The impacts of lockdown are being felt in many different ways but one of these is in weight gain among certain sectors of the population. If you are due to undergo joint replacement surgery this could have a detrimental impact on the outcomes of your surgery.
Research into lockdown weight gain
A study published in the journal Appetite in January 2021 looked at obesity, eating behaviours and physical activity during the pandemic among UK adults. The findings were based on an online survey carried out during April and May of 2020 examining quality of diet, physical activity, overeating and the impact of lockdown on physical and mental health.
A high number of respondents reported negative changes in their eating and physical activity. More than half (56%) reported snacking more frequently and having problems with controlling their food intake compared to before lockdown. This was particularly common among people with a higher BMI. A decline in mental health due to the pandemic was associated with a risk of overeating and lower physical activity. The number of UK adults experiencing a significant mental health problem is estimated to have risen by around 50% during the pandemic.
Causes
Researchers attribute these weight-related behaviours to a range of possible causes including supply chain disruption and panic buying, leading to a reduction in fresh foods. The closure of many outpatient clinics and elective operations limited access to weight management services and bariatric surgery and there were fewer opportunities for exercising with the closure of gyms and pools. Many people were fearful about going outside due to the risk of contracting Covid and people with obesity were disproportionately likely to be affected by lockdown measures such as shielding.
“Covibesity”
In the journal Obesity Medicine in September 2020, an article coined the phrase “Covibesity” to describe the behavioural, psychosocial and environmental changes leading to widespread rapid weight gain during the pandemic. Authors point to the combination of increased food shopping, take-aways and alcohol sales, as well as working from home, greater screen time and online advertising focused on children as contributory factors in what researchers describe as the “new pandemic”.
Impact of being overweight on joints
If you have a degenerative condition like osteoarthritis, being overweight or obese places additional extra pressure on damaged joints. Experts estimate that being just 10 pounds overweight adds 15-50 pounds of additional pressure to your knee joints. This makes you more likely to develop osteoarthritis and if you have the condition already it is likely to worsen it.
Fat in the body releases proteins that cause inflammation. These proteins spread throughout the body including to the joints, increasing the risk of osteoarthritis. And because being overweight is associated with being less physically active, the joints become less supple and flexible in people with a higher BMI.
Impact on surgical outcomes
Being overweight is associated with poorer surgical outcomes among patients undergoing joint replacement surgery. An article in the Annals of The Royal College of Surgeons of England looked at the impact of BMI on total hip replacement outcomes. Researchers studied nine separate papers and found that obese patients needed more intra-operative blood transfusions and experienced more blood loss and longer operations. It was a similar picture in studies into the outcome of knee replacement surgery. Researchers found that obese patients spent longer in hospital, had higher complication rates and were more likely to be discharged to a rehabilitation centre rather than being sent straight home. There is also a greater risk of wound problems, infections and ligament damage among patients who are morbidly obese (a BMI of more than 40).
If you have gained weight during lockdown, your orthopaedic surgeon may advise losing it before your joint replacement surgery. The fact that there is currently a longer wait for surgery may be a hidden blessing advantage as it provides an opportunity to follow a healthy balanced diet and lose extra pounds. We are happy to advise on the best way to lose weight and improve your outcomes prior to joint replacement surgery. Contact us for more details.
Carrothers Orthopaedics Consultations
Carrothers Orthopaedics is still here for our patients during this time. Whilst treatment options have been restricted in previous months, we are still providing online consultations via Zoom or telephone, as well as face to face as the condition necessitates.
We are here for you to talk through your symptoms, provide diagnosis with imaging modalities and discuss the full range of treatments available to you.
If you are experiencing new musculoskeletal symptoms or require support or advice about an existing condition please contact us.
