Anaesthesia and Weight
WHAT YOU NEED TO KNOW
If you’re a fat person seeking surgery, you may have been told you need to lose weight first due to “anaesthetic risks.” This guide will help you understand what the evidence actually shows about anaesthetic complications and your rights as a patient.
Understanding Anaesthetic Risk
The largest study ever conducted on anaesthetic complications (the NAP4 study in the UK) found:
- Only 0.006% of all surgeries had any anaesthetic complications
- When comparing fat and thin patients, there was no significant difference in many types of complications
- In some cases, thin patients actually had higher rates of certain complications
- Most complications were related to healthcare delivery problems, not patient size
Understanding the Real Issues
When complications did occur, the study found they were usually caused by:
- Poor planning by medical staff
- Communication failures between healthcare teams
- Lack of proper equipment
- Procedures being performed at inappropriate times or locations
- Insufficient staff expertise or training
Your Rights as a Patient
You have the right to:
- A proper pre-surgical evaluation by an anaesthetist
- Discussion of all available anaesthetic options
- Access to appropriate equipment and facilities
- Care from properly trained staff
- Clear communication about your treatment plan
What Good Care Looks Like
Proper anaesthetic care for Fat patients should include:
- A comprehensive pre-surgery assessment
- Discussion of specific anaesthetic techniques for your situation
- Multiple backup plans for airway management
- Access to appropriate equipment
- Care from experienced staff members
Common Myths vs. Facts
Myth: “Fat patients are always high-risk for anaesthesia”
Fact: Research shows no significant difference in many types of complications between fat and thin patients.
Myth: “Weight loss must come before surgery”
Fact: There is no medical evidence supporting mandatory weight loss before surgery. Most complications are actually related to healthcare delivery, not patient size.
Myth: “It’s too dangerous to operate on fat patients”
Fact: With proper planning, equipment, and expertise, surgery can be performed safely on patients of all sizes.
Advocating for Yourself
If you’re being denied surgery due to your size:
- Request a detailed explanation of specific medical concerns
- Ask about alternative anaesthetic techniques
- Request a second opinion if needed
- Remind healthcare providers that blanket policies based on weight are discriminatory
- Ask for documentation of specific medical contraindications if surgery is denied
Questions to Ask Your Healthcare Team
- What specific anaesthetic technique do you plan to use?
- What is your experience with patients my size?
- What equipment and resources are available?
- Will I have a pre-surgical consultation with the anaesthetist?
- What backup plans are in place?
Making an Informed Decision
If you’re struggling to access appropriate surgical care:
- Consider seeking a second opinion
- Contact patient advocacy organizations such as The Fat Doctor
- Document all interactions with healthcare providers
- Consider consulting with a patient advocate or legal professional if you believe you’re facing discrimination
This information, provided by Dr. Asher Larmie, is based on current scientific evidence including the findings of the fourth National Audit Project, which focused on Major Complications of Airway Management. It is intended for educational purposes and should be used in consultation with qualified healthcare providers. Every patient’s situation is unique, and individual medical advice is essential.