Orthopedic doctors and bariatric surgeons discuss the risks of excess weight and sudden weight loss without adequate nutritional supplementation
Obesity or overweight always represents a warning sign for professionals who will perform surgery on these patients, as it increases the risk of cardiovascular complications, thrombosis and can also interfere with postoperative healing. However, orthopedic doctors have questioned the effectiveness of abrupt weight loss in patients undergoing knee or hip surgery.
A recent one item published in the Journal of Arthroplasty shows that people who have lost a lot of weight in a short period of time – through diet, exercise, clinical treatment or bariatric surgery – have a higher risk of infections and hospital readmission than to patients undergoing surgery without treating obesity.
“The study showed that patients who lose a lot of weight quickly also lose important nutrients, calories and proteins during the weight loss process. It has been shown that in Class I obese people (BMI < 35) and other people overweight, significant weight loss prior to surgery can be even more problematic and lead to higher rates of complications due to pre-existing nutritional status This is why nutrient replacement during a weight loss process is so important and recommended", explains Rogério Fuchs, orthopedist specializing in knee surgery. .
Another factor identified with rapid and significant weight loss, in some cases of patients losing 100 pounds in six months, for example, is the increased risk of developing osteoporosis and weakening of the joints.
Nutritional integration
Nutrient and iron loss is part of the reality of bariatric patients treating obesity or those who have lost a lot of weight while on a restrictive diet. In these cases, continuous integration is essential to avoid complications and ensure patient well-being.
Orthopedic doctor Thiago Fuchs, a specialist in knee and hip surgery, explains that obesity is a major risk factor, but nutritional deficiency can also serve as a warning for cases of osteoarthritis and weakening of the bones.
“This condition also makes the possibility of knee or hip surgery difficult, as joints and bone quality can be compromised due to this nutrient deficit. For this reason, weight loss should always be carried out under medical and nutritional monitoring”, he warns. According to him, when a prosthesis is necessary in an obese patient, the surgeon considers clinical examinations, possible complications and evaluates with the patient the risks and benefits of weight loss before surgery.
The president of the Paraná section of the Brazilian Society of Bariatric and Metabolic Surgery (SBCBM-PR) and bariatric surgeon José Alfredo Sadowski explains that obesity causes other diseases, such as joint problems in the knees and hips due to mechanical overload. “Weight loss is essential to relieve pain and also to improve postoperative outcomes in cases requiring surgery,” says Dr. José Sadowski. However, the surgeon also points out that rapid weight loss, regardless of the method, without medical and nutritional monitoring and without adequate vitamin and protein supplementation, can lead to worse outcomes and increase the complication rate in surgeries.
Impact of obesity on the knee and hip
A new study carried out by researchers from the WHO (World Health Organization) and published in the journal Hand pointed out that more than one billion people worldwide suffer from obesity. In practice, this means approximately 1 in 8 individuals.
In Brazil alone, the number of people suffering from obesity has increased by 72% in the last thirteen years Abeso (Brazilian Association for the Study of Obesity and Metabolic Syndrome).
The new study concluded that the global prevalence of obesity more than doubled among adults over age 20. In 2021, more than 43% were overweight. Among children and adolescents (5 to 19 years old), the incidence quadrupled.
In addition to comorbidities such as diabetes, blood pressure, cardiovascular problems and sleep apnea, obesity also has a strong impact on the knee and hip joints. “Overweight increases the load on the knee and hip and favors the appearance of arthrosis, lesions and wear of the cartilage. When conventional treatment does not bring improvements or does not relieve the patient’s pain, knee replacement surgery may be resorted to or hip”, concludes Thiago Fuchs.
Website: https://institutofuchs.com.br/
Source: Terra
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