Lifestyle Medicine Cuts Infection & Pain After Joint Replacement – GLP-1s Show No Benefit

New research presented at the American College of Lifestyle Medicine annual conference in Dallas suggests a strong link between proactive lifestyle changes and improved outcomes following total hip and knee arthroplasty. Patients who participated in an intensive lifestyle medicine program before surgery experienced a lower rate of infection and less persistent pain 90 days after the procedure compared to those who did not.

Lifestyle Medicine and Surgical Outcomes

The study, conducted between March 2022 and September 2024, involved retrospectively reviewing data from patients undergoing total hip or knee arthroplasty. Patients were divided into two groups based on their willingness to embrace behavioral change. Those opting for change enrolled in a comprehensive lifestyle medicine program, setting goals like weight loss or smoking cessation and receiving individualized support from a team of healthcare professionals.

Did You Know? The lifestyle medicine program included access to physical therapists, exercise kinesiologists, dieticians, health coaches, counselors, and even culinary medicine resources.

The program was highly personalized, with patients selecting team members and creating their own pathways to achieve their goals. Those not interested in behavioral change met with a physician for information on lifestyle factors related to their condition.

According to Heidi Prather, DO, medical director of the Lifestyle Medicine Program at Hospital for Special Surgery and professor of physical medicine and rehabilitation at Weill Cornell Medicine, the results demonstrate that lifestyle interventions can mitigate surgical risks in a sustainable way.

GLP-1 Medications and Post-Surgical Recovery

A subanalysis of the data focused on patients using GLP-1 medications for weight reduction. While these medications were associated with weight loss, they did not yield the same positive effects on infection rates or pain levels as the comprehensive lifestyle program. In fact, patients taking GLP-1s reported more frequent opioid refills in the 90 days following surgery.

Expert Insight: These findings suggest that focusing solely on weight loss, even with medication, may not be sufficient to optimize surgical outcomes. A broader consideration of metabolic health and potential muscle or bone health impacts is crucial.

Dr. Prather emphasized the importance of considering a patient’s total metabolic burden, not just weight, and suggested that individuals using GLP-1s may require additional support to prevent muscle wasting and maintain bone health.

What Might Happen Next

Further research is likely to explore the specific types of support and programming needed for patients on GLP-1 medications undergoing joint replacement surgery. It’s possible that body composition assessments could become a standard part of the preoperative evaluation process for these patients. Additionally, healthcare providers may increasingly emphasize the benefits of comprehensive lifestyle medicine programs as a means of optimizing patient outcomes and potentially reducing healthcare costs associated with total joint arthroplasty.

Frequently Asked Questions

What was the timeframe for the data reviewed in this study?

Data from patients undergoing total hip or knee arthroplasty between March 2022 and September 2024 was retrospectively reviewed.

What did the lifestyle medicine program involve?

The program involved patients identifying goals (like weight loss or smoking cessation) and participating in one-on-one and group sessions with a team of healthcare professionals, including physical therapists, dieticians, and counselors.

Did patients taking GLP-1s experience the same benefits as those in the lifestyle medicine program?

No, patients taking GLP-1s for weight reduction did not experience reduced infection rates or less persistent pain, and they refilled their opioid prescriptions more frequently in the first 90 days after surgery.

As healthcare increasingly focuses on holistic patient care, how might lifestyle interventions become more integrated into surgical preparation and recovery plans?