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Obesity and Arthritis: A Doctor's View

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Do you feel a twinge of pain in the knee or hip when you go for a walk? If you do, you may want to consider the impact your weight has on your joints.

While many people easily understand and associate the relationship between obesity and heart disease or diabetes, the relationship between obesity and arthritis is not always as evident.

A Little Extra Weight Leads to a Lot of Extra Joint Stress

When you have obesity, there is increased wear and tear on your joints. As a result, joints are more likely to be damaged, which may result in arthritis pain—especially in the knees, hips, and other weight-bearing joints. In fact, there is an unfortunate cycle related to obesity and arthritis. Arthritis most commonly leads to pain and decreased amounts of activity. Decreased activity often leads to weight gain. Weight gain places more strain on your joints and often results in more pain. Without weight loss, the cycle can be difficult to break.

One pound of extra weight is equivalent to 4 pounds of extra stress on a joint. For example, being 10 or 100 pounds overweight puts an extra 40 or 400 pounds of pressure on the knees, respectively. While studies have not demonstrated that weight loss slows the progression of osteoarthritis, weight loss clearly decreases the negative impact on your weight-bearing joints.

I should also point out that people who have obesity tend to get arthritis earlier in life. If you ultimately require joint replacement surgery, increased weight will wear down your artificial joint similar to your natural joint. As a result, you may end up needing a second artificial joint or you may find yourself in a position where you have few other treatment options at a relatively young age with many years ahead of you.

Losing weight, while not easy, is recommended for overweight patients with or without arthritis.

A Simple Strategy for Weight Loss and Pain Relief

There is a very simple calorie-in versus energy-expended formula: if you consume more calories than you burn throughout the course of a day, you will gain more weight. Likewise, if your energy expenditure exceeds calories in, you will lose weight.

For example, to lose half a pound a week, you’ll need to remove roughly 250 calories from your day. The best way to do this is through a combination of exercise and diet—you can eat 125 fewer calories and burn off 125 calories while exercising.

I have found, both personally and in my practice, that increased physical activity is not enough for weight loss—when you decrease caloric intake and increase physical activity at the same time, you’ll get better results.

There is very good data that supports self-tracking of targeted behaviors. When exercise and caloric intake are tracked (e.g. written down in a journal or in your favorite app), you are more likely to eat less and exercise more. Interestingly, people who track exercise not only exercise more but also seem to get more enjoyment from the activity.

Self-tracking addresses one of the common reasons diet and exercise attempts fail—a lack of immediate results. Self-tracking provides an immediate reward and encouragement; a much better alternative to waiting for the large, delayed rewards of weight loss. You are able to wake up everyday and shoot for clear goals, making it very easy to get back to improving eating and exercising if you fall off the bandwagon.

There are additional benefits to implementing this strategy. While losing a few pounds may be better for your joints, decreasing your weight by 5 to 10% will significantly decrease your risk of heart attack or stroke. Similarly, exercising for 30 minutes daily will also decrease your risk of developing diabetes. Maintaining a moderate weight will not only improve your joint health, but your overall health as well. Talk with your doctor about following a balanced nutritional plan and finding an exercise regime that fits your lifestyle.

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THIS CONTENT DOES NOT PROVIDE MEDICAL ADVICE. This content is provided for informational purposes and reflects the opinions of the author. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional regarding your health. If you think you may have a medical emergency, contact your doctor immediately or call 911.