This ad for moisturizer suggests you use their body creme ” for sexy knees”.

One of the things I am constantly told as a fat person is that for fat people, knee pain is inevitable.  And in fact, I am told, I can expect a lifetime of “bad knees”.  Now, given my somewhat skewed view of the universe, rather than scaring me silly, the threat of “bad knees” usually make me think of an image like the one in the body cream ad above, or this silly image below:

BadKneesBut putting the silly pictures aside for a moment, I am an athlete who has had some problems with knee and leg pain my entire life.  I have been lucky enough to have some doctors who are great, but have also run into the all-too-common problem of fat-phobic doctors diagnosing me with having knees while fat.

My feet and leg problems started at birth.  When I was very young, and quite skinny, I was severely pigeon-toed.  As a result, I wore a brace with bars connecting my feet to bed every night.  It looked sort of like this:

footbraceNow I wore this brace to bed back when I was too young to untie and tie my own shoes.  I’m fairly sure that the need to get in and out of bed to go potty while wearing these things has shaped my sardonic view of the world, but I digress.

When I was in high school, and I was going through one of my thin periods, I ran track.  I ran the mile and the 2 mile races (mostly because nobody else wanted to…).  When I first started running, I had severe problems with shin splints.  Because I was thin, nobody thought that the solution was simply to tell me to lose weight.  We tried a variety of things including elaborate taping, different icing regimens and a lot of aspirins before somebody figured out that I just needed tennis shoes with a different sort of arch support.  For an investment of $25 the problem was solved.

Later in life, I suffered a few injuries.  I had a fairly severe meniscus tear in my knee as a result of leaping onto a pile of mats to adjust some audio equipment at the gym.  I also tore a ligament in my foot because I tripped on the front of my sandal and landed wrong.  Each of those injuries netted me a month or two on crutches.

So when I got midway through my most recent jaunt of marathon training, it’s not surprising that I found myself coping with some knee pain.  Luckily I had a great GP at the time who referred me to a sports medicine doctor.  He confirmed that I had a whole lot going on in the lower-extremities department.  He noted the flat feet (that I’ve had since birth) the fact that my feet pronate (also had since birth) and prescribed some custom shoe inserts and a few specific exercises I could do to strengthen my knee joint.  Problem solved.  Marathon finished.  Cheap medal and sweaty finish line photos earned.  And even though I was about the same weight then that I am now, neither my GP or my sports medicine guy gave me any flack about my weight.

444pmI didn’t realize then just how lucky I was.

Since then, I have moved and changed insurance and have had other doctors.  These doctors were not so great actually.  One of them asked about knee pain (I didn’t bring it up).  And I said, that yes, sometimes after a tough workout, my knees will be a little sore.  “Aha!” the doctor cried. “This is proof positive you need to lose weight.  If you lose weight, your knee pain will go away.  If you stay this weight your knees will hurt all the time!”


The fact that my knees function at all, given the foot problems I was born with as well as the athletic injuries I’ve suffered is pretty amazing.  And at no point, did this doctor ask about any medical history regarding my feet, shoes, injuries, sports activities or anything else.  He simply predicted that I would be in pain as long as I was fat and that the remedy was simply to lose weight and keep it off.

Never mind that I didn’t come in there asking about knee pain.

Never mind that there is no method, and I mean NONE that is proven to be successful for long-term weight loss in most people and that even if I was one of the 5-10 percent of people who are able to lose weight and keep it off, there is no guarantee that it will do anything at all to relieve knee pain.

Never mind that there are successful methods of coping with knee pain that are widely considered effective for people of all sizes and that these methods have nothing to do with losing weight.

Nope, once this doctor diagnoses you with fat knees, the treatment is a single piece of paper with a diet on it.  According to Doctor Know-It-All, the way to fix your knee problems is, Breakfast: One egg (boiled), one piece of wheat toast (dry), one cup of coffee (black) and 4oz. orange juice, etc…

And my story is so mild compared to the other stories that I hear from folks about this subject.  People who are suffering from knee pain and told that all they have to do is lose weight and their knee pain will go away.  And they are told that their doctor won’t bother to try any other treatment for knee pain until after they lose weight.

It’s lazy and it’s unethical.

If you are coping with knee pain, there are some things you can do.  Very often, knee pain can be improved by correcting underlying muscle imbalances.  You can get help from a physical therapist or sports medicine specialist.  You can supplement this therapy with simple at-home exercises like those offered by my colleague Cinder Ernst.  Also, you may need to see a foot doctor to get custom inserts made for your shoes.  Sometimes simply switching to a good sturdy shoe with good arch support can make all the difference.

You may also find help, as I did from somebody who teaches Alexander Technique and can help you figure out what you are doing in your every day life that exacerbates your knee pain.

Exercise can really help folks coping with knee pain, but it’s important to do it the right way.  Make sure you get the help of an exercise instructor or personal trainer to make sure that you are working out in a way that strengthens and doesn’t threaten your knee joints.  I offer a few simple tips in this video.

Not all fat people have knee pain.  Not all thin people are free from knee pain.  But whatever your size, there are things you can do to protect your knees and help you cope with knee pain should it arise.  Make sure you get the help you need, and don’t let anybody scare, threaten or intimidate you by diagnosing you with having knees while fat.


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12 Comments. Leave new

  • I’m finally seeing a doctor who is actually treating my joint pain and didn’t mention my death fat at all. It is like a gift from heaven, which is pretty sad.
    I have pain in all of my joints because I have IBD related arthritis. I refuse to believe that the weight of my fingers makes my knuckles hurt, etc., as some previous doctors have suggested.

  • I love the “Bad Knees” pics!

    I was first told that I needed a knee replacement back in the 1970’s, when I was seriously UNDERweight (5’5″ and 98 lbs.) A wise doc told me to wait, that the procedure would improve, and so I didn’t get the replacement. The diagnosis was a gift, though, because now that I’m a fat middle aged woman docs are only too happy to tell me that it’s all about my weight.

    They look at me like I’m lying when I tell them it has nothing to do with my fat – it started with patellas that have tilted outwards since I was born, and flat feet, and some of those creepy baby braces you pictured (so sorry you had to wear those.) But because I was diagnosed with Bad Knees young and thin, I can remind myself my knees are not something I have “done to myself” and I don’t need to be ashamed of myself on account of them.

    Now I’m 58, fat, and I have Very Bad Knees. No doc I have found will touch them, though, because they are the Dreaded Fat Knees, etc. etc. But at least I can be angry instead of feeling ashamed and guilty, and I gather that at least THAT is healthier.

    • Hiya Rabbiadar! So sorry you’re having trouble with your knees and your doctors. As far as finding a doc that will help you, I would encourage you to keep at it. I have heard a lot of stories of fat people finding the right knee doctor after a lot of searching. The right doc is out there for you somewhere. Wishing you good luck and good health!

  • Can I petition for a language change – instead of bad knees, can they hereafter be known as “naughty knees”? Seriously, great post and thanks for pointing out the extreme laziness that so often passes for medicine!


  • I could write a book about the difference in medical care for fat and thin people. As a heavy kid, my knee problems started at age 10, and didn’t finally get diagnosed as anything but “fat knee” until I was 16, at which point I had surgery to correct the physical abnormality that had already led to arthritic changes in that knee. Fast forward 8 years from that, when I had actually succeeded at losing weight and keeping it off, and was about a size 8…started having pain again and from first appointment to surgery took a total of 2 months. And no one felt the need to give me diet advice or offer to test me for diabetes that I had zero symptoms of.

    I am actually still keeping the weight off (and believe me, its near superhuman to do so, and probably involves hitting a genetic lotto as well) and dealing with another knee injury, and every time I go to the doctor and get heard instead of dismissed, I think of all the folks that, because of their weight, don’t get their problems addressed.

  • This is a brilliant and compassionate post. I imagine I wasn’t the only one who imagined herself printing it out and taking it to her doc. Thanks, TFC! 

  • […] Thornton interviews the always awesome Mary Lambert about body image, makeup, and fashion. -Fat and bad knees. -So much yes to Marilyn Wann’s rant about people who claim to be fat-positive but brag about […]

  • I know this is an older post, but THANK YOU!

    I am currently quite overweight but wasn’t always. I was never skinny, but I used to be a normal size. I actually injured my knee playing soccer which I have played my whole life until the injury. At the time I was told I dislocated my knee cap, was told to do one exercise 300 times a day (literally) for two weeks and it would be fine. So I did, wasn’t fixed, and have since been to about 12 other doctors for the same problem. My knee was injured when I was 14, I am now 22. I have yet to find two doctors who agree on the problem. Every single doctor has told me something different and most of them have said “it could be this, but either way you need to lose weight.” None of them want to take the time to realize that the main reason I am overweight is because of my knee injury. Yes, as I’ve gotten older I’ve struggled with depression and eating my feelings but most of that is because I’m overweight, which again started when I hurt my knee and can no longer run, walk stairs, walk for long distances, jump, lift weights, etc. I have yet to find a knee brace that helps well enough for me to exercise on much less a doctor that can actually tell me what’s wrong and treat the real problem.

    Losing weight is impossible without cardio. Yes, you will lose wight just on dieting but that only lasts so long. I’m not just a fat lazy f*ck who doesn’t want to lose weight. If I could do cardio, I would in a heartbeat. I actually miss running and playing soccer. But with my knees the way they are, the second I run or walk up the stairs or even trip or slip, my knee pops out of place and pops itself back in, and then I can’t even stand up for two weeks. And you want to tell me that all I need to do is lose weight?

    And this happens every time I go to the doctor about anything. Which is why I no longer go to the doctor. Hand falls asleep at random times for no reason? Fat. Muscle spasms in your back? Fat. Skin allergies? Fat.

    I’m tired of it. And most of my pain problems go back to having flat feet since birth also, but nobody thinks to ask about my feet.

    • Morgan, I am so sorry you are going through this. You have a right to have proper care for your knee problem. And weight loss should NOT be a prerequisite. Are you able to exercise in the water at all? Or in a chair? I ask this not because I want you to lose weight, but rather because it sounds like exercise made you feel better and it is something I think you once enjoyed. I am so sorry that you are going through this BS and it IS complete BS.

      I don’t know where you live, but I can suggest that this list contains some doctors that are less fat phobic and might be willing to look at your knee and not your body size as the problem.

      Ragen Chastain has some wonderful advice for dealing with doctors here:

      And I might suggest that no matter why your depression started, you might wish to work with a professional on that front as well. Depression is serious business.

      I hope that you find the help you need and are (literally) back on your feet sometime soon.


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