A new publication co-authored by Professor Tom Wainwright, ORI Visiting Fellow Dr Matteo Briguglio, and collaborators from Milan (Italy) challenges the conventional use of Body Mass Index (BMI) in assessing surgical risk before major orthopaedic procedures.
Published in the International Journal of Orthopaedic and Trauma Nursing, the article titled “To lose weight or to weight the loss?” explores whether BMI is the most appropriate tool to guide decisions around preoperative weight loss for patients undergoing elective orthopaedic surgery. The authors argue that BMI alone can be an imprecise measure that may unfairly delay or deny surgery to individuals who could benefit, while inadvertently not identifying others at higher risk.
Drawing on evidence from international guidelines and large registry datasets, the article outlines why BMI-based mandates for preoperative weight loss may not improve—and may even worsen—outcomes. Instead, the authors advocate for a more nuanced approach that prioritises functional health, nutritional status, and cardiorespiratory fitness over simple weight targets.
Professor Wainwright commented: “This paper contributes to an important international discussion about how we balance safety, efficiency, and equity in orthopaedic surgical pathways. It reinforces the need for multidisciplinary, individualised care models, especially as we seek to further personalise and optimise patient care.”
This work aligns with ORI’s strategic focus on evidence-based, person-centred innovations in musculoskeletal care and follows prior research into prehabilitation and nutritional related factors before and after surgery.
