How Obesity Makes Arthritis Management Worse
Consider this: Every one pound of excess weight exerts three to six pounds of extra force on joints, says Dr. DiRenzo. If youre 10 pounds overweight, it increases the force on your knees by 30 to 60 pounds with each step being 100 pounds overweight means 300 to 600 pounds of extra pressure. All that extra weight on already damaged joints worsens the pain and stiffness and can accelerate disease progression.
Extra fat also means more inflammation. Cytokine levels are already high when you have inflammatory arthritis obesity compounds it. Research published in the journal Autoimmunity Reviews found obesity can lead to more active and severe RA and PsA. Youre less likely to achieve sustained remission, as well, compared to those with a healthy BMI, according to other studies. And research suggests obese people with ankylosing spondylitis a type of inflammatory arthritis that can causes some vertebrae in the spine to fuse are likely to have worse symptoms, less physical function, and lower quality of life.
Plus, obesity may impact how well some of your arthritis meds work, adds Caroline A. Andrew, MD, medical weight management specialist at the Hospital for Special Surgery in New York City. Studies have shown that some DMARDs , which are used to treat inflammatory arthritis, may not be as effective in people who are overweight or obese, she says.
The Impact Of Weight On Your Knees
Even if excess weight isnt the source of your knee pain, being overweight or obese can aggravate any condition causing this type of discomfort. The load on your knee joints equals four times your body weight. So, if you weigh 150 pounds, your knees support 600 pounds of force when you stand or walk. The pressure can increase with actions such as walking up steps, climbing an incline, or squatting to pick up something from the floor
The benefit of weight loss works along the same scale. Thats why losing even 10 pounds can make a measurable difference. Being 10 pounds lighter reduces the load on your knees by 40 pounds.
The Benefits Of Maintaining A Healthy Weight
Everyones body is different, and Dr. Brown can tell you the healthy weight range for your unique body type. That being said, if you are overweight or obese, there are some major benefits to losing weight and maintaining a healthy weight, whether you have arthritis or feel concerned about developing it.
These benefits include:
- Less pain
- Reduced inflammation
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Types Of Back Pain Related To Obesity
Higher body weight increases the likelihood of developing several serious health conditions, such as type 2 diabetes, high blood pressure, and heart disease. Obesity is also related to conditions that specifically affect the spine and lower back, namely:
- Herniated discs. Obese or overweight patients are considered more likely to experience a herniated disc, a common cause of leg pain or sciatica due to a lumbar radiculopathy. The disc is more likely to herniate as it is forced to compensate for the pressure of extra weight on the back.8
- Osteoarthritis. Extra body weight strains joints in the spine and leads to an increased risk of developing spinal osteoarthritis. A BMI greater than 25 increases the risk of developing osteoarthritis.9
On occasion, degenerative spinal conditions may need to be treated with surgery. Obesity has been associated with a greater risk of complication or infection in individuals who require surgery.10 Surgery typically remains worthwhile when medically indicated.8,11 Weight loss before undergoing back surgery may help improve the postsurgical healing process.
Read more about Lumbar Spine Surgery
Does Obesity Cause Arthritis The Facts Arthritis Patients Must Know
CreakyJoints reports on the complexities around obesity, its impact on arthritis management, and what experts want you to know.
CreakyJoints spoke to Caroline A. Andrew, MD, medical weight management specialist at HSS, who explained the impact of obesity over how well your arthritis medications work. Studies have shown that some DMARDs , which are used to treat inflammatory arthritis, may not be as effective in people who are overweight or obese, said Dr. Andrew.
However, some medications that are used to treat rheumatoid arthritis and other inflammatory arthritis conditions can impact ones weight. Long-term use of glucocorticoids is associated with weight gain, cited Dr. Andrew. Several medications used for arthritic pain can also cause weight gain. Dr. Andrew advised, If possible, try to see an obesity medicine specialist, a physician who has been trained in weight management. This type of provider can do a thorough assessment, including a review of a patients medication list, and potentially to help mitigate some of the weight effects of the arthritis medications.
Read the full article at Creakyjoints.org.
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How 10 Lbs Makes A Big Difference To Your Knees
So losing 10 pounds will result in 30 pounds less pressure per knee, per step.
Now, think about how many steps you take each day. The average person takes about 5 to 6 thousand steps a day5 doing things like walking to the bathroom and shopping at the grocery store.
Together, 5 thousand steps and 10 pounds of bodyweight combine to generate 150 thousand pounds of pressure on the knees per day:
When multiplied by 365 days , that difference grows to 54 million pounds of pressure:
In other words, losing 10 pounds can make a difference of nearly 55 million pounds of pressure on your knees each year.
Variabilities in the calculationsKeep in mind that the numbers used in the calculations above are estimates. Experts estimates of pressure on the knee per pound of bodyweight vary, ranging from 2:1 to 4:1. The ratio may be influenced by factors such as anatomy, gait, and footwear. In addition, the number of steps you take per day can vary widely.
How Fat Affects Arthritis
Arthritis is painful the way it is. Being overweight can worsen symptoms, make medications less effective, and can contribute to the offset of other health problems. Obesity is also a risk factor for developing osteoarthritis, the most common joint disorder affecting knees, hips, the back, and the neck. But how can fat have an impact on arthritis? And what can we do to overcome most of the issues? We condensed for you all you need to know about obesity and arthritis in this article.
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Obesity And Joint Pain
Obesity is among the leading causes of immobility in adults. An accumulation of excess body weight increases pressure on the joints, especially the hips, knees and ankles. Over time, excess weight can cause cartilage in these joints to wear down, and this may lead to severe pain and difficulty walking.
The Link Between Obesity And Psoriatic Arthritis
Psoriatic arthritis is an autoimmune disease that makes your skin scaly and red. Studies show that obesity is a precursor to psoriasis and psoriatic arthritis obese people are three times more likley to develop psoriatic arthritis than those at a normal weight.
Another way weight plays a role in your arthritis is that obesity increases inflammation throughout your body, which, in turn, may settle in your joints. That inflammation may also interfere with your medications to control it.
However, if you lose fat, even 10% of your extra weight, it could mean a 50% improvement in the pain level associated with your arthritis. It will also enable you to get more exercise, allow your medications to do their job, and improve your overall health.
Body Weight Affects Joint Inflammation
Fat cells release substances that promote body-wide inflammation. If youre overweight, youll have more of those unwanted chemicals circulating through your body. The inflammation triggered by fat cells aggravates the joint inflammation already caused by rheumatoid arthritis and osteoarthritis.
People who are overweight or obese and who also have rheumatoid arthritis experience more joint pain than patients with a normal weight. However, weight loss can lower inflammation, improve joint function, and help reduce your joint pain.
If youre overweight and you struggle with knee pain, or pain in any of your weight-bearing joints, we can treat the problem in your joint and relieve your pain, while also recommending gentle exercises that will help you lose weight without further aggravating your joints.
To get started on the road to joint health, call Pennsylvania Orthopedic Associates, or schedule an appointment online.
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How Do I Lose Lower Back Fat
There are many different ways to lose lower back fat. One popular method is to do exercises that target the abdominal and lower back muscles. These exercises can help to tone the muscles and reduce the amount of fat in the area. Another method is to change your diet. Eating foods that are high in protein and fiber can help to boost your metabolism and promote fat loss. Additionally, making sure to get plenty of sleep and staying hydrated can also help improve your bodys ability to burn fat. By following these tips, you can start to see a difference in the amount of lower back fat you have.
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Being Overweight Causes Hazardous Inflammations
- University of Oslo
- A possible molecular explanation for why overweight is harmful has been discovered by researchers. They suggest that overeating increases the immune response. This increased immune response causes the body to generate excessive inflammation, which may lead to a number of chronic diseases. This new knowledge may provide new drugs for heart attack, stroke, cancer and chronic intestinal inflammation.
Researchers have found a possible molecular explanation for why overweight is harmful. This new knowledge may provide new drugs for heart attack, stroke, cancer and chronic intestinal inflammation.
“We believe that there is a connection between metabolism, inflammation, heart attack and stroke,” says Bente Halvorsen, professor at the Research Institute for Internal Medicine, University of Oslo, Norway. Together with the research group’s leader, Pål Aukrust, who last year received the university’s research award for his work on inflammatory diseases, and researcher Arne Yndestad, she has looked deeply into the molecular explanation of why overweight is harmful. “With this new knowledge, we can better understand why too much food can cause such serious diseases as heart attack, stroke, cancer and chronic intestinal inflammation.”
We eat too much
Overeating increases the immune response. This increased immune response causes the body to generate excessive inflammation, which may lead to a number of chronic diseases.
Strengthening the theory
Does Belly Fat Cause Lower Back Pain
There is a long-standing debate about whether or not belly fat is linked to lower back pain. Some experts argue that carrying excess weight around the midsection puts stress on the lower back, which can lead to pain and discomfort. Others claim that there may be other factors at play, such as hunching over for prolonged periods of time due to poor posture. Ultimately, it seems that the jury is still out on this issue and more research is needed to determine an exact link between belly fat and lower back pain. In the meantime, maintaining a healthy weight and practicing good posture may be the best way to protect your back from any potential discomfort associated with belly fat.
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How Can I Help My Patients To Manage Their Weight More Effectively
- Assess weight and advise all overweight and obese persons to lose weight
- Review health benefits emphasizing the link between weight loss, exercise and improvement in joint pain
- Suggest an initial weight loss goal of 10% and a safe rate of weight loss
- Review changes in eating, behavior, and physical activity that are necessary to lose weight
- Discuss how to proceed and maximize support
- Monitor progress with follow-up visits
There are many things you can do to facilitate safe and effective weight management practices with your patients with arthritis. First, address weight directly as an important component of arthritis management. Clearly advise all overweight and obese patients to lose weight. Second, review the health benefits of small weight losses with patients, emphasizing the positive effects of reduced weight and exercise on OA-symptoms such as pain. Third, suggest an initial weight loss goal of 10% if patients are successful achieving this, further weight loss can be attempted, if appropriate. A recommended rate of weight loss is 1-2 lbs per week. Fourth, discuss with patients how they can best achieve weight loss. Successful strategies for weight loss include calorie reduction, increased physical activity, and behavior therapy designed to improve eating and physical activity habits. Specifically, you should suggest that overweight and obese patients:
What Happens To Your Weight When You Start Ra Treatment
Generally speaking, a newly diagnosed RA patient who was losing weight will start regaining weight once they begin treatment, because the medication will address the underlying inflammation that was responsible for the weight loss.
If RA symptoms improve with treatment, a person can start to do physical therapy and exercise and start to regain muscle mass. Appetite may also improve, says Dr. Andrews.
However, all drugs have side effects, including RA medications. Depending on what you take and how your body reacts to it you might experience weight gain or weight loss. According to one 2016 study, the drug leflunomide , one type of disease-modifying anti-rheumatic drug for rheumatoid arthritis, is more apt to cause weight loss as a side effect than some other RA medications. It sometimes causes diarrhea, nausea, and upset stomach, all of which can exacerbate weight loss.
No matter which RA drug regimen youre on, be sure to talk to your doctor if you start losing weight for no apparent reason. That change is reason enough for your doctor to order some tests and reassess your disease activity. If your RA is no longer being well controlled, it may be time for change in your treatment plan.
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Why Would Rheumatoid Arthritis Cause Weight Loss
RA probably isnt the first disease that comes to mind when you think of unexplained weight loss, but there are a few reasons why RA sometimes causes people to lose weight.
Early on, when the disease is active, theres a lot of inflammation, and can be a side effect of inflammation, says Joshua Baker, MD, assistant professor of rheumatology and epidemiology at the University of Pennsylvania and Philadelphia VA Medical Center.
More specifically, the same cytokines that wreak havoc on the joints of people with RA also impact metabolism and contribute to the breakdown of muscle. That could happen if you have RA but havent yet been diagnosed if youve been newly diagnosed and treatment hasnt had a chance to kick in or if youve been living with RA for a while but your current treatment has stopped working.
Another reason rheumatoid arthritis can cause weight loss is that it can decrease your appetite, says Caroline A. Andrew, MD, a medical weight management specialist at the Hospital for Special Surgery in New York City. Aches and pains can be a factor as well: If a person has significant joint pain and cannot move easily or exercise, there may be a loss of muscle mass, causing weight loss, she says.
The Arthritis Diet: How Excess Weight Damages Your Joints
Despite the claims you may see or read sometimes, there is no magic arthritis diet. No single food or special eating plan can slow arthritis or reduce pain. A well-balanced diet is important for your overall health and energy level, of course. But when it comes to managing osteoarthritis, the single most important thing you can do is to maintain a healthy weight.
If youâve dieted before, you already know thatâs not easy. But arthritis sufferers have an added reason to try to drop even a few pounds. Excess weight puts added stress on joints, particularly knees, causing pain and worsening arthritis damage.
âBeing just 10 pounds overweight increases the force on your knees by 30 to 40 pounds with every step you take,â says Kevin Fontaine, PhD, assistant professor of rheumatology at Johns Hopkins University. Small wonder, then, that being obese is linked to a four- to five-fold increase in the risk of developing osteoarthritis.
If youâve tried and failed to lose weight before, donât be discouraged. You donât have to lose a lot to have an impact on arthritis. âAlmost any weight loss can have beneficial effects, especially in reducing pain,â says Fontaine. And though losing weight and keeping it off isnât easy, some people do succeed. By learning how these losers succeeded, researchers have identified six key winning strategies.
The Role Of Obesity In Disease Course
In addition to increasing the likelihood of an individual developing RA, obesity may negatively affect the disease course for individuals with obesity. Dr. Matteson provided one plausible reason for this finding: The extra weight is especially bad for hips, knees, and ankles, and accelerates the development of arthritis in these joints already due to mechanical stress.”
A recently published cross-sectional study of patients with RA evidenced a direct association between elevated BMI and increased swelling of lower extremity joints. Furthermore, participating patients showed a higher disease activity score, specifically with the validated DAS-44 disease activity measure.¹¹
Other studies have substantiated the role of obesity in the course of . In an investigation of the histological and transcriptional features of synovial tissue in patients with RA, a team of scientists demonstrated that patients with RA who were also overweight or obese had higher degrees of synovitis both at disease onset and after achieving remission. Based on their results, the team recommended that patients with RA aim to manage their weight throughout the course of their disease.²