February 24, 2020

Obesity and Weight Loss: How It Affects Our Joints

By Scott Grabill, DO

 

Obesity is a well-known risk factor for developing bone and joint problems. It has a cumulative effect on patients’ joints over their lifetime. Excess body weight leads to increased forces across the joints, as high as four to seven times the body weight in the knees and hips. Obesity can lead to a lifetime of wear and tear that would not occur in a patient at optimal body weight. 

Even older patients who only become obese later in life can feel the effects in their joints. If they suffer from arthritis or other musculoskeletal conditions, their symptoms become more problematic and existing pains become worse, especially in weight-bearing joints. Symptoms may not bother some patients very much at first, but with sustained weight gain, forces involved in the mechanics of walking, sitting and standing are altered, often leading to development of pain. Weight gain can cause more pain than a patient might have had with the same condition but at a normal weight. 

Obesity also is a significant risk factor for surgical complications. Overweight patients who may be a candidate for surgery, specifically knee or hip replacements, are at a higher risk for infections, mechanical failure of their joint replacement, and blood clots such as DVT and pulmonary embolism.  This is true for both patients who become overweight later in life and those who have struggled with extra pounds throughout their lifetimes. 

While there are multiple factors involved in the development of bone and joint diseases – including genetics, previous injuries, and cumulative wear and tear – obesity can play a major role. 

One of the most common ailments for patients who are obese for an extended period of time is osteoarthritis, which results in pain, swelling and loss of motion in joints due to a breakdown of cartilage. 

Other issues include nutritional abnormalities, metabolic syndromes like diabetes, and osteoporosis. These conditions lead to decreased bone density, placing patients at risk for fractures. In addition, obese patients experience higher forces that may contribute to additional damage such as joint dislocations, torn meniscuses, and sprained ligaments, which can be more severe with increased body weight. 

The good news is that weight loss can reverse many of the problems associated with obesity. When patients lose weight, they can feel better. As weight decreases, joint problems become less symptomatic and less painful. Weight loss can even slow the progression of diseases. From a surgical standpoint, if patients lose their extra pounds before surgery, they can return to a normal risk profile. 

With weight loss and proper care for their joint disease, most patients can return to a healthy lifestyle of activities they enjoy!

Dr. Grabill is a Board certified orthopaedic surgeon at Sports Medicine and Orthopaedic Center, based in Chesapeake. He specializes in knee and hip joint replacement and treatment of arthritis. www.smoc-pt.com