[The obese patient and surgical intervention]

In obese patients the risks of morbidity and mortality is increased with high probability in surgical procedures. The secondary metabolic disturbances of obesity do not require special regimes for parenteral and enteral nutrition in most cases, since the common marked hyperinsulinemia is normalized quickly during the catabolic phase. Due to a preoperative weight reduction of approximately 10% a normalization of the disturbed metabolic parameters and impaired lung function almost can be achieved. In the stressed obese patient a hypocaloric, parenteral nutrition enriched with proteins seems useful, whereby endogenous fat deposits serve as energy donators without using lean body mass.