It’s 2015. If doctors don’t know how to operate on fat bodies. Then they shouldn’t be doctors. We have enough resources an equipment to deal with “obese” patients. There is no need for the medical community to continue fat shaming.
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.
Sources:
Palmer M, Schaffner F. Effect of weight reduction on hepatic abnormalities in overweight patients. Gastroenterology 1990; 99: 1408–13.
Albert S, Borovicka J, Thurnheer M, et al. Pre- and post-operative transaminase changes within the scope of gastric banding in morbid obesity. Schweiz Rundsch Med Prax 2001; 90: 1459–64.
Gholam PM, Kotler DP, Flancbaum LJ. Liver pathology in morbidly obese patients undergoing Roux-en-Y gastric bypass surgery. Obes Surg 2002; 12: 49–51.
Ramsey-Stewart G. Hepatic steatosis and morbid obesity. Obes Surg 1993; 3: 157–9.
Clain DJ, Lefkowitch JH. Fatty liver disease in morbid obesity. Gastroenterol Clin North Am 1987; 16: 239–52.
Marik P, Varon J. The obese patient in the ICU. Chest 1998; 113: 492–8.
Ribstein J, duCailar G, Mimran A. Combined renal effects of overweight and hypertension. Hypertension 1995; 26: 610–5.
Braekkan SK, Siegerink B, Lijfering WM, Hansen JB, Cannegieter SC, Rosendaal FR. Role of obesity in the etiology of deep vein thrombosis and pulmonary embolism: current epidemiological insights. Semin Thromb Hemost 2013
Allman-Farinelli MA. Obesity and venous thrombosis: a review. Semin Thromb Hemost 2011; 37:903-7.
This is very true. When I had open heart surgery, there were various complications as well as problems with the anesthesia because of how fat I was. Thanks be to God my surgeon was top notch. But the fact of the matter is that if I was a thinner patient, the surgery would have been far less traumatic. In fact, if I had not put on so much weight, my aortic valve would have lasted me longer. So, yeah, biological and scientific realities are at stake when you carry too much weight.
I have seen some communities on tumblr try to push a “body positive” self esteem agenda by dismissing health risks of obesity as fat bias.
Yes. You can be beautiful no matter what your body looks like.
No. You cannot always be healthy regardless of what your body looks like, and while self confidence is important, taking care of yourself and addressing health problems-including being overweight- is important.
Thanks for someone being honest and real about the risks of obesity and the medical field
