Why Orthopods Should Prescribe Weight Loss

Nearly half of the U.S adult population is projected to have obesity within the next decade, but for many orthopedic physicians, this is already a reality in their practice.1 As many as 55% of patients presenting to orthopedics for total joint replacement are obese, creating a crisis of Orthobesity.2 Orthopods can intervene in this crisis if they prescribe weight loss to their patients.

Obesity is a risk factor for MSK issues

There is resounding evidence that obesity is a risk factor for a host of musculoskeletal (MSK) issues and surgery complications, including:

  • 20 times the likelihood of needing a knee replacement compared to non-overweight individuals.3
  • 15% greater chance of sustaining an MSK injury of any kind for overweight individuals and 48% greater for individuals with Class III obesity.4
  • Significantly increased risk of wound infection, pulmonary complications, deep vein thrombosis (DVT), pulmonary embolism (PE), myocardial infarction (MI) and other complications following orthopedic surgery.5

Likewise, even moderate amounts of weight loss can greatly improve patients’ MSK health and their odds of successfully recovering from surgery. Just one pound of weight loss, for example, relieves 4 pounds of pressure on the knee. This can greatly reduce stress on the joints and subsequent symptoms of pain.6

“…the preventative benefits of weight loss illustrate the importance of targeting all of your obese orthopedic patients with a prescription for weight loss. Not just those who need to lose weight in preparation for surgery.”

Why Orthopedics?

Obesity and orthopedic issues are closely linked, an association Prescribe FIT describes as Orthobesity™. This means that orthopedic physicians are already in close proximity to the problem and are well aware of the multitude of benefits weight loss can confer to their patients’ MSK health. As such, these physicians are in an ideal position to help combat Orthobesity™ directly by prescribing weight loss to their patients.

In fact, orthopods can prescribe weight loss as a conservative treatment for MSK-related issues before surgical intervention. A 2021 study found that overweight and obese people who lost over 7.5% of their body weight (e.g., 15 pounds for a 200-pound individual) were less likely to require total knee replacement relative to those who lost no weight or gained weight.7

Weight loss is also one of the top treatment recommendations by the American Academy of Orthopedic Surgeons (AAOS) for osteoarthritis of the knee.8  Given the importance of losing excess weight to improve pain, function, and surgery outcomes, orthopedists are responsible to inform their patients about the benefits of weight loss to their MSK and overall health.

Lastly, the preventative benefits of weight loss illustrate the importance of targeting all of your obese orthopedic patients with a prescription for weight loss. Not just those who need to lose weight in preparation for surgery.

What about primary care?

Obesity is linked to over 60 chronic conditions.9 Orthopedists can fill a critical gap in their obese patients’ healthcare by discussing weight loss with them in the context of their MSK health. Although patients may receive weight counseling from a primary care provider, orthopedic physicians are better equipped to educate patients on the benefits of weight loss particularly regarding their MSK health.

Additionally, the more channels for education on how excess weight impacts patients’ overall health, the more comprehensive their understanding of the benefits of prioritizing weight loss. Orthopedists can even be leaders in the fight against obesity by offering a weight loss program as an extension of their practice, discussed in more detail below.

Not only will patients benefit from a weight loss prescription, but orthopedic practice can benefit as well. First, there are several billable versions of the E66 obesity diagnosis code that can be used for reimbursement purposes.10  Second, physicians eligible for a Merit-Based Incentive Payment System (MIPS) can receive payment bonuses by providing weight-related preventative care and screening.11

How to Prescribe Weight Loss

It’s important to note that it often isn’t enough to simply offer generic advice and hope that your patients listen. In reality, patients fare much better on their weight loss journey when providers offer specific advice to their patients and check in regularly on their progress. To illustrate, one study found that patients lost an average of 7 pounds more when their provider offered specific advice to engage in a weight loss program compared to patients who only received generic advice to “lose weight” or “exercise more.”12

With the rise in popularity of remote patient monitoring (RPM), orthopedists can readily prescribe a weight loss program to their patients without excessive up-front costs or disruption to their current workflows. One such program is Prescribe FIT: a full-service remote patient monitoring and lifestyle health solution that helps patients lose weight with simple changes to nutrition, physical activity, and lifestyle. Learn more about us at

Published on October 17, 2022