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An Orthopedic Surgeon Weighs In on Weight Loss

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My sister, Leah, is 6 ½ years younger than me. She is my best friend. She is brilliant. And hilarious. And engaging. She is an author and a teacher. She is a guru of mindfulness. And for the past many years, she has been losing a battle with her weight. This morning she announced that enough was enough. She did it publicly in an article on Medium.

As a pediatric orthopedist, obesity is my enemy in many ways. When children carry extra weight, they are prone to leg deformity, slips in their hip growth plates, and worse procedural/surgical outcomes in cases of broken bones.

Adults who are overweight have a myriad of extra challenges with their bones and joints. It can be tempting to pursue medical treatment for these aches and pains in the form of pain medication, steroid injections, and even surgery. Let's face it: Weight loss is so much harder than an external fix. I need to choose every word carefully when I approach this dilemma with my patients. It can just sound just plain mean when they come to seek relief for knee pain from an orthopedist and learn that weight loss is more effective than joint replacement. When a vulnerable person wearing a hospital gown sits on a paper-sheeted exam table, I can see so much in their sad, angry, or discouraged eyes.

For every pound we gain, our knees feel it times four. When going downstairs, our knees feel each additional pound times 10. I use these facts for motivation, as knee pain more reliably decreases with weight loss than with surgery. If heart health, diabetes risk, high blood pressure, and vanity are not reasons enough, extra weight actually hurts our bodies by causing joint pain.

Still, I have not had the pleasure of watching enough people change their lives for the better by moving to a healthier weight. Last week, I had the honor of witnessing success. A young woman came to see me nine months after I reconstructed her ACL for clearance to get back to full participation in sports and activities. She had lost 80 pounds. Her mother said that she lost a small child. I saw her pride on every inch of her face. She listed so many social and physical benefits to her new body habits. I added one more: now her knee is less likely to become arthritic.

Leah and I grew up with a father who was an orthopedist. He made us accountable for our aches and pains. We did not get notes of excuse to skip the mile run in gym class. When I broke my arm at the age of eight, it took a week for him to actually believe me enough to take me in for an X-ray. Our father battled with his weight for much of his life. He exercised with abandon though, and did so even in the final months of his battle with cancer.

So, we are two sisters that are anything but passive. When Leah complains about plantar fasciitis or pain in her feet, when she complains about knee pain or breathlessness, she is quick to preface our conversation with the words, "I know it is because I need to lose weight." My sister is aware and determined. She has played around with strategies to lose weight for a years, but what I see now in her eyes and her written words is full-on determination. I will be there with her every step and pound of this journey.

Image by CuteCute / Shutterstock

Jennifer Weiss, M.D. is an orthopaedic surgeon specializing in Pediatric Orthopaedic Surgery and Sports Medicine. She actively writes and speaks on the topic of women in medicine. She is on the American Academy of Orthopaedic Surgeons Board of Directors, and she teaches communication skills to physicians throughout the Southern California Region of Kaiser Permanente. She can be contacted at and @mymomthesurgeon.

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