One third of the US population is battling obesity and its complications including Heart Disease, Diabetes, Stroke, Depression and Cancer according to the Centers for Disease Control and Prevention. Obesity is connected to arthritis in many ways including the development of osteoarthritis and rheumatoid arthritis as well as worsening disease activity.
WHAT DOES OBESITY DO?
- First, obesity causes excess pressure or weight on the joints which can cause joint pain, decrease mobility, and stiffness. The excess force with weight gain is placed on the joint and leads to more mechanical loading and pressure on the joint. Pain can be experienced during physical activity.
- There have been numerous studies linking obesity with degenerative or osteoarthritis (OA) of the knees and hips and rheumatoid arthritis, especially in women. The relationship between Obesity and Osteoarthritis is well established for hip and knee osteoarthritis. There is a significant increase in the development of knee OA once an individual reaches a BMI of 30 kg/m2 or higher.
Some studies have also found that individuals who are obese are more likely to need a joint replacement and obesity may also slow down the rate of recovery.
- More importantly, the inflammation chemicals (cytokines) produced in fat or adipose tissue can also play a role in producing pain in joint tissues. When excess force is placed on cartilage and bone, chemicals may be triggered to be released. These cytokines can be detected in rheumatoid arthritis. Some studies have demonstrated that with obesity, an individual may have less response to a medication used to treat RA versus a non-obese person.
- The more an individual weighs, there is also a greater chance of suffering from gout, arthritis where uric acid crystals deposit in the joints.
- Obesity is also linked with the onset of psoriasis, inflammatory skin disease, and psoriatic arthritis
- Psoriatic arthritis is strongly associated with central obesity and Metabolic Syndrome
What is Metabolic Syndrome?
- High blood pressure 130/85 mm/Hg or above High triglycerides levels 150 mg/dL or higher
- High blood sugar (glucose > 100 mg/dL
- Excess waist body fat/abdominal obesity- Waist size is more than 35 inches in females and 40 in males
- High triglycerides level 150 mg/dL or higher
- LOW HDL levels (40 mg/dL or less for men and 50 mg/dL or less for women
WHAT TO DO?
It is recognized that even a small weight loss can lead to improvement of joint function and mobility.
All rheumatologist should work with internists , nutritionists, endocrinologists and obesity specialists to focus on achieving patients’ ideal BMI and support patients’ weight loss efforts.
Losing weight leads to:
- Improved joint function
- Pain Reduction
- Less Inflammation
- Better cardiovascular health
- Decrease Diabetes risk
- Better sleep😴
It is essential for the physician to start the discussion of weight loss and achieving a good/ideal BMI.
The individual may need counseling and therapy, customized exercise programs (walking, stationary bike to begin), medications or even bariatric surgery in some cases. Some individuals have also found acupuncture, cognitive behavioral therapy and meditation to be helpful.
PREVENT OBESITY TO PRESERVE YOUR JOINTS!!
References: Adult obesity facts. US Centers for Disease Control and Prevention website. October 2016, Joint Bone Spine.2012: 79 (3):291, Impact of Obesity on Arthritis Outcomes. Rheumatology Advisor. October 2016