Obesity is linked to diseases including diabetes and cancer, but a recent study published in the Journal of Bone and Joint Surgery shows that the condition – which the American Medical Association declared a disease in 2013 – is also tied to an uptick in knee and hip replacements, with an emphasis on total knee replacements.

Oh, and these knee replacements are also happening among increasingly younger adults.

Researchers found that the number of total knee replacements tripled between 1993 and 2009, and that the jump tracked with the climb in US obesity numbers. Researchers attribute 95% of the increased demand to obesity.

“If rates of overweight and obesity continue to climb, we should expect further acceleration in the number of knee replacements performed annually,” study lead Peter Derman, of New York’s Hospital for Special Surgery said in a statement.