Why Obesity Matters in Orthopedics or Extra Weight means Extra Risk – By William P. Rix, M.D.

Posted on July 1, 2010 by NHOC Tech under Featured Articles

It’s common knowledge that obesity is a medical risk for heart disease, hypertension, and diabetes.  Did you know it directly impacts your orthopedic health as well?

One third of Americans are obese, with obesity defined as a body mass index (BMI) greater than 30 (see nhlbisupport.com to calculate yours).  Carrying this extra weight contributes significantly to developing osteoarthritis in the weight-bearing joints. Compared to normal weight patients, orthopedic surgery on obese patients is more difficult, and results in more blood loss and longer operative times.  In addition, post op complications such as wound infections, blood clots, and medical problems are significantly higher.

In major orthopedic trauma, obese patients sustain more complex fractures and have a higher mortality rate than their normal weight counterparts.  Post-op complications in this group include an increased rate of hardware failure, fracture displacement, and nonunion.

As paradoxical as it sounds, many overweight people are actually under nourished, consuming “empty calories” devoid of necessary vitamins and minerals.  This condition can lead to osteoporosis and poor wound healing.

The alarming nationwide increase in obesity in children is particularly worrisome.  These children are at risk for slipped hip growth plates, bowing of the knees, and kneecap and foot problems.  Many of these children have inadequate intake of vitamin D and calcium, so necessary for proper growth and optimal skeletal strength.  This is something you can’t make up after maturity is reached (see bestbonesforever.gov/parents).

What is the cause of this obesity epidemic?  There are as many theories out there as there are fad diets.  However, the short answer is that we overeat because we can, i.e., food is cheap and available.  Unfortunately, much of this food is processed and fast food, which is loaded with sugar, fat, and salt.  These are trigger foods that incite cravings which bypass the “I’m full” signal.  The biggest villain is sugary beverages which we consume on average of 50 gallons per person per year!

The solution to our escalating weight problem is complex, but as individuals we can take charge of our own lives and make healthful life style changes.  Focus on one unhealthy habit, master that, and then start on a second.  For instance, stop drinking soda pop, eliminate evening TV snacking, and don’t skip breakfast – our most important meal.  Start exercising.  This can be as little as 30 minutes per day, 3-5 times a week of uninterrupted walking, biking, swimming, gardening, or even housework.  Avoid the latest fad crash diet in favor of moderation.

Take control and start lowering your risk factors.  Your bones and joints will thank you and your orthopedist will be proud of you.