Limited mobility as a result of injury or joint disease is a significant disadvantage in your efforts to lose weight without surgery. When I walk into an exam room to meet a new patient and see a cane or walker, I recognize that my chances of helping this patient meet with success without surgery just dropped by 75% As we described earlier, a loss of mobility results in a loss of muscle and the amount of muscle on your frame is one of the most important factors in determining your body’s set point. If you are faced with a permanent deficit in your mobility, weight loss surgery is likely your only option for success. Nonetheless, there are exceptions to this rule and I’ve worked with several patients who have lost 75 lbs. or more through nutritional changes alone despite being dependent on a walker.
Those who are unfortunate enough to have lost all of their mobility and are dependent on motorized assist devices (as opposed to canes, walkers and conventional wheelchairs) are very risky surgical candidates. Great care should be exercised in the decision to pursue weight loss surgery in this group of patients. I’ve found that these patients are much more likely to suffer from surgical complications than the rest of us, and even in the face of a smooth recovery benefit much less from surgical intervention. I would strongly encourage any patient who is completely immobile to pursue an aggressive pre-surgical weight loss and physical therapy program to regain as much mobility as possible before undergoing surgery.
Many patients who suffer a temporary loss of mobility after an injury will gain a lot of weight in a short period of time. If you are able to return back to a high level of activity, this weight gain may be temporary and not require surgery. However, if the effects of the injury linger and are aggravated by your excess weight, surgery may be your best option in an effort to get out of the spiral of worsening mobility leading to increased weight leading to worsening mobility. It is critical that these patients immediately enroll in physical therapy or undergo orthopedic surgery soon after their weight loss surgery in order to restore their mobility as close to their pre-injury state as possible.