Obesity is intricately linked with multiple medical problems, knee pain, and hip pain. With more than 74% of its population considered overweight or obese, the United States is the ninth-most corpulent nation on Earth, according to the World Health Organization.

A recent study by the Centers for Disease Control and Prevention suggested that the problem is getting worse. The researchers wrote that “the waists of men, women, blacks, whites and Mexican-Americans all grew significantly from 1999 to 2012.”

The average man’s waistline expanded from 38.9 inches to 39.7 inches, while the typical woman’s measurement grew from 36.3 inches to 37.8 inches, according to the study (published in the Journal of the American Medical Association).

USA Today reported that researchers detected an increase in “abdominal obesity” in 43 percent of men and 64 percent of women. In 1999, the statistics were 37 percent of men and 55 percent of women.

The study involved 32,816 adults, including African-American women in their 30s, Mexican-American women older than 70, Mexican-American men in their 20s, African-American men in their 30s and white women in their 40s.

The Washington Post noted that “obesity calculated from body mass index, which measures body fat based on height and weight, (has) remained relatively stable.” However, BMI does not measure the distribution of weight. Patients with normal BMIs can have large waistlines, which leave them more vulnerable to cardiovascular disease.

Patients with abdominal obesity also are more likely to experience hip pain or knee pain. They have an elevated risk of osteoarthritis developing in their hips and knees, which sometimes requires joint replacement.

In a story by The Associated Press, Dr. William Dietz (an obesity expert formerly with the CDC) said: “Even though the obesity rate may be stable, fat distribution may be changing. The seemingly contradictory trends are puzzling. It could be that Americans are exercising less and getting flabby. But because fat weighs less than muscle, they are not necessarily getting heavier.”

To prevent abdominal obesity, it is necessary to adopt a healthy diet and engage in regular exercise. The body stores carbohydrates as fat, often in the lower part of the torso. Reducing carb intake is key to staying in shape.

A balanced diet consists primarily of vegetables, fruits, whole grains and lean protein. These foods contain few calories, but provide the vitamins, minerals and fiber essential to fitness. Spinach and other green, leafy veggies are the best because they deliver nutrients while burning fat.

Studies have linked sedentary behaviors, like spending too much time sitting, with a number of illnesses and diseases. Couch potatoes also are more susceptible to hip or knee osteoarthritis, which causes pain and limits mobility.

The solution is to stay active and adopt a regimen of daily exercise. Effective workouts can be as simple as walking or running in place, or on a treadmill, while watching television.

Other popular options include walking or running outside, swimming in a pool, and playing sports like tennis or golf. Cardio exercises, those that sustain an elevated heart rate for 20 minutes, burn the most fat.  If you need help addressing your knee pain or need help developing a proper exercise regimen, contact our renowned sports medicine team at San Diego Orthopedic Surgery today.



Knee pain and hip pain can be a result of osteoarthritis.  Sometimes shedding a few of the extra pounds we carry around with us can provide substantial pain relief.  In fact, some patients who have been told they may be a candidate for joint replacement find that the weight loss improves their pain to such degree that they no longer feel the need to undergo the surgical procedure.

What is obesity?

Due to modern day fast-paced daily lifestyles, many people are eating on the run, mostly snack type take away foods, resulting in growing weight problems. When a person consumes more calories than they burn, this leads to overweight and eventually obesity. Recent studies have shown that almost two thirds of Americans are overweight to some extent, and at least one third of these are actually obese.

Which  foods contribute most to overweight issues?

Food loaded with sodium, fat and with a low nutritional value, is the main culprit. Unfortunately these foods which include TV dinners, fast food such as hot dogs, burgers, and sugary drinks, are cheap and convenient for busy folk.

Why do people overeat?

There is not a “one shoe fits all” reason, although you could have some things in common with someone else.

Here are some well known reasons for overeating:

  • Boredom.
  • Depression or anxiety.
  • A rushed lifestyle which results in eating too much junk food.
  • Nibbling snacks while on the phone, in the car, in front of the computer or watching TV.
  • Poor lifestyle habits.
  • Portions which are hopelessly too large for your needs.

The risks of obesity.

Obesity is a risk factor for several diseases such as type 2 diabetes, hypertension, heart problem  issues, stroke and osteoarthritis. Carrying too much body weight can do real damage to your knees and hips, setting you up for a lot of pain.

Research has shown that when you weigh more than you should, the extra force on the knee cartilage results in knee pain, which over time, can be linked to osteoarthritis.

The same applies to the hip, where pain which seriously limits mobility, is also associated with obesity. Studies show that cartilage damage causes hip pain which may also lead to osteoarthritis. If overweight and obesity is allowed to continue unchecked, a knee replacement as well as a hip replacement, is very much on the cards.

A smart way forward.

Losing weight will cut your risk of obesity-related diseases, and definitely ease the pressure on your joints which causes knee and hip pain. Note that you may not be overweight, but still have knee pain and hip pain. If that is the case, keeping your weight down is just as important to prevent the pain from getting worse.

Embarking on a weight loss program is the smartest way forward to improve your health and take some of the stress off painful knee and hip joints.

A good dietician can help you plan healthy meals so that you consume fewer calories, and show you how to adjust your portions so that you steadily begin to lose weight (phentermine).

Make the right decision to put yourself back on the road to pain free, optimal good health.

If you have been told you would benefit from a hip replacement or knee replacement, call us to schedule an appointment to discuss your options.  Our award winning surgeons at Orthopedic Surgery San Diego will provide you individualized treatment to get you back in the game!



The medical community is never short on opinions on how to manage chronic pain. Common recommendations range from the use of anti-inflammatories such as NSAIDs, to stretches, exercises, even meditation. One effective fix that isn’t usually mentioned: weight loss. Now a new study has appeared which suggests the effects can be profound:

The study included 20 obese patients who had weight-loss surgery and 40 patients who had total knee replacement due to arthritis.

One year after their procedure, the patients who had weight-loss surgery reported significant improvements in knee pain. Their results were comparable to the patients who had a knee replacement, according to the study, which was presented Friday at the annual meeting of the American Academy of Orthopaedic Surgeons, in New Orleans.

It is yet another reminder that our knees are complex mechanical systems, and that ensuring their safe operation has as much to do with reducing loads as reducing stress. The collateral health benefits of weight loss only shore up the case, of course, and lend credence to a holistic view of sports medicine that incorporates the entire body as a single system.

Furthermore, there is growing scientific evidence that injections of PRP (platelet rich plasma) and/or stem cells into the arthritic knee provide significant pain improvement.  In fact more and more evidence seems to indicate that PRP is more effective in reducing knee pain than the highly touted hyaluronic acid (HA) injections, such as Synvisc, Hyalgan, Orthovisc, and Suppartz.

Want to learn more about knee pain or knee surgery in San Diego? Please contact my orthopedic surgery offices here today.

© 2023 Dr. Robert Afra – San Diego Orthopedic Surgery Shoulder – Knee – Elbow