Alexander and Liston coined the term ‘Obesogenic society – where people are addicted to fast foods and supermarkets and a sedentary lifestyle promoted by television and cars’ [Alexander and Liston, 2006, p. 1167]. It is an undeniable fact that the United States has an overweight and obesity problem, the prevalence has doubled since 1960, the latest statistics from the Center for Disease Control and Prevention (CDC) report obesity (body mass index (BMI)⩾30) in adult men (33.3%) and adult women (35.3%) and more than 66% of adult Americans are considered overweight [CDC (Department of Health and Human Services), 2008]. Extreme obesity has increased from 0.8% to 4.9% [Bellar et al, 2008]. Visit the CDC website at http://www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/index.htm for a very graphic slide show of the ‘fatting of America.’

The Weight Control Information Network classifies obesity as a chronic illness with an annual $117 billion cost (Weight-control Information Network (National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH)), 2007). In 2003, obesity was the second leading cause of preventable death in the United States [Garza, 2003]; it is now on the way to surpassing smoking [Abir and Bell, 2004]. But it is not just a problem in the United States; it is becoming a worldwide problem. What does this obesity epidemic mean to the PeriAnesthesia practitioner?

Consent for surgical procedures is in the public domain following the Bristol and Liverpool enquiries [Department of Health, 2001a; House of Commons, 2001]. A legal and ethical principle exists whereby consent must be obtained before commencing a physical examination, starting treatment or physical investigation, or providing care. Non-compliance with this requirement is treated most seriously and professionals who choose to do otherwise risk investigation by the relevant regulatory body and/or legal proceedings. Guidance for health and social care professionals, including students, relates specifically to physical interventions on living individuals. The following research investigated patient satisfaction with the process of declaring informed consent prior to surgery. In 2006, a retrospective descriptive survey of a random sample of 200 patients two months following surgery was conducted in a local hospital in Northern Ireland. Data analysis generated frequencies and percentages using the Statistical Package for the Social Sciences (SPSS). Results suggested that the majority of respondents expressed satisfaction with the amount of information they had received, and most preferred to receive information from a mixture of doctors and nurses. The majority wanted the same amount of information, though there was a significant number who wanted more information. The importance of ensuring the patient receives adequate information prior to surgery/procedure is imperative if the health service is to offer transparency in surgical service provision in line with government guidelines.