On 2015 Feb 16, John Friesen commented:

The authors report that an atropine dose of 0.5 mg was dangerously low in this morbidly obese patient. They present evidence to support scaling the dose according to lean body weight. However, lean body weight cannot be used directly as a weight scalar: it must be increased(1) such that it is normalized to ideal body weight(2). In this way, safe adjustments can be made for drugs whose dosages scale with lean body weight.

1 Bouillon T, Shafer SL. Does size matter? Anesthesiology. 1998 Sep;89(3):557-60. Bouillon T, 1998

2 Friesen JH. Lean-scaled weight: a proposed weight scalar to calculate drug doses for obese patients. Can J Anesth. 2013 Feb;60(2):214-5. Friesen JH, 2013

On 2015 Feb 16, John Friesen commented:

The authors report that an atropine dose of 0.5 mg was dangerously low in this morbidly obese patient. They present evidence to support scaling the dose according to lean body weight. However, lean body weight cannot be used directly as a weight scalar: it must be increased(1) such that it is normalized to ideal body weight(2). In this way, safe adjustments can be made for drugs whose dosages scale with lean body weight.

1 Bouillon T, Shafer SL. Does size matter? Anesthesiology. 1998 Sep;89(3):557-60. Bouillon T, 1998

2 Friesen JH. Lean-scaled weight: a proposed weight scalar to calculate drug doses for obese patients. Can J Anesth. 2013 Feb;60(2):214-5. Friesen JH, 2013