It is preferable to lose weight before the surgery; however, it’s understandable that it’s really difficult to do. Patients with knee and hip arthritis are unable to exercise, unable to run. They are unable to use a treadmill or an elliptical. They can do core exercises and upper extremity exercises to a decrease their weight. Additionally, patients may consult a weight loss surgery before the surgery. It’s important to take vitamin D after any weight loss surgical procedure to ensure that the vitamin D levels are adequate after weight loss surgery.