With almost three-quarters of men and 60 percent of women in the United States being obese or overweight, obesity is a prevalent issue in our society. If you or a loved one falls into this category, your doctor may have told you to hold off on surgery until you’ve lost weight. Obesity can often make surgeries more complicated for physicians and far riskier for the patient. Today, then, we’re breaking down all you need to know about the risks associated with undergoing surgery when obese and how you can safely address weight loss before surgery.

Is it normal to be told I should lose weight before I have surgery? 

Yes. Surgery puts your body through an incredible amount of physical stress. Think of it like running a marathon. The healthier you are going into your procedure, the stronger you’ll get through and recover from surgery. If your doctor is addressing weight loss before surgery with you, it’s likely because she’s worried about some serious risks. 

What does it mean to be obese? 

Obesity is a measure of someone’s height and weight (their Body Mass Index, or BMI) taken to determine their total body fat. A BMI of 30 or higher is considered obese. You can calculate your BMI here.

What risks are associated with surgery when obese?

Across the board, obesity is associated with a longer length of hospital stay and higher readmission rates. If you’re undergoing what’s considered an elective procedure—like a hip or knee replacement—your doctor might want you to hold off until you can get down to a body weight that’s healthier (and less risky) for surgery. (One study found that obesity resulted in longer, more complicated hip surgeries and higher rates of dislocating the hip in the future.) If your doctor has addressed weight loss before surgery with you, she could be worried about any of the following prominent risk factors: 

• Higher risk of heart attack
• Poor wound healing 
• Higher risk of surgical site infections
• Higher risk of urinary tract infections
• Compromised operative exposure (meaning your doctor has difficulty accessing the surgical site)
• Thromboembolism (blood clot)
• Inadvertent injury
• Impaired cardiorespiratory function

Why is surgery for the obese so risky? 

There are a number of factors that contribute to both riskier procedures and prolonged recoveries in those who undergo surgery when obese. Some common ones include:

• Breathing tubes are harder to administer
• High blood sugar leads to an increased risk of surgical site infections
• Fatty tissue doesn’t heal as well
• Added weight puts more stress on a wound after surgery

How should I approach weight loss before surgery?

The first thing to know about weight loss before surgery is that you don’t need to “get skinny”. For many, dropping just 10 percent of your body weight is a great goal. To get your body in the best shape for surgery, we recommend:

• Talk to a professional: You should always start by talking to your physician about weight loss before surgery—especially if you’re considering a specific diet. If you’re serious about dropping weight and keeping it off, we also recommend talking to a nutritionist to find an approach that’s healthy and effective for you. 
• Change your mindset: Instead of thinking of it solely as a weight-loss journey, think of it as preparing your body for a major event. Focus on eating healthy foods and replacing empty calories with nourishing ones, as opposed to just eating less. 
• Avoid crash-dieting: Fad diets might work quickly, but they’re not without their pitfalls. Crash-dieting can be extremely stressful on your body—and the last thing you want before surgery is major stress. 
• Make a point to move: A comprehensive approach to losing weight is always the best option for sustained benefits. In addition to dietary changes, look for ways you can work off calories. Find an exercise routine—even if it’s just a 20-minute walk at lunch every day—that works with your lifestyle and that you actually enjoy, rather than an activity that you absolutely dread. Make mindful decisions to move every chance you can—take the stairs, park in the farthest parking spot, stretch while you’re watching television at night, etc.