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I’ve previously written a series about fat people and joint health, including joint pain, osteoarthritis, and resources to fight BMI-based joint surgery denials. I’ve added a new resource to the list thanks to Dr. Greg Dodell who let me know about this new study.

Before I get into this particular study, I want to offer a reminder that even if higher-weight people didn’t have the same outcomes as thin people:

1.       That wouldn’t mean that the patient’s weight is the problem. There are any number of confounding variables (including the impact of weight cycling on the patient, practitioner weight bias impacting the procedure, structural weight stigma impacting the procedure - including tools, best practices, and other medical equipment being developed for thin bodies and often to the exclusion of fat bodies - and the impact of patients trying to lose weight prior to surgery and going into the surgery undernourished.)

2.       That wouldn’t make weight loss the correct next step. First of all, because it’s highly unlikely to work and second of all because it’s possible that the weight loss attempt, even if it is successful in the short term, could negatively impact surgical outcomes as this study shows.

3.       That shouldn’t automatically be a reason for denying the surgery. The idea that fat people only deserve healthcare if they have the same outcomes as thinner people is based in weight-stigma. It also means that the ways that the healthcare system fails to support and accommodate fat people then gets taken out on fat people, then subsequently used to justify more exclusion of fat people from care. Fat people getting a surgery to reduce pain or improve quality of life is a worthy goal, even if there might be more complications or different outcomes. If there is actually a higher risk for higher-weight people (and that would require good, unbiased research to detect) then, first and foremost, we should get better at performing surgeries and after care on fat patients and, in the meantime, the risk should be communicated accurately to the patient and then the patient should be allowed to make the choice. I want to note that that would require systemic change to the way that surgeons’ performance/statistics are judged so that they aren’t encouraged to cherry pick the easiest cases and deny care to those who might be (or whom they perceive might be) at greater risk for complications.

With all of that said, let’s look at this study - Differential Impact of Body Mass Index in Hip Arthroscopy: Ob*sity Does Not Impact Outcomes., by Suri et al published in The Ochsner Journal.

This study reviewed the medical records of 459 patients who had undergone hip arthroscopy at a single facility from 2008 to 2016. They divided the patients into BMI-based weight categories of “underweight,” “normal weight,” “overweight.” and “ob*se.” (Note that the entire idea of categorizing people by BMI is

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