What is BMI, and why is it important in the context of prosthetic surgery?

BMI (body mass index) is a measure based on a simple formula that compares body weight to height:

BMI = weight (kg) / height² (m²)

This value helps determine whether a person’s body weight falls within the healthy range. The WHO (World Health Organization) uses the following categories:

• 18.5–24.9: normal weight
• 25–29.9: overweight
• 30–34.9: Class I obesity
• 35–39.9: Class II obesity
• Over 40: Class III, severe obesity

The higher the BMI, the greater the health risk. In joint replacement surgery, overweight and obese patients have a higher risk of surgical complications, such as:

• infections,
• wound-healing problems,
• blood clot formation,
• anesthesia risks,
• loosening or accelerated wear of the implanted prosthesis.

For this reason, BMI plays a crucial role in the safety and long-term success of the surgery.

What changed in government benefits in 2025?

2025. Effective April 1, the National Hospital Directorate (OKFŐ) and the National Health Insurance Fund Administration (NEAK) introduced a new protocol:

• Patients with a BMI over 35 are not eligible to be placed on the waiting list for hip or knee prosthesis surgery.
• Those who are already on the list but exceed the weight limit may be temporarily removed from the list until they lose weight.

The decision was justified on the grounds that this would reduce surgical complications and the risks associated with the intervention.

How does this affect patients’ lives?

The new regulations could affect tens of thousands of middle-aged and elderly patients. Many of them have been living with pain and limited mobility for a long time, and joint replacement surgery would be the only lasting solution to their problems.

However, the introduction of the new conditions is causing serious difficulties:

• The Challenge of Weight Loss: Most patients awaiting a prosthesis have limited mobility, which makes it particularly difficult for them to lose weight.
• Delay: If you are unable to lose the required amount of weight in time, your surgery may be postponed by months or even years.
• Pain and a Deteriorating Quality of Life: Delaying surgery further worsens patients’ quality of life, mobility, and mental well-being.

Many people feel that this measure will push them out of the public health care system.

What can someone do if they’ve been removed from the waiting list?

• Personalized weight-loss program: A meal plan developed with the help of a dietitian that takes the patient’s limited mobility into account.
• Exercise therapy: Gentle forms of exercise supervised by a physical therapist, such as water aerobics and chair exercises.
• Psychological support: Emotional support during weight loss is crucial for many people.
• Weight loss through medication or surgery: As a last resort, weight-loss medications or bariatric surgery may be considered on the advice of a doctor.
• Regular follow-up: Your family doctor or treating physician can help you track changes in your BMI and reapply for placement on the waiting list.

Why Should You Choose a Private Hospital?

The LIV Duna Medical Center in Budapest is one of Hungary’s most modern private hospitals, providing high-quality orthopedic care to patients awaiting hip and knee replacement surgery. At the hospital, BMM’s experienced, internationally recognized surgeons perform interventions using state-of-the-art technologies—including robot-assisted surgical systems. Our goal is to provide safe, personalized, and prompt care with short wait times and comprehensive patient pathway management, thereby offering an ideal solution even for those who cannot be treated in a timely manner due to the limitations of the public healthcare system.

What can someone waiting for prosthetic surgery do today?

1. It’s a good idea to check your BMI— and if it’s over 35, start a conscious weight-loss program.
2. You should schedule a consultation with your family doctor or an orthopedic specialist —whether in the public or private sector.
3. Consider seeking care at a private hospital, especially if the pain is severe and mobility is significantly limited.
4. Moving toward your goal with awareness and patience —preparation is just as important to the success of prosthetic surgery as the intervention itself.

The role of BMI, or body mass index, in planning prosthetic surgeries is now of not only medical but also strategic importance. It is important for those affected to be aware of their options so they can make an informed decision about their own health and future—whether they choose public or private care.