A message from Dr. Adrian Alvarez
Founding
President of ISPCOP
There is a global epidemic threatening the health of people
throughout the world. That epidemic is “Obesity”. Whereas at one
time the problems of obesity were confined to only wealthy
industrialized nations, today its prevalence is rising in both
developed and developing countries.
Obesity-related medical consequences are now even affecting the
children in those societies.
There has been an impressive and sustained quantitative and
qualitative growth of the problem in the last decades. At
present, one in five American patients has a Body Mass Index
(BMI) over 30, one in fifty has a BMI over 40 and one in 400 has
a BMI over 50.
In addition, obesity is associated with significant medical
co-morbidities, many of them causing serious, debilitating and
progressive sequelae. While these obesity-related health
problems have major implications for the individual patient,
they also have an enormous impact on the health resources of the
countries involved. Indeed, one finds that obesity causes
significant resource utilization (days in hospital) and great
perioperative morbidity and mortality. Pathophysiologic changes
induced by obesity (cardiac, respiratory, metabolic and
digestive amongst others) and frequent co-morbidities (arterial
hypertension, type II diabetes mellitus, respiratory disorders,
and so forth) are commonly responsible for these findings. All
these considerations reach the highest expression in morbid
obesity (BMI over 40), that is, obesity that if untreated,
significantly shortens the individual’s life expectancy.
The physical— and even psychological— complexity commonly
observed between the morbidly obese population sustains the
concept that these patients should not be handled by a small
number of physicians, but rather requires the collective and
collaborative participation and expertise of physicians and
scientists from diverse fields.
Many years ago, in an attempt to adequately treat the morbidly
obese patient, special operative interventions were developed
and performed. Today, “Bariatric Surgery” is considered the only
effective treatment for the morbidly obese.
Since Obesity and Morbid Obesity are present in such a high
percentage of general population, it is not unusual for any
health care provider to be confronted by these patients
undergoing either a bariatric or non-bariatric surgical
procedure. In order to rationally approach this particular and
widespread situation, the International Society for the
Perioperative Care of the Obese Patient was conceived.
The council members of the ISPCOP and I welcome you to the
ISPCOP and look forward to an exchange of information and
experiences through this website regarding the perioperative
care of the obese patient.
It is our deepest hope that, in the near future, we will witness
the much-needed improvements in this challenging field.
Dr Adrian Alvarez
Founding President ISPCOP
Department of Anesthesiology
Hospital de Clinicas “Jose de San Martin”
Buenos Aires
Argentina
