“…An inverse correlation between anti-Xa levels in the first 10 hours and body weight with fixed prophylactic doses of 40 mg enoxaparin has been demonstrated, which suggests that current fixed-dose thromboprophylaxis is likely inadequate in heavier patients. 3,4 A review of observational studies suggests that with fixed dose thromboprophylaxis, VTE rates in the obese are twice that of the non-obese, with a subgroup analysis of the PREVENT trial demonstrating no benefit of standard-dose dalteparin over placebo in the morbidly obese population. 3 Randomised control trials involving bariatric surgery groups have demonstrated lower rates of VTE with higher doses of LMWH, with no associated increase in bleeding events.…”