Nature Medicine | Spoonful of Medicine

Mysteries about drug metabolism in the obese weigh on doctors

By Alisa Opar The surgery was a success, but a question loomed after the procedure: given that the patient was obese, what was the right antibiotic dose? “The thought was, well, she’s twice as big as a normal person, so we’ll give her twice the dose,” says Aaron Cook, a clinical pharmacy specialist at the University of Kentucky in Lexington. “For that drug, levofloxacin, there’s just no information to go on, no dosage recommendation for obese patients.” The patient fared well, but such conundrums are becoming increasingly common as obesity rates rise around the globe. Just a month ago, researchers 


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