How Should Obesity be Measured and How Should Anesthetic Drug Dosage be Calculated?

Abstract

The risks involved with being overweight or obese are related to the deposition of adipose tissue (adiposity). There are several ways to assess adiposity and body composition. Current medication dosage recommendations are usually based on weight alone and are intended for normal-weight individuals of varying size. Since drug dosage is based on total body weight, the changed body composition and pathophysiological alterations in obesity are likely to affect the pharmacokinetics and pharmacodynamics of anesthetic drugs. Rather than using weight-based measures of obesity, physicians need to look for methods of assessing adiposity that predict how dysmetabolic an obese individual actual is. Anesthesiologists need to use individualized dosing scalars to take into account these changes.