Tips for Losing Weight Before Hip Replacement

This article is part of the Ultimate Guide to Hip Pain Relief.

Carrying a significant amount of extra weight can complicate your life in many different ways. If you suffer from chronic hip pain, being overweight can also accelerate your feelings of discomfort and make it harder to find relief.

Though making the diet and lifestyle changes necessary to get to an ideal, healthy weight is always challenging, it can be easier to get to a healthier weight when you consult with a weight management physician or health coach who understands your goals and what works for you.

IBJI recently chatted with Dr. Inbar Kirson, physician with board-certification in Obesity Medicine and expert on customizing weight loss plans to help overweight patients in their journey to find pain relief, and Dr. T. Andrew Ehmke, board-certified orthopaedic surgeon with fellowship training in joint replacement. Their responses—below—have been edited and condensed for space.

Frequently Asked Questions About Obesity & Hip Pain Relief

What’s the connection between weight and hip joint health?

Dr. Kirson: Your hip is one of the main weight-bearing joints in your body. You use it for sitting, standing, walking, running, bending, and many other movements. Although your hip can handle a fair amount of wear and tear, being overweight worsens hip pain in two main ways:

• It causes increased inflammation throughout your body, contributing to more pain and swelling in your hip joint.
• It puts more pressure on your hip joint, which speeds up your hip's aging process.

Dr. Ehmke: Like any mechanical part, the more stress you put on it, the faster it will wear out. Even if you are only 10 pounds overweight, each step is an extra 50 pounds of pressure on your hip joint.

The bad news is that once the damage is done to your hip joints' cartilage, it's permanent. The good news is that by losing weight, you can take some of the pressure off your hip joint and drastically slow down any further damage, which can decrease the amount of pain you feel.

I have had hip patients who got into a weight loss program to prepare for hip replacement surgery, then—once they lost weight—they found their pain drastically decreased, and they were able to put their surgery off for quite a while.

How does losing weight affect arthritis and hip pain?

Dr. Kirson: Studies have shown that as weight increases, hip pain increases. That's why losing as little as 5% of your weight can significantly reverse inflammation and relieve hip pain.

Some studies have shown that losing even one pound will take six pounds of force off your hip and help you find hip pain relief.

How is hip replacement surgery different when a patient is overweight?

Dr. Ehmke: Being overweight impacts the actual hip replacement procedure and a patient's recovery.

• Hip surgery: Being significantly overweight can increase a patient's chances of complications during and after surgery. Since overweight patients have extra tissue on their bodies, it is more difficult to see what I am doing (think building a ship in a bottle), so I have to make a longer incision. When I need to cut into more muscle and tissue to see what I am doing, this increases how long my patient has to be under anesthesia. After their more complex surgeries, overweight patients have an increased risk of infections, blood clots, and wound healing problems.
• Patient's recovery time: As mentioned above, even the best hip surgeons often can't perform minimally invasive surgery when their patients are overweight. The longer incisions they have to make during the procedure can result in more pain, more weakness, and longer overall recovery, including potentially extended stays in the hospital before discharge and an increased chance of needing to recuperate in a nursing home. Being overweight before hip replacement surgery can also make it take longer before a patient can do basic activities—such as getting out of a chair, getting dressed, going up or down stairs—unassisted.

Patient Success Story: Learn how Sharon T. lost weight before her hip replacement surgery

How much do you have to weigh before you’re eligible for hip replacement surgery?

Dr. Ehmke: When overweight patients ask me about their ideal weight before hip replacement surgery, I discuss it with them because the answer is different for everyone.

In medicine, we often go by a patient's body mass index or BMI to determine their target weight. In most cases, I use a BMI cutoff of around 40, but ideally, I would like to see my patients under 30.

There are many BMI calculators available online to figure out the ideal weight. Weight loss is always tough, and most patients are well aware they are overweight and have struggled to lose weight many times unsuccessfully on their own.

That's why I highly recommend getting involved in a structured weight loss program, like IBJI's OrthoHealth, that includes physicians, registered dieticians, and nurses that can guide them through the process and keep them accountable. Many of my patients have successfully completed these programs and lose well over 50 pounds in preparation for surgery.

What are some recommended methods for losing weight before hip replacement surgery (and keeping it off)?

Dr. Kirson: Everyone is different. What works for one person isn't necessarily going to work for someone else. At IBJI, we know that losing weight only works when a plan is individualized, but some universal strategies are effective for most people working on weight loss before hip replacement:

• Keep a food journal. Being more mindful is helpful for anyone trying to make a change. When you write things down throughout the day, it helps you pause and think about what you are about to eat. You can also keep a journal by taking a picture of your food right before you eat. That way, if you are about to eat something you might not think is healthy for you, you naturally have time to think: "Is this what I really want and need to eat right now?" Even if 50% of the time you chose to eat it still, that's a 50% improvement.
• Focus on nutrition. Understanding what your body needs to eat to be healthy—and making sure you get that at every meal—can help you lose weight and improve your metabolic health. Our bodies need the right mix of protein, fat, vitamins, and minerals. Eat your meal in this order: protein first (often comes with the fat), vegetables next, and leave your carbs (starchy foods) for last. Your body and mind will love you for it.
• Make breakfast a priority. Breakfast is the meal you eat after fasting for 10–12 hours overnight. It doesn't have to be a particular food group, nor do you have to eat it at a specific time of day. If you usually don't eat until 11 a.m., that is fine. What's more critical is what you chose to eat. Pick foods with a fair amount of protein to start your body's engine.

Get Help Losing Weight Before Hip Surgery

OrthoHealth at IBJI

Whether you are facing hip surgery or looking for ways to find hip pain relief to avoid joint replacement, you don't have to lose weight on your own. IBJI's weight management physicians, hip surgeons and health coaches can help.

At OrthoHealth, our multidisciplinary team of physicians, nutritionists, health coaches, and physical therapists can help you make reasonable and medically-sound, sustainable lifestyle and diet changes that are proven to work.

Ready to get started? Enroll in OrthoHealth
You can discuss an OrthoHealth referral with any of your current IBJI providers. Or call our OrthoHealth intake coordinator at 847-324-3020.

Check out IBJI's additional online resources for overweight patients with hip pain who need help reaching optimal health.

Request an Appointment with a Hip Doctor →

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