Preoperative Evaluation and Intraoperative Care of the Obese

Abstract

Morbid obesity (MO) has been documented throughout history, even in times and cultures that had limited food supplies or excessive physical activity. Surprisingly, even in areas of the world where such limited food is available that growth stunting is found in the population, MO is seen in members of that cohort, and does not correlate with ingested calories (1). In the last 25 years, there has been an unprecedented growth in the proportion of the population above the ideal body weight. MO is the fastest-growing disease in the industrialized world with an estimated 1.7 billion affected worldwide (2,3). This disease is now surpassing undernourishment in prevalence (2). This rise is independent of age, education, ethnicity, sex, and smoking status. These changes, although most prominent in industrialized countries, are seen throughoutmost cultures and nations.With this rapid growth of obesity, sharp increases in the number of comorbid diseases have followed (4). Themost serious are neoplasia of multiple organs, diabetes, hypertension, coronary artery disease (CAD) and its sequelae, pregnancy-related problems, arthritis, and extensive social consequences (4).