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Musculoskeletal Disease -

-"Obesity has a significant impact on the musculoskeletal system, being associated with both degenerative and inflammatory conditions. Future research assessing the effects of obesity and weight loss as well as further elucidating the action of adipocytokines will aid in the assessment and management of this increasingly prevalent condition." [Obesity and the musculoskeletal system. Anandacoomarasamy A, Fransen M, March L. Curr Opin Rheumatol. 2009 Jan;21(1):71-7.]

Joints:

Strain on and consequent inflammation of tendons and ligaments related to weight-bearing joints (spine, hips, knees, ankles and feet) is common in obese individuals. This is a result of the strain placed on those joints by the excessive weight that they are forced to bear day in and day out, together with poor posture and poor muscle tone. These strains in time lead to stretching of ligaments and then malalignment of the joint surfaces. Arthritis (inflammation of the joint linings and degeneration of articular cartilage) develops as a result of the abnormal loads on malaligned joint surfaces. Healthy articular cartilage enables the joint to move freely and painlessly. The damage by arthritis to the joints, ligaments and tendons causes instability of the involved joint(s) and chronic pain that is aggravated by movement. Once arthritis is established, exercise becomes even more difficult, so weight increases and muscular tone deteriorates, setting up a vicious cycle.

To relieve the chronic pain and inflammation, people often take non-steroidal anti-inflammatory medications that may have significant adverse effects on the gastrointestinal tract and the kidneys, as well as other organs.

Once arthritis has reached an advanced stage, orthopaedic surgery may be the only way to relieve the chronic pain and complications of the arthritis. However, there are many risks involved in orthopaedic surgery in morbidly obese patients and there is a great risk of early failure due to the same mechanical problems that caused the arthritis in the first place.

With significant weight loss the mechanical problems may be alleviated so that joint problems may be relieved by conservative, non-surgical treatments. If orthopaedic surgery is required, significant weight loss will greatly facilitate the surgery and will increase the chances of a successful, long-term result.

Muscles:

Fibromyalgia is a chronic pain disorder characterized by widespread muscular pain and the presence of 11 of 18 specified tender areas known as trigger points. Pain commonly occurs in the neck, back, shoulders, pelvis and hands. The vast majority of the individuals affected are women. It may also involve fatigue, sleep disturbances and mood disturbances, such as depression and anxiety. The condition is episodic, with flare-ups that vary in intensity and come and go over time.

Quality of life is significantly associated with BMI in fibromyalgia syndrome. Weight loss may improve physical functioning in this disorder.

It has been reported that significant weight loss following laparoscopic Roux-en-Y gastric bypass was associated with resolution or improvement of fibromyalgia. [The effect of laparoscopic Roux-en-Y gastric bypass on fibromyalgia. Saber AA, Boros MJ, Mancl T, Elgamal MH, Song S, Wisadrattanapong T. Obes Surg. 2008 Jun;18(6):652-5.]