Perioperative management of the obese surgical patient

Introduction: The escalation in the prevalence of obesity throughout the world has led to an upsurge in the number of obese surgical patients to whom perioperative care needs to be delivered. Sources of data: After determining the scope of the review, the authors used PubMed with select phrases encompassing the words in the scope. Both preclinical and clinical reports were considered. Areas of agreement: There were no controversies regarding preoperative management and the intraoperative care of the obese surgical patient. Areas of controversy: Is there a healthy obese state that gives rise to the obesity paradox regarding postoperative complications? Growing points: This review considers how to prepare for and manage the obese surgical patient through the entire spectrum, from preoperative assessment to possible postoperative intensive care. Areas timely for developing research: What results in an obese patient developing 'unhealthy' obesity?