Weight

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What should I do now –  Eat less, move more, bring your weight towards normal

Being overweight or underweight increases your risk for an operation.
BMI more than 35 – Risk Factor increase is clear but the amount is uncertain

BMI less than 20 – Risk Factor increases 3-4 times

A BMI  over 35 might mean your operation is postponed

 BMI is the ratio of height to weight.  It is a simple guide to obesity and weight related health.  As a guide a healthy adult weight is a BMI between 18.5 to 25, with 25 to 30 being overweight and over 30 is obesity.
It has been shown that a high BMI (over 35) is often associated with more surgical risk (chest infections, wound infections) and more problems with successful outcomes in weight bearing joint surgery (this means hip, knee, foot and back surgery).
A low BMI (below 20) can signify poor nutrition and there are risks that this nutritional aspect means your ability to overcome the “surgical insult” and repair healing may be reduced.
Use the NHS calculator to work out your BMI, then see the specific operative guidelines depending on your result.
 

BMI Less than 20

If your BMI is less than 20  then this might indicate poor nutrition (you are not eating well), or underlying illness, but may also be normal for you. Discuss with the practice if this is the case so that action can be taken in time.

BMI 20-25

Congratulations it is likely you are of a generally healthy weight.  This should mean your surgical risk is not elevated.

BMI 25-35

This suggests you are overweight and we would recommend you aim to reduce your weight over time.  We are not aware however that this particularly causes surgical problems at this time.

BMI 36+

At this level it is likely your weight will play a part in increasing your risk during and after surgery.  Although you may not achieve a “normal” weight by the time you get to surgery it is sensible to make steps to reduce your weight and to increase your fitness.  It makes sense that every pound or kilo you can lose before surgery will improve your risks.  Short term, and longer term weight reduction will be beneficial but crash dieting and severe food restriction could lead to similar nutritional problems as seen in the people who are underweight and under-nourished i.e. poor healing.  Some conditions can be helped in themselves by weight loss (hip or knee pain, some breathing issues, back pain) and it is sometimes possible to delay or avoid surgery if this can be addressed.

What options are there

Many times people know the issue and avoid tackling it.  They often know what works for them and the run up to surgery can be a trigger to “seize the moment” and if this applies to you then please take this opportunity.

For those that appreciate help there are commercial offerings like independent slimming organisations in your area such as Slimming World, Rosemary Conley or Weight Watchers.

Bariatric surgery (“Stomach stapling” etc.) may be suitable where the problem is severe.  Sometimes this is recommended to occur before other surgery where someone is severely overweight and the risks are considered appropriate.

What is the evidence

Weight Evidence

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