Opinion: BMI as a barrier to orthopedic surgery doesn’t make sense for patient health

I am getting bent out of shape over surgeons telling patients they cannot get a knee replacement because they are above a certain BMI cutoff.

Here’s a familiar scenario: A patient with a high body weight and BMI limps down the hall to my exam room. “How have you been?” I ask. He sighs. “I still can’t get a new knee. The other doc says I have to I lose 50 pounds before I can go under the knife!” So, this guy, a former college athlete, has been told he can’t get surgery until he loses weight, but chronic pain, immobility, and stress all make it much harder to lose weight. He has been advised to see me, an endocrinologist, to find out how to reduce his weight and BMI so he is eligible for surgery. I tell him that medications approved for weight loss have the best effect when combined with regular physical activity and a healthy diet.

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