Following amputation, individuals often experience significant psychological challenges, including depression and decreased motivation to move, which often lead to a more sedentary lifestyle, weight gain, and ultimately obesity. Obesity is a risk factor for comorbidities including diabetes, heart disease, and stroke, but for patients with amputation, these risk factors take on added significance.1,2 Obesity may increase the risk of overuse injuries such as tendinitis, plantar fasciitis, and osteoarthritis, which are significant to the prosthetic prescription.3 The complications that obesity introduces to the prosthetic fitting process pose specific difficulties for the prosthetist. Excess residual-limb soft tissue results in a less secure fit because there is no firm foundation-no bony lock-for the prosthetic socket. Excess rotation and pistoning of the soft tissue results in less control over the prosthesis and poor stability. Volume management is an issue for all individuals with amputations, but amputee patients who are obese experience significant volume fluctuations resulting in poor socket fit, and, more often than not, clinics are unable to receive reimbursement from third-party payers for the number of socket replacements needed to accommodate these volume changes and properly fit the patient’s residual limb over time. There are limited component options for patients who are overweight, and these components are generally more expensive and need frequent repair.4 Finally, the patient may not be at the functional level required for device reimbursement.
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