterwards. Stuff like this filtered through the kidneys and liver.
Obese patients have much higher rates of renal hypertension, which affects the kidneys, and morbidly obese patients have a 90% likelihood of having abnormalities in their liver.
That all adds up to a really bad time, and drugs being filtered out of the system quicker and therefore not working as intended. And you really want your anesthesia to work right when people are cutting into you.
In addition to this, some weight-based drugs are affected by fatty tissue, and some are not, so this can cause problems in determining the proper dosage.
Obese patients are at a higher risk for deep-vein thrombosis – this is when a blood clot forms in a deep vein, like in the leg. Surgery is recognized as a risk factor for DVT, and so obese patients undergoing surgery are doubly at risk.
Finding veins in the patient is also made difficult – it’s the difference between finding the edge piece in a 1000 piece puzzle, vs finding it in a 100 piece puzzle.
It’s harder to monitor blood pressure in obese patients as well, as standard cuffs may not work due to there being too much fatty tissue between the blood vessel and the cuff.
When you’re performing surgery, you have to pull back the flesh and muscle to get to where you’re trying to operate on – the more you have to pull back, the more difficult this becomes.
This image shows how much more you’re having to work through when doing an operation on an obese person:
So no, it’s not a matter of doctors being bad at their job. Surgery by itself is a difficult and risk-laden process – adding obesity on top of that adds an uneccessary layer of additional risk and complexity.
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