The benefits of weight loss before orthopedic surgery

If you are very overweight and your orthopedic surgeon has indicated to you that you would benefit from surgery, you may have also been told that you need to lose weight first. Studies show that a weight loss of even just 5-10% of your total body weight can significantly reduce complications and increase healthy outcomes in obese and overweight patients; along with many other non-surgical health benefits.

For people who are obese--defined as having a Body Mass Index (BMI) of 30 or higher--the risk of developing life-threatening complications during and after surgery is higher when compared to patients in the lower weight range. “Having a higher weight before orthopedic surgery increases the risk of complications, including wound infection, blood clots, heart problems, and dislocation of the joint, which can lead to the need for revision surgery,” says Dr. Azure G. AdkinsGeneral and Bariatric Surgeon at Austin Regional Clinic. “There is also a higher risk when undergoing anesthesia if you are at a higher BMI.”

The risks of joint replacement surgery in people who carry too much weight

Every surgery carries the risk of complications, but heavier people have a much higher risk of major complications after joint replacement surgery. This risk increases at a BMI of 30 and again at 40. These risks include:

  • Infection—Overweight people have a higher rate of infection near the incision site as well as deep inside the new joint. Excess fatty tissue also can increase the amount of time they spend on the operating table, which leads to an increased risk of infection.

  • Heart problems-- Surgery always puts stress on our bodies, including our hearts. Studies have shown that overweight patients undergoing total hip replacement may have a higher rate of heart problems, including heart attacks, after surgery.

  • Blood clot-- Carrying extra weight increases the risk for developing blood clots after surgery. These clots may occur in the legs (deep venous thrombosis or DVT) or in the lungs (pulmonary embolism or PE). When they occur in the lungs, these clots can be life threatening.

  • Poor wound healing—Incision sites need a healthy supply of blood and oxygen to heal after surgery. Excess fat can slow blood and oxygen from reaching the surgery site, which increases the time it takes to heal.

  • Problems with anesthesia-- Although small, there is always a very real risk when undergoing anesthesia. One condition that makes anesthesia even riskier is sleep apnea, which can cause one to temporarily stop breathing while asleep. Obese patients are much more likely to have sleep apnea than others.

  • Need for a second surgery-- Study after study has shown that whether the cause is infection, dislocation, fracture, or hardware failure, larger patients are at a higher risk for needing another surgery.

  • Less successful results--Patients with a BMI greater than 30 may have less successful results when compared to people with a BMI less than 30. These risks increase even more when your BMI reaches 40.

Your health care provider will usually be able to figure out your BMI. You can also calculate it yourself with the online BMI calculator.

Reduce risk and increase success

“Weight loss before surgery can set you up for greater success during and after the procedure by reducing the risk of complications and improving joint function after surgery,” says Dr. Adkins. “Indeed, weight loss may decrease your pain to the point where surgery is no longer needed, or can possibly be delayed for a few years.”

Weight loss help

Losing weight and keeping it off can be a challenge, but getting support can make it achievable. Working with an established program often leads to the best weight loss success. Austin Regional Clinic offers support and solutions through ARC Healthiness, a lifestyle change and weight-loss program.

ARC Healthiness offers a variety of services, to better meet your individual needs; work one-on-one with a Registered Dietician through ARC Medical Nutrition Therapy, try two types of meal replacement plans, and even bariatric surgery. ARC Healthiness services:

If you would like to book an appointment with an ARC physician, or if you would like to learn more about weight loss options through ARC Healthiness, you can do so online at or by calling 512-272-4636.

Tags: weight loss, Bariatric Surgery , BMI

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