Obesity, Weight Loss, and Joint Replacement Surgery

BMI is a measure of body fat based on height and weight. Typically, the higher your BMI, the more body fat you have. Your doctor will use the following calculation to determine your BMI:

For an adult, the following BMI ranges apply:

Patients with obesity are more likely to have certain diseases and health conditions that increase the risks of surgery. These include:

• Cardiovascular disease, including high blood pressure
• Type 2 diabetes
• Obstructive sleep apnea
• Metabolic syndrome—a group of health conditions that increase your risk for developing cardiovascular disease and type 2 diabetes

It is important to be in the best health possible before your surgery. If you have one of these conditions, your doctor will work with you to ensure that it is managed and under control before your procedure.

There are risks associated with every surgery. However, some risks are greater for patients with obesity.

Joint replacement will help relieve your pain and enable you to live a fuller, more active life. However, if you have obesity, you may never achieve the increased mobility and range of motion experienced by a patient of normal weight.

You may also experience more implant and prosthesis complications after surgery, including:

• Component loosening and failure
• Dislocation of the replacement joint, especially in the hip

In some cases, a second “revision” surgery may be necessary to remove failed implants and replace them with new ones.

In most cases, total hip and total knee replacement are elective procedures. For this reason, your doctor may recommend that you try nonsurgical treatments—such as medications and physical therapy—in order to delay your joint replacement surgery. This will give you time to lose weight and reduce your BMI before your procedure.

Patients who need joint replacement surgery often intend to lose weight after their procedure—when their relief from pain will enable them to be more physically active.

In reality, however, studies show that just a small percentage of patients with obesity actually lose weight after joint replacement—the majority of patients maintain the same BMI after surgery.

Rather than waiting, there is great value in establishing a healthier lifestyle now—before your joint replacement surgery. Losing weight and reducing your BMI will decrease your risk for complications and increase the likelihood of a successful surgical outcome. In some cases, it may also decrease your pain to the point where joint replacement may no longer be needed—or can be put off for a number of years.

Although reaching and staying at a healthy weight can be a long-term challenge, the payoff is significant. If you need help losing weight and lowering your BMI before joint replacement surgery, talk to your primary care doctor. He or she can recommend specific low-impact exercises and activities and help you choose a commercial weight-loss plan that fits your needs and lifestyle.