Obesity and Weight Loss: How it Affects Our Joints

By Dr. 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. The excess body weight leads to increased forces across the joints, as high as four to seven times the bodyweight in the knees and hips.  Obesity can lead to a lifetime of wear and tear that otherwise would not occur in a patient at optimal bodyweight.

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 the weight-bearing joints.  Symptoms may not bother some patients very much at first, but with sustained weight gain, forces involved with the mechanics of walking, sitting, and standing are altered, often leading to development of pain. A patient’s weight gain can cause more pain than they might have with the same condition, but at a normal bodyweight.

Obesity is a significant risk factor for surgical complications.  Overweight patients who may be a candidate for surgery, specifically knee or hip replacement, are at a higher risk for infections, mechanical failure of their joint replacement, and blood clots such as DVT and pulmonary embolism.  These risk factors pertain to both patients who become overweight later in life and those that have struggled with weight throughout their lifetime.

While obesity can play a major role in the development of bone and joint diseases, there are multiple factors involved.  Genetics, previous injuries, cumulative wear and tear, and obesity can all place patients at increased risks of joint degeneration.

One of the most common ailments for patients who are obese for an extended period of time, is osteoarthritis. Osteoarthritis is a disease that 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. Obese patients experience higher forces which may lead to additional damages such as dislocation of joints, torn meniscuses, and sprained ligaments.  These injuries typically 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. The loss of weight can even slow the progression of the disease. From a surgical standpoint, if a patient loses their extra body weight 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!

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