Malaysia Healthcare Chronicles

The Weight We Bear – Understanding Obesity’s Orthopaedic Risk


Excess body weight, a growing concern worldwide, can impact not only appearance but also lead to debilitating health issues. Obesity strains the entire body, particularly the musculoskeletal system – bones, joints, muscles, ligaments, and nerves – which work together for movement. This extra weight increases pressure on joints, potentially causing or worsening orthopaedic problems like chronic pain and osteoarthritis. Additionally, the risk of injuries rises.

Assessing Your Risk and Potential Consequences

To assess your risk, calculate your Body Mass Index (BMI), a measure of weight relative to height. Maintaining a healthy BMI minimizes stress on the body and reduces the likelihood of developing these musculoskeletal issues. Here’s a breakdown of BMI categories:

  • 25-29: Overweight
  • 30-39: Obese
  • 40-49: Morbidly Obese
  • 50+: Super Obese

By maintaining a healthy weight, you can promote musculoskeletal health and prevent a host of orthopaedic problems.

The Increased Risk of Pain

Being obese increases the risk of pain in both adolescents and adults. In the elderly, obesity doubles the risk of chronic pain. This can be from tissue like tendons and ligaments, or the worsening of existing conditions like fibromyalgia, a disorder with symptoms like fatigue, sleep, memory, and mood problems in addition to musculoskeletal pain. 

Common Orthopaedic Issues:

  • Rheumatoid Arthritis: An autoimmune disease attacking the joint lining, causing inflammation, swelling, and potential deformities. Genetics play a major role (60% link), with women more susceptible, especially after 40. Smoking and obesity are risk factors, with obesity increasing the chance by 20%. Excess weight fuels inflammation, worsening rheumatoid arthritis. Fat cells release cytokines, proteins promoting chronic inflammation – more fat, more cytokines. Currently, there’s no cure, but management focuses on pain and symptom control. Notably, some medications may be less effective (up to 50%) in obese patients.
  • Osteoarthritis: This progressive disease, the most common form of arthritis, results from cartilage breakdown protecting bones. It affects most commonly hands, knees, hips, and spine. Obesity increases the risk of developing it in hands, knees, and hips, and accelerates its progression in knees and hips. Each pound adds 4-6 pounds of pressure on knee joints, potentially wearing out cartilage and leading to total knee replacement. The need for this surgery is 8.5 times higher in obese patients (BMI 30+). While incurable, an active lifestyle and weight management can slow progression and manage pain.

A Higher Likelihood of Injury

Being obese increases your chances of getting hurt by about 48%, likely due to physical limitations. The risk of falling or tripping also rises with increasing obesity levels.

Obese individuals are more susceptible to obstructive sleep apnea, a disorder where sleepers experience pauses in breathing or shallow breaths, leading to disrupted and poor-quality sleep. Sleep apnea further increases the risk of road injuries, as sleep deprivation can cause drivers to nod off behind the wheel.

Maintaining a healthy weight can significantly lower this injury risk – a definite bonus on top of reducing your chances of chronic diseases!


  • American Academy of Orthopaedic Surgeons (
  • Arthritis Foundation (
  • Australian Institute of Health and Welfare (
  • Mayo Clinic (
  • World Health Organization (

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