Weight loss is helpful prior to surgery if you plan far enough in advance. Surgery is technically more complex as obesity increases. If your BMI is greater than 40 (morbidly obese) hip resurfacing is no longer possible; even stemmed total hip replacement is challenging. Risk of postoperative complications including infection, venous thromboembolism (blood clots), fracture, and even cardiac complications is significantly increased. I will operate on even the morbidly obese, but you must understand that you are putting yourself at higher risk by going into surgery too heavy.

I recommend weight watchers, a Mediterranean diet and aerobic exercises. You must avoid all forms of sugar, artificial sweeteners and processed carbohydrates (white bread, white rice, regular pasta and potatoes), fried foods and limit animal fats. Whole grains, nuts, limited fruits and healthy plant oils such as olive oil and canola oil and small quantities of lean meat can be the basis for a healthy nutritious and extremely tasty diet.

There is now ample evidence that you actually feel more satisfied and less hungry if you eat this type of food than if you consume larger amounts of empty carbs. This not only makes it easier to loose weight, but also this diet reduces your cardiovascular risk. This food also tastes much better than typical American food once you learn how to prepare it properly. Despite their name, Olive Garden does not serve a Mediterranean diet!

Most diet pills and diet programs are unhealthy and/or are a gimmick to take your money. Body fat is essentially a biological battery that stores energy. You must burn more energy than you take in if you want to burn off the energy in the battery and loose weight. It is a simple concept. Anything else that advertisers concoct prays on peoples’ wishful thinking. There is no magic solution. The concept is simple, but achieving sustained weight loss is a difficult task that requires strong will power and usually a willingness to unlearn all the bad dietary advice we have gotten from our culture.

Over the last 50 years our industrial food industry has figured out what to do to food to want to make us subconsciously overeat and thereby increase their sales. Adding salt and sugar or artificial sweeteners to everything including vegetables and meat, makes us overeat. Highly processing all carbohydrates causes rapid breakdown and absorption in our gut after a meal resulting in high spiking blood levels of sugar followed by high insulin output by our pancreas and a sudden crash in our blood sugar levels. This not only damages our pancreas over time and causes diabetes, it makes us crave more food hours after we have just overeaten. Adding fat to food increases its taste to us especially if this is unhealthy animal fat. Trans fats are manufactured from healthy plant fats as a substitute for animal fats, but they have been found to be even unhealthier than animal fats.

Beyond weight loss, a healthy diet would avoid pesticides, genetically modified food, as well as all animals raised on an unnatural corn diet. Almost all farm-raised animals from chickens to beef to fish are now fed on corn diets that increase their ratio of omega 5 to omega 3 fats that they contain. This makes them unhealthier for us to eat. The solution for this is to eat organic food and grass fed animals and wild fish whenever possible. The cost of these foods is higher, but ultimately the health benefits to our environment and us will be immense if we can force our food industry to change.

Buy the good stuff whenever you can, eventually, as our food industry will be forced to change it is likely that prices will come down. Most people who read this can easily afford to pay even double the price for their food. But this is not necessary. Just eating out a few times less will enable most people to buy healthier ingredients to make these healthier foods for themselves. You are what you eat. Most health care dollars in the US could be saved if people ate healthy reasonable amounts, exercised regularly, didn’t smoke and drank alcohol in reasonable amounts.