In the USA, almost 74% of adults age 20 and older have chubby or obesity, and of that number almost 42% have obesity.

Not only are chubby and obesity complex and serious diseases, but clinicians and researchers are continuing to find out how they’ll impact health outcomes – from heart and musculoskeletal health to risk for disease, including cancer.

Recent research published within the journal SURGERY shows that obesity can also be related to increased risk of complications following surgery, including infection, blood clots, and kidney complications.

We want to proceed to acknowledge that chubby and obesity can have medical impacts that are not limited to heart disease and diabetes and liver failure. They can even make recovery from surgery harder, and these data can inform the conversation happening at a broader public health level addressing obesity.”

Robert Meguid, MD, MPH, researcher, professor of cardiothoracic surgery within the University of Colorado Department of Surgery

Risk after surgery

Using data drawn from the National Surgical Quality Improvement Program, Meguid and his co-researchers studied an initial data set representing greater than 5.5 million patients, 44.6% of whom had obesity. They focused on nine surgical specialties, including general, thoracic, and vascular, comparing pre-operative characteristics and post-operative outcomes inside body mass index (BMI) classes.

They found that in comparison with patients of normal weight, patients who had chubby or obesity had higher risk-adjusted odds of developing infection, kidney failure, and venous thromboembolism, or blood clots within the veins, following surgery. Patients within the obesity class III category, with a BMI of 40kg/m² or greater, also had elevated risk of unplanned hospital readmission.

“Once we began the research, we did think that increased risk can be the case,” Meguid explains. “Though, we did think we’d see increased risk for other post-operative complications beyond infection, kidney failure, and thromboembolism in each chubby and every class of obesity, but that wasn’t what we saw.”

A public health issue

In his surgical practice, Meguid has observed that extra intra-abdominal fat tissue can lengthen the duration of surgeries and make them more complicated. The information he and his colleagues analyzed showed that surgery times on average were six minutes longer for patients with obesity.

Chubby and obesity also is usually a consider patients’ immediate recovery from surgery. “It may possibly be more difficult for patients with chubby or obesity to be up and moving around after surgery,” Meguid says. “With lung surgery particularly, ambulating after surgery is a critical a part of recovery. It may possibly improve a patient’s spirits, it decreases risk of pneumonia, it might improve comfort and reduce the danger of blood clots forming, it might help the bowels get up. It is so vital that patients are capable of be up and walking after surgery, but it might be especially difficult when obesity is an element.”

Because chubby and obesity are such complex topics, and is incredibly personal and sensitive for the people living with them, a challenge for clinicians and researchers is initiating conversations in a way that’s direct without being blaming.

“As providers, we are able to generally expect to broach uncomfortable and sensitive topics,” Meguid says. “We must be straightforward in talking in regards to the body, and we must be honest with our patients. With chubby and obesity being so prevalent in our society, this is just not a difficulty that is going to be solved by one surgeon or one institution. It is a public health issue that we must be addressing at every level – local, state and national.”

Source:

University of Colorado Anschutz

Journal reference:

Madsen, H. J., et al. (2023). The association between obesity and postoperative outcomes in a broad surgical population: A 7-year American College of Surgeons National Surgical Quality Improvement evaluation. Surgery. doi.org/10.1016/j.surg.2023.02.001.