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January 29, 2026

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Key takeaways:

• Patients in a lifestyle medicine program experienced reduced infection risk and less pain 90 days after TJA.
• However, patients on GLP-1s for weight loss did not experience the same health benefits.

DALLAS — Patients who participated in an intensive lifestyle medicine program before total hip and knee arthroplasty had reduced infection risk and less pain 90 days after surgery compared with those who did not participate in the program.

“This study provides the proof on concept that lifestyle medicine interventions not only helps reduce your metabolic burden, but it also translated into health mitigation risks that are sustainable that we don’t see with other methods,” 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, told Healio about results presented at the American College of Lifestyle Medicine annual conference. “Lifestyle medicine can be a great tool to use in that preoperative space.”

Change in lifestyle

Prather and colleagues retrospectively reviewed prospectively collected data from patients undergoing total hip or knee arthroplasty between March 2022 and September 2024. Patients were triaged into two groups “based on their willingness and confidence in [behavioral] change,” according to Prather.

Patients interested in behavioral change were enrolled in an intensive, interprofessional, standardized lifestyle medicine program where they identified goals to achieve prior to surgery (eg, weight loss, smoking cessation) and participated in one-on-one and group programs.

“The team members that patients chose to work with included physical therapists, exercise kinesiologists, dieticians, health coaches, counselors and smoking cessation, and we offer culinary medicine, as well,” Prather said. “They picked their team members and attended group and one-on-one sessions based on their goals and created their own pathway. No one person’s path looks the same.”

Patients who were not interested in behavioral change were enrolled in the selective track where they met with a physician and received information on lifestyle factors and how it relates to their musculoskeletal condition and health.

Prather and colleagues found that when compared at 90 days postoperatively, patients who enacted lifestyle change had a lower rate of infection and less persistent pain compared with those in the selective group. Based on these results, Prather said implementation of a lifestyle medicine program may reduce costs and improve patient outcomes after TJA.

“[These results] suggest that it’s not just the surgery we’re doing, but the environment we’re putting the prosthesis in may need to be as ideal as possible and patients’ outcomes might be better,” Prather said. “Study the host and not just the procedure.”

GLP-1 subanalysis

In a subgroup analysis that compared patients who chose to take GLP-1s for weight reduction and those who did not, Prather and colleagues found the use of GLP-1s was associated with weight loss but not the other health risk benefits.

“[Patients on GLP-1s] did not experience reduced infection and they did not experience less persistent pain. In fact, they refilled their opioids more in the first 90 days after surgery,” Prather said.

According to Prather, these results suggest that surgeons should take total metabolic burden into account in addition to weight loss. She also said patients taking GLP-1s for weight loss may need to be supported differently to reduce the risk for muscle wasting and poor bone health.

“We need to be on top of this. We’re now looking into what specific programming and support patients need if they are on a GLP-1. Should we be doing body composition on every single one of them and making sure that that stays stable?” Prather said.

For more information:

Heidi Prather, DO, wishes to be contacted through mediarelations@hss.edu.

Published by:

Sources/Disclosures

Source:

Prather H, et al. Outcomes comparisons of lifestyle medicine programs implemented to reduce surgical risks. Presented at: Lifestyle Medicine Conference; Nov. 16-19, 2025; Dallas.

** Disclosures: ** Prather reports no relevant financial disclosures.

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