If you are receiving injections for weight loss and are due to have joint replacement surgery or other orthopaedic procedures, there are some important things you need to know.
What are weight loss injections?
Weight loss injections are an effective new treatment for obesity and excess weight. They are known as GLP-1 agonists because the drugs they contain mimic a hormone in your body called GLP-1 or glucagon-like peptide-1, which is released after eating. Originally developed for people with type 2 diabetes, GLP-1 slows down your digestion, lowering your appetite and making you feel fuller after eating. Because you feel less hungry, having a GLP-1 agonist injection means you eat less and, so, lose weight.
Weight loss injections are becoming increasingly popular. In the UK, it is estimated that around 1.5 million people currently use them. The most commonly available are Wegovy and Ozempic (semaglutide), Mounjaro (tirzepatide) and Saxenda (liraglutide). All are designed to be self-injected. People who meet specified criteria may be offered weight loss injections on the NHS while many others pay privately for the treatment.
It is predicted that the number of people having weight loss injections will continue to rise, so it is important to understand the implications if you are due to undergo any kind of surgical or non-surgical procedure for your joints, including joint replacement surgery, knee arthroscopy or therapeutic injections.
The impact of excess weight on joints
Carrying excess weight places a strain on joints, particularly those that are damaged or diseased due to osteoarthritis. The facts speak for themselves. For every extra pound of body weight, your knee joint is subjected to around four pounds of additional pressure when you walk, run or go upstairs. So even a few extra pounds amounts to a lot of extra pressure.
Over time, this added pressure increases wear and tear on the cartilage lining the joints which helps them to move smoothly. In addition to cartilage damage, fat tissue produces cytokines which increase inflammation in the body and can speed up joint damage. Being overweight can make it harder to lead an active lifestyle, which contributes to the further loss of movement and flexibility in the joints.
As orthopaedic surgeons we encourage people to maintain a healthy weight and exercise regularly, both for the health of their joints and also for their overall physical and mental health. Weight loss injections may play a role in this but, if you are due to have an orthopaedic procedure – including surgery and therapeutic injections – it’s important to talk to your orthopaedic surgeon to let them know about your weight loss treatment.
How weight loss injections can affect joint surgery
Safety guidance related to weight loss injections is still evolving and, so, could change in the future. These drugs slow how quickly your stomach empties and, even at lower doses, the effects can last for up to three weeks. When you are having a surgical procedure, whether it is under sedation or general anaesthetic, it is vital that your stomach is completely empty. This is because if any food or fluid remains, there is a risk that your stomach contents could enter your lungs – a process referred to as aspiration. If this occurs it can result in serious complications.
What to do if you are having weight loss injections prior to joint surgery
If you are having weight loss injections, it is essential to stop them at least three weeks before your surgery. In other words, the last injection should be given three weeks or more before the date of surgery. This will allow sufficient time for all food to leave your stomach before the procedure. This is important whether you are having a general anaesthetic or sedation as both carry a risk of aspiration.
As with all kinds of surgical and non-surgical procedures, your orthopaedic surgeon will discuss your individual risks and provide detailed instructions beforehand. If you would like more advice on managing weight loss injections prior to surgery, or information about any procedure to relieve joint pain, please contact us.
Frequently Asked Questions
Is it OK to have weight loss injections if I’m having joint surgery?
Yes, providing you follow your surgeon’s instructions to stop the injections at least three weeks before surgery.
Is carrying excess weight bad for my joints?
Being overweight places additional pressure on your joints. If you have a condition like osteoarthritis, it can increase cartilage loss.
Is exercising good for my joints if I have arthritis?
Gentle low impact exercise, such as walking, swimming or yoga, can help keep joints supple. It can support you to maintain a healthy body weight which reduces pressure on weight-bearing joints.
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