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I hope you’ve been reading Dr. Barbara Bergin’s humorous and informative series of blog posts about what happens to our bodies as we age. She cracks me up sometimes, but I’ve learned a lot about why various parts of my body seem to be turning on me. This week she’s talking about women over 50 and fat knees.

XOXOX, Brenda

As we age, many of us start noticing that our previously trim knees start looking fatter, regardless of our weight. I can tell you that I’ve never had a guy complain about fat knees… unless they’re on his wife, in which case I hand her the card of a good divorce attorney. There are a few of us who just have fat knees, even if we’re otherwise “thin.” Fat knees are in the gene pool, so blame your mom or dad. 

Many women come to see me, thinking it’s an orthopedic problem, because they’re hurting themselves in a futile attempt to make their fat knees go away. Some women are doing hardcore weight lifting exercises to “tone up” their knees, stretches, leg lifts, and those pesky squats, thinking they’ll eliminate the fat around their knees.

It won’t.

Your knees might get a little thinner if you lose weight in general, but the shape won’t change. By now, most of us know we can’t spot reduce. When we lose weight, we lose it everywhere, including our head and our big toe. This cowgirl can tell you that I have two different hat sizes in the closet, along with a full range of skinny to women-sized jeans. There are two other reasons our knees get bigger as we age, and they have nothing to do with our weight. 

First, an arthritic knee is a bigger knee. As we lose cartilage, our bones get closer together, and we begin to form spurs. All the soft tissue around these spurs begins to bulge out, and combined with inflammation and swelling, the knees get bigger, sometimes profoundly so. BTW, treating the arthritis has little to no effect on the “thickened” knee. 

Second, our knees are no different than our face. As we lose collagen in the skin and subcutaneous tissues, the flesh on our thighs and knees begins to sag. Throughout our body we have fascial attachments of our fat and flesh to the underlying muscles. If we didn’t have this, all of our flesh would drift down to our feet like candle wax. Instead, it just sags down to the next fascial attachment, and with the knee, that’s about a hand’s breadth below the joint, on the inside of the leg. In general, there is a little more fat on the inside of your knee than the outside—that’s where it pooches—and sometimes it’s bigger on one side than the other. Some patients even believe there’s a tumor there, and they insist on MRI scans to make sure there’s no cancer. Ninety-nine percent of the time it’s just fat.

You can’t exercise or stretch it away. A plastic surgeon, however, can suck it out.

As always, I encourage you to send loving chi to your knees, and all parts of your body for getting you to this ripening age. They feel your angst, and they don’t like it either. Be kind. Send love. Rub lotion on those chubby knees, but please don’t try to squat or diet the chubby knee away. You’ll get frustrated—perhaps hurt yourself—and end up having to see someone like me. 

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Dr. Barbara Bergin is a board certified Orthopedic Surgeon who has been taking care of the bones and joints of Austin, Texas, for over 30 years. She prefers prevention to treatment and takes a natural approach to both when possible. By informing her readers and patients through 1010ParkPlace and her blog,, she wants to prevent 100,000 injuries before she retires.

13 thoughts on “WOMEN OVER 50 AND FAT KNEES”

  1. Thank you! I am a seamstress and here complaints from my over 50 female clients about their knees. Now I can share that they are perfectly normal and maybe they may prefer hems at the low knee. As for me, I am just about to rub some cream on them. I thank my knees for taking me faithfully through life.

  2. I had fat knees until 6 months ago when I lost 50lbs eating low carb and no refined sugar. I also started doing easy squats. It is actually a cardiac rehab exercise I was told about. I started doing 10 and have worked my way up to 30.. Now my fat knees are at least more sculpted! I recommend easy squats to any aging senior. Going from a size 12 to a size 8 helped too.

    • You are my hero ! How did you lose the weight? I am size 12 having been size 6/8 for most of my adult life. At 73 I find it very difficult to get the fat moving…please share.

      • Weight loss has been the most difficult thing I have ever had to tackle. Some would say that I went to medical school. That had to be hard. Weight loss would be equivalent to going to three and a half years of medical school and quitting. Then going back for three and a half more, quitting…and doing that 12 times over. I still don’t know if I’ll finish med school. I’m approaching the 3.5 year point again…
        This time I’m doing it with medications. I feel very strongly about the need most of us who struggle with our weight have, for help. We need help. And for some of us, that comes in the form of a pill. The medical community has had its 60 year trial of telling us to diet more, exercise more and fell bad more. And guess what. It didn’t work. As a whole, we’re bigger than ever. There are a lot of medications out there to help with weight loss, and they work. We might need to stay on them indefinitely, or at least go back on them as we start to gain again. Our body’s metabolism is fighting against our weight loss. Now, just like the few people who can do squats, there’s always someone out there who says they lost weight and kept it off by taking some vitamin, but statistically, it’s way less than 1%. My parents are an example. When they were about my age (in their 60s), they got on the Adkins diet, did gentle exercise and lost their weight. Now, at 90, they are 2 skinny old people. They eat a hearty breakfast every day, and then they just nibble at dinner time. I’m trying that too. Not going to do aggressive exercise that ends up hurting me. Light exercise: walking, lifting light weights. Eat a decent breakfast with my folks. Go light at dinner, and try not to eat after 8:00. Probably should eat protein with every meal. Avoid sugary stuff of course. The closer you can get to eating naturally prepared foods (like not highly processed), intuitively seems better.
        Well, that was a long response. Hope it helps.

  3. I have ALWAYS been aware of FAT KNEES especially the women who wear leggings with short tops!!
    I always say to myself if they could just see themselves……..
    KNEES GIVE YOUR AGE AWAY TO ME RIGHT AWAY.Otherwise your face and the rest of your body could FOOL ME!
    Bottom line it is NOT A NICE SIGHT TO BE SEEN……….wearr a long top that hits below the knees!
    Which by the way have started on ME at AGE 62!

    • Turtle neck tops and scarfs hide sagging necks too and three quarter sleeves sagging upper arms. Living with ageing body effects can be done with grace and really who cares but ones self. Beauty is in the eye of the beholder.

  4. When I was young I wore lots of pants and my husband said one day you’ll want to hide your legs but for now, show them off. At the time I hadn’t thought about young legs versus old legs, but he was right. I’m 61 and my knees and legs are starting to show their age.

  5. At last I find out the truth about my knees. I can now just accept the reality and quit pushing myself. Thanks so much. I tend to wear calf length or long pants but now I am free!

  6. Dr. Bergin I too am in my early 60’s. I distinctly remember when I was a teenager, I asked my mom, “Mom, why don’t you wear shorts?” Her response at the time which totally baffled me was, “I don’t wear shorts because I have fat knees!” I remember thinking, ok, that must be something you won’t understand until you get old! ha! Now I get it!! My mother was never overweight, and luckily I have her same metabolism. But I have noticed that my knees are “sagging” a bit and do look “fatter” — just another nail in the vanity coffin for us ladies!

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