Friday, May 16, 2008

Obesity - Dangerous To Your Health

Fat people are a danger to themselves. Health not withstanding (diabetes, hypertension, stroke, cardiac disease, arthritis, etc. are all shown to increase in patients with, um, largess) there are many more practical and truly understated reasons to remain thin:

1) radiology equipment may not be able to accomodate your size (CT or MRI scanners that can't handle the weight/ size)

2) getting any central line placed is much harder due to obliteration of normal anatomical landmarks by fat and once obtained many healthcare workers won't want to remove it even if a "potential" infection is suspected leading to possible catheter related infections

3) peripheral IV's are often obtained only through multiple, painful attempts and frequently are 22 gauge size or smaller, in the fingers or feet, lending them to being subpar for any real utilization if acutely ill

4) intubations are harder, messier, and patient's tend to decompensate faster with larger body habitus - plus bag masking is harder on someone who's chin doesn't really exist anymore

5) lumbar punctures, epidurals, spinals, etc. are much harder to obtain as, once again, normal anatomical layouts are obliterated by fat

6) beds may not be able to support you unless "special" ones are obtained which could leave you waiting in uncomfortable chairs, wheelchairs, or stretchers for prolonged periods while one is obtained

7) moving patients from stretchers to OR tables requires more personnel and once on the table you have a higher chance of falling off due to weight balance being less central

8) when incapacitated, being turned, changed, etc. is harder on the nursing staff, requiring more staff to accomplish the job, and therefore lending to potential reductions in care over time and bedsore formations

9) harder to hear heart and lung sounds - plus radiographs tend to have abnormal shadows and lines from rolls of fat which can impair diagnosis of conditions

10) many drugs are given based on ideal body weights and larger status leads to variable dosage delivery. Fat is also large storage pool for many drugs which can lead to reduced effective concentrations intially only to then have an increase as the drug stored in fat is released and joins the already circulating concentration with resultant overdosing.

Just some things to consider when the current culture tries to tell us to be "happy with yourself just as you are". Be happy, but work towards losing weight - it's best. Humans are not naturally fat.


Anonymous said...

When I got to the word "largess" I accidentally read it as "largeass" the first time. I guess it works either way.


Anonymous said...

What happens to the fat when an obese person loses the weight? Are you a support for obesity surgeries, since your speciality will keep you in the oR?

Congrats MD.

Anonymous said...

So spelling and reading are a difficulty to you...once I read the word "malevolent" as
male volent, but I was in grammar school.
Congrats MD!

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