The Truth About Osteoarthritis

Being overweight puts stress on every system of the body, and that includes bones. Even an extra 10 pounds of body weight can add strain and pain to knee and hip joints. The worst of it is that joint pain makes it harder to exercise, but less exercise can lead to even more weight gain.

As we age, our bodies change in visible and not-so-visible ways. Weight gain often accompanies middle age, as muscle mass decreases and the body’s metabolism, or how efficiently we burn calories, slows down. Meanwhile, over time, the smooth cartilage in our joints wears away, causing pain. Cartilage is a kind of tissue that connects bones together. It’s softer and more flexible than bone, and it helps the bones move smoothly against each other when we bend a knee or an elbow. When the cartilage breaks down, the bones rub painfully against each other. This is called osteoarthritis.

Osteoarthritis is the most common form of arthritis, often coming on gradually with age, as cartilage naturally wears away over time. But carrying excess weight puts more stress on the joints, and can cause the cartilage to deteriorate faster. A large national study showed that people who are overweight have more than four times the risk of developing arthritis in the knees.

It stands to reason that bending and lifting all that extra weight would take a toll on the knees, but surprisingly, overweight people also have increased risk of arthritis in the hands. This may be due to inflammation. Fat cells release molecules called cytokines, which promote inflammation. Cytokines from fat have been shown to break down cartilage, leading to arthritis pain.

If being overweight leads to arthritis, can losing weight undo the damage? Happily, yes. Recent studies have found that in older, obese individuals with knee osteoarthritis, healthy weight loss resulted in relief from knee pain. Remarkably, the researchers showed that the people felt better and reported fewer symptoms after losing weight even though imaging revealed that the joint damage had not been reversed.

Another study investigated the relationship between weight loss and arthritis on the biochemical level. They found that weight loss by any method reduced the harmful cytokines that can attack cartilage and lead to arthritis pain. This is great news. If joint pain is making you feel like exercise is out of the question, there’s still hope. The study looked at weight loss by way of surgery, medications, diet, and exercise; regardless of the method, weight loss success paved the way to fewer biochemical and mechanical stressors on the joints.

If aching joints are keeping you from exercising, don’t give up. FDA-approved weight loss medications can help get you back to a healthier weight, relieve the stress on those joints, and lessen the pain of osteoarthritis.

References

Anderson J, Felson DT: Factors associated with osteoarthritis of the knee in the First National Health and Nutrition Examination (HANES I). Am.J.Epidemiol. 1988;128:179-189.

Wang T, He C. Pro-inflammatory cytokines: The link between obesity and osteoarthritisCytokine Growth Factor Rev. 2018 Dec;44:38-50. doi: 10.1016/j.cytogfr.2018.10.002.

Gudbergsen H, Boesen M, Lohmander LS, et al. Weight loss is effective for symptomatic relief in obese subjects with knee osteoarthritis independently of joint damage severity assessed by high-field MRI and radiographyOsteoarthritis Cartilage. 2012;20:495-502. doi: 10.1016/j.joca.2012.02.639

Vincent HK, Heywood K, Connelly J, et al. Obesity and Weight Loss in the Treatment and Prevention of OsteoarthritisPM&R. 2012;4:S59-S67. doi:10.1016/j.pmrj.2012.01.005

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