Managing Obesity and Joint Pain

By

Susan Fishman

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Two out of three Americans are either overweight or obese. If you fall into the obese category (defined by a body mass index, or BMI—the measure of body fat based on weight in relation to height—of 30 or higher), you are about 60 percent more likely to develop arthritis than someone of normal body weight.


The good news is that every step you take to lose weight—and every pound lost—can reduce your chance of developing osteoarthritis (degenerative joint disease), or reduce your pain if you already have it.

Two Weighty Paths to Joint Pain

There are two ways being obese can increase your risk for developing osteoarthritis or make existing joint pain worse:

1. Excess weight puts additional physical stress on your joints.

The joints that hold us up when we stand and carry the weight of our body are called “weight-bearing” joints. Our primary weight-bearing joints are the ankles, knees and hips, but we also have weight-bearing joints in the feet, pelvis, lower back and spine. The more weight that’s put on a joint, the more stressed it becomes.

For every pound of excess weight we carry, there are four pounds of pressure loaded on to the knees. So if you are 20 pounds overweight, that’s an additional 80 pounds of pressure. A person who is 100 pounds overweight has 400 pounds of pressure on his knees.  

2. Inflammation—that often comes with weight gain—may contribute to joint pain.

Fat creates chemicals in the body that often promote inflammation. This can also cause our joints to break down more quickly and can lead to osteoarthritis.  

Losing Weight (Even a Little) Can Help

Even a small amount of weight loss can have a big impact on your joints, especially if you already have osteoarthritis. In one study among younger obese women, the risk of developing osteoarthritis dropped 50% with each 11-pound weight loss. Men who reduced their BMI from 30 or higher to between 25 and 29.9 saw about a 20% decrease in knee osteoarthritis. Women with a similar change saw a 30% decrease.  

People with rheumatoid arthritis (RA) need to be especially mindful of their weight. Not only can RA cause inflammation, it also can change your body composition, causing it to favor more fat than muscle.

Doctors often suggest an initial weight loss goal of 10% for people who are obese. Here are a few tips to help get you started:

  • Cut back. Instead of jumping into a full-blown diet, a good first step is to cut back on both fat and total calories. While limiting dietary fat can help you reduce calories and is good for your heart, you must also reduce your overall calorie intake to reach your weight loss goal.

  • Gradually increase your activity. Start out slowly, and progress to 30 minutes or more of exercise on most or all days of the week. If joint pain is affecting your ability to exercise, ask your doctor about effective ways to increase your activity level that will be easier on your joints.

  • Get professional help. Emotional issues are usually the cause of weight gain and need to be addressed to help you avoid the things that trigger overeating or binge eating for you.

  • Talk to your doctor. Ask about additional treatment options to support your diet and exercise efforts, such as gastric surgery, medication or a structured weight-management program that offers education and support. They are many inexpensive options available, for example in commercial centers or hospitals. While clinical programs are often more costly, in some cases they may be covered by health insurance.

Overall, be patient with yourself. If you fall off the weight-loss wagon, try to get back on as soon as possible and start again. The more you practice this quick recovery, the easier it will be to recognize what caused the overeating and how to avoid it or deal with it in other, more productive, ways in the future. And the happier your joints will be for it.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Apr 5, 2016

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Medical References

  1. How Fat Affects Arthritis. Arthritis Foundation. http://www.arthritis.org/living-with-arthritis/comorbidities/obesity-arthritis/fat-and-arthritis.php
  2. The Wear and Tear of Obesity: the Burden of Weight in Joint Disease. Obesity Action Coalition. http://www.obesityaction.org/educational-resources/resource-articles-2/obesity-related-diseases/the-wear-and-tear-of-obesity-the-burden-of-weight-in-joint-disease
  3. Role of Body Weight in Osteoarthritis. John Hopkins Arthritis Center. http://www.hopkinsarthritis.org/patient-corner/disease-management/role-of-body-weight-in-osteoarthri...
  4. Why Weight Matters When it Comes to Joint Pain. Harvard Health Publications. Harvard Medical School. http://www.health.harvard.edu/healthbeat/why-weight-matters-when-it-comes-to-joint-pain

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