Call to be frank in obesity under new Choosing Wisely Australia guidelines

A LEADING Australian anaesthetist is urging Ballarat patients struggling with obesity to be upfront and be confident they have the right facilities and options for treatment.

The call comes amid new recommendations, released on Monday, from the nation’s peak surgical bodies to under the Choosing Wisely Australia banner to guide doctor-patients talks. 

Ballarat is among the third-fattest region in Australia with more than 70 per cent of the population deemed overweight or obese and, according to Australian Health Policy Collaboration, more than 70 per cent of Wendouree residents are classed obese by body mass index.

Australian and New Zealand College of Anaesthetists president David A Scott said this was not an issue patients should shy away from when it comes to improving health outcomes. 

"We want to emphasise these should be empowering conversations with doctors, anaesthetists and patients – you should be asking, is this the right place for me?” Professor Scott told The Courier.

“Patients need to recognise they have the right to be upfront for their safety and best health outcomes.”

Professor Scott said it took preparation and planning, particularly in anaesthetics, to ensure the best choices were made for larger, high-risk patients. This included the right facilities and the right level of round-the-clock post-operative care.

But this could also involve options and support to control and lose weight to improve outcomes.

Professor Scott said there were severe risks involved in obese patients undergoing anaesthetic, including difficulty securing airwaves, risk of regurgitation, difficulty finding veins, affects on breathing from pain medications, and slow-healing wounds.

This was why, he said, it was important for doctors and patients to recognise anaesthetists should be part of surgery planning discussions, and that hospitals have appropriate staff and resources for larger patients, and their individual needs, in proposed surgeries.

Choosing Wisely Australia has also put anaesthetic risks of operating on the elderly in the spotlight in its latest recommendations. The combined group is also questioning necessity in the number of antibiotics prescribed and scans ordered for common ear, nose and throat conditions, especially in low-risk patients.

ANZCA, Australian Society of Otolaryngology Head and Neck Surgery and Royal Australasian College of Surgeons each made five new recommendations in discussing treatment options.

Ballarat Health Services has been contacted for comment on high-dependency obese patients.