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Timing Is Everything: What You Should Know About Weight Loss Before Hip Replacement Surgery

Jeffrey H. Miller, M.D.
Apr 22
3 min read

Updated: Aug 12

While speaking with a well-respected orthopedic surgeon about the importance of starting lymphedema treatment before orthopedic surgery, he asked an intriguing question: Could preoperative weight loss help manage lymphedema and, in turn, improve surgical outcomes?

That question sparked my curiosity, and I began digging into recent research. What I found was surprising: it's not just whether you lose weight before surgery that matters—but when you lose it.

If you’re preparing for a total hip replacement and your doctor has mentioned weight loss, you might be wondering how much it helps and when to start.

New studies, including one from the Journal of Arthroplasty, reveal that the timing of weight loss can significantly influence your recovery and risk of complications. Here's what you need to know.

A photo of a young woman measuring her waist.

Jump to a Certain Section

The Hidden Risk of Losing Weight Too Close to Surgery
Why Does Timing Matter So Much?
Is Delaying Surgery for Weight Loss Always Worth It?
So, What Should You Do?

The Hidden Risk of Losing Weight Too Close to Surgery

Many doctors recommend weight loss before surgery because a high body mass index (BMI) has been linked to complications like infections or poor wound healing.

That’s still true—but a 2024 study found that losing weight in the 3 to 9 months before surgery might actually increase your risk of complications.

In this study, people who started with a BMI between 45 and 50 and lost weight to below 35 saw more infections if the weight loss happened just a few months before surgery.

On the other hand, those who lost weight at least a year ahead of time had fewer infections and better outcomes.

Why Does Timing Matter So Much?

It may come down to how your body responds to recent weight changes.

Rapid or recent weight loss might weaken the immune system or impact how well you heal. Weight loss over a longer period allows your body to stabilize and better prepare for surgery.

In fact, constantly having a high BMI wasn't as risky as losing weight right before surgery. Patients who remained obese had elevated risk, but not as high as those who lost weight in the 3–9 month window.

Is Delaying Surgery for Weight Loss Always Worth It?

That’s a tricky question. Another study looked at patients with a BMI over 40 and found no clear benefit from losing more than 5% of their body weight before surgery.

These patients didn’t have fewer complications—and in some cases, delaying surgery to lose weight could mean more time living in pain and limited mobility without real surgical benefit.

So, What Should You Do?

If your doctor suggests losing weight before hip replacement surgery, here are a few things to consider:

Start early, ideally a year or more before surgery if possible.
Aim for slow, steady weight loss to give your body time to adjust.
Don’t rush to drop pounds right before surgery; it might do more harm than good.
Talk to your surgeon about what makes the most sense for your situation.

Everyone is different, and what works for one person might not be ideal for another. But this research suggests that strategic timing is just as important as the weight loss itself.

References

Shul C, Hameed D, Oster B, et al. (2024). The Impact of Preoperative Weight Loss Timing on Surgical Outcomes in Total Hip Arthroplasty. J Arthroplasty, 39(6), 1424-1431. doi: 10.1016/j.arth.2024.02.075.

LaValva SM, Grubel J, Ong J, et al. (2024). Is Preoperative Weight Reduction in Patients With BMI ≥ 40 Associated With Lower Complication Rates After THA? J Arthroplasty, 39(9S1), S73-S79. doi: 10.1016/j.arth.2024.06.016.

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