Obesity is a major health care dilemma. All aspects of medical care, including anesthesia, are affected by it. All physiologic systems are altered by obesity, which imparts a higher risk for complications in the perioperative period. Hypertension, diabetes, hypermetabolic syndrome, obstructive sleep apnea (OSA), reactive airway disease, and related cardiopulmonary maladies are all associated with obesity. Mask ventilation, laryngoscopy, and intubation in the obese appear to be more problematic than in the lean patient population. Obese patients may be more likely to have gastroesophageal reflux disease and thus are at higher risk for regurgitation and aspiration. Problematic mask ventilation and esophageal intubation may further exaggerate these risks.

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