Obesity Treatment in Orthopaedic Surgery

According to the World Health Organization, obesity is a global health epidemic, which has nearly tripled in prevalence since 1975. Worldwide in 2016, 13% of adults 18 years and older had obesity (body mass index ≥ 30 kg/m2) and 39% were overweight (body mass index 25.0 to 29.9 kg/m2). In the United States, approximately 35% of adults have obesity and 31% are overweight. Obesity increases stress throughout the musculoskeletal system and carries a higher risk for the development of osteoarthritis and various other musculoskeletal conditions. When patients with obesity undergo orthopaedic procedures, weight loss is a critical aspect to appropriate preoperative counseling and treatment. Weight loss can improve obesity-related comorbidities such as metabolic syndrome, diabetes, cardiovascular disease, and obstructive sleep apnea, which in turn may reduce complications, minimize long-term joint stress, and improve outcomes among patients undergoing orthopaedic procedures. The effects of obesity on patients undergoing total joint arthroplasty has been previously described, with reported associations of increased risk of infection, revision, blood loss, venous thromboembolism, and overall costs. The purpose of this article was to provide orthopaedic surgeons with strategies for obesity treatment.