The Effects of Obesity on Feet and Ankles
Excess weight, and particularly obesity, can have a significant effect on diseases and conditions associated with the feet and ankles.
A 2007 study1 of over 1,400 patients at an orthopedic practice resulted in the finding that excess weight and obesity significantly increased the risk of tendinitis. There was some evidence of an increased risk of plantar fasciitis and osteoarthritis (OA) as well. Being that all three can be aggravated by increased stress (weight), the results of this study are very plausible.
The ankles are weight bearing joints and feel the effects of excess weight and obesity earlier and often more severely than other joints in our bodies. Just like the knees, even small increases in weight can cause significant discomfort or pain. Many of us take upwards of 10,000 or more steps each day, each of which place a strain on weight bearing joints around the body.
Foot and ankle problems, as well as excess weight in general, can cause changes in posture and gait, which can further pressure other areas of the musculoskeletal system including the hip and spine. It is clear that when our bodies are out of balance, multiple structures are affected. And without correction or treatment, these issues may become permanent.
As we know from more recent research, the progression of OA in the ankles may be sped up by the presence of pro-inflammatory proteins known as cytokines. These are produced by visceral fat — the “bad,” white fat that often accumulates around the abdomen. Cytokines can directly attack the joints, breaking them down and causing OA to worsen.
Foot Issues Beyond Orthopedics
Beyond orthopedic concerns of the feet and ankles, type 2 diabetes, one of the leading comorbidities associated with obesity, can cause devastating problems in the lower extremities. Diabetic neuropathy – pain associated with diabetes – is common in patients with poorly controlled or uncontrolled type 2 diabetes. Further, diabetes can lead to ulcers and eventually amputation, as a result of poor circulation due to the disease. And today, the leading cause of lower extremity amputations remains diabetes.
Longer-term, foot and ankle problems can lead to a reduction in exercise, which can, in turn, create an even greater weight issue. A vicious cycle ensues, causing more pain and dysfunction. The answer is, in large part, weight loss. However, losing weight is often easier said than done, especially over the long term. Diet and exercise is ineffective in up to 95% of patients. For some, weight loss surgery, also known as bariatric surgery, is an option to not only lose weight, but to eliminate many of the diseases associated with morbid obesity and slow the progression of OA of the ankle.
- 1Frey C, Zamora J. The effects of obesity on orthopaedic foot and ankle pathology. Foot Ankle Int. 2007;28(9):996-999. doi:10.3113/FAI.2007.0996