Weight Loss May Prevent, Treat Osteoarthritis in Obese Patients

... obesity actually may trigger the biomechanical and inflammatory changes that cause osteoarthritis, and the pain and loss of mobility associated with the condition. "There's a clear link between obesity and osteoarthritis, and the link is both from biomechanical factors as well as systemic factors. The systemic component appears to be significant," ...Approximately one half of osteoarthritis cases of the knee could be avoided in the U.S. if obesity was removed as a risk factor, according to the article. Other highlights include:

  • Greater weight and load bearing across a particular joint leads to increased wear.
  • White adipose tissue (WAT), a powerful endocrine organ that can trigger inflammation, is found in abundance in obese adults.
  • Obesity is considered to be an underlying cause of hypertension, insulin resistance and other metabolic syndrome conditions.
  • Obesity is a strong independent risk factor for pain, especially in soft-tissue structures such as tendons.
  • Weight loss can diminish pain, and restore function and quality of life in osteoarthritis patients, and possibly avert approximately 111,206 total knee replacements each year.

This sounds great, excepting that, for the obese, losing weight and keeping it off long terms is nearly impossible. I read that the only people who succeed in keeping significant weight loss beyond two years are those, less than 1% of people, who can count every bite they eat for the rest of their lives.

I have so many health problems which would improve if I lost a lot of weight. But the prospect of totally reorganizing my life around obsessive counting of everything I eat and around hours of daily exercise is kind of terrifying. I'd have to decide that my gut instincts about hunger can't be trusted (which I know intellectually), like rewiring my brain. People who have eating disorders sometimes convince themselves that the feeling of hunger is a good thing, and satiety is harmful. One person I know who succeeded in long term significant weight loss described a similar mental process. That kind of brain rewiring is a threshold I've been afraid to cross.

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All those diets I've tried only made me focus on food until I thought of nothing else - just the reverse of what I wanted. What a torture to think constantly of eating when you don't want to eat! The Paleo lifestyle gives me the freedom to think of something else and I even lost some weight. Have you tried Paleo, Ruth?

Dr. Mcdougall, a proponent of a very lowfat vegan diet, thinks that people in Western countries get overweight because the standard diet is very promoting of weight gain - high-fat, and lots of food that is full of the fat, sugar and salt that makes food appetizing without costing the manufacturer much. 

Of course lack of exercise is also part of it, but what he suggests is moderate daily exercise, not hours and hours of working out. 

Something to consider ... it certainly works for some people, and it's a way of eating that can be very long-term healthy, if you are careful to get necessary supplements.  Many vegan advocates including Dr. Mcdougall downplay the need for supplements, but I don't think that's reality-based, it's only in an effort to promote the diet.  The site veganhealth.org has a lot of good science-based info on supplementation.

It can be challenging to transition to such a diet, one's satiety mechanisms and one's food tastes need to adapt.  But it can be helpful including with diabetes.  I eat this way and it seems long-term very satisfying and nutritious and colorful (lots of colorful vegetables). 

By the way I have osteoarthritis too, not because of excess weight or age, but from an old knee injury.  Grim reality, my knee is slowly enlarging and getting more painful.




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