BMI should be available before counselling and written consent is obtained as surgical and anaesthetic risks rise with increasing BMI. Many gynaecological conditions will respond favourably to weight loss e.g. menstrual disorders, PCOS, subfertility, prolapse and stress incontinence. Non-surgical management of the obese patient with benign disease is often most clinically appropriate. There should be clear discussion and documentation of which medical treatment options have been offered and whether they were accepted or declined.
In situations where surgery is deemed necessary for benign disease, weight loss is desirable and should be advised. The increased risks of common intra- and post-operative complications such as bleeding, visceral damage, wound infection, thromboembolism and respiratory tract infection should also be discussed and documented.