To Your Health: Weight control key in battling arthritis and more

By Alfred Casale - To Your Health
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Last week, I described the different types of arthritis that can cause pain, limited movement and disability. Most arthritis isn’t preventable, but for some, weight control can be a big help in minimizing the ravages of arthritis.

More than 70 percent of Americans over the age of 20 are considered overweight, and nearly 37 percent of those are considered obese, according to the Centers for Disease Control and Prevention (CDC). Though this can cause a variety of health problems, some issues go untreated due to the stigma attached to those extra pounds.

Conditions like diabetes, heart disease and high cholesterol require careful monitoring to keep you as well as possible, but many people overlook the chronic pain of joint problems, which can go untreated for years.

For obese patients, the most affected joints are those that carry the most weight: our knees and hips. For every pound a person is overweight, force on the knee is increased by four pounds of pressure.

When you consider how many steps we take in a day, the added wear and tear on our joints is a major contributor to chronic pain.

Arthritis, a category of conditions marked by severe pain and joint deterioration, is considered the leading cause of adult disability in the United States, with over 54 million diagnosed patients. It affects one in three obese people.

Here’s what you need to know about being overweight with arthritis, from managing your condition to beginning the journey toward a healthy weight:

Most common types of arthritis for overweight patients

Osteoarthritis and rheumatoid arthritis are the two types of arthritis commonly associated with excess weight. These types of arthritis cause deterioration, are associated with inflammation in our most-stressed joints, and can ultimately require corrective surgery.

Osteoarthritis causes cartilage, a connective tissue that covers the end of joints to protect against friction, to break down in the hips, knees, neck, lower back or hands. The condition is most often associated with “wear and tear” on the joints, amplified by the increased pressure of use while overweight.

Rheumatoid arthritis (RA) is an autoimmune disorder that emerges when the body’s own systems work against it. With RA, our own enzymes cause a breakdown in joint lining and increase inflammation. People with RA also experience fever, fatigue, anemia and other internal side effects.

Inflammation is a common thread in both conditions, exacerbated by the extra fat stores in the body.

Fat is a tissue itself, which contributes to inflammation in the joints as they create heat while performing regular function. If you are storing a considerable amount of fat, it can begin to act like an incubator for organs and joints.

Treatment for the joints

Treatment for osteoarthritis includes anti-inflammatory or disease-modifying anti-rheumatic drugs, as well as physical therapy to relearn good habits. However, damaged cartilage does not regenerate and may require joint replacement surgery in serious cases.

With RA, your doctor may prescribe an anti-inflammatory medication as well as biologic drugs, which target the specific enzymes that cause deterioration without compromising all of the other immune responses.

Easing into weight loss

Weight loss is one of the only direct ways to reduce the pressure on your joints, but it’s not always easy.

Obesity can be viewed as a disorder in which your body develops characteristics that can actually keep you from dropping too many pounds. Our brains are hard-wired to go into ‘starvation mode’ if too much of our fat stores are compromised, making it even harder to slim down.

Plus, chronic joint pain can make it difficult to exercise, especially if your condition has gotten bad enough to consider a joint replacement.

With all of this in mind, it’s best to start slow. Decreasing portion size, introducing healthier foods, and wearing a pedometer are great steps in the right direction. Consulting with your care team will also help you establish a goal, and a plan to get there safely. But there’s no doubt that losing those extra pounds will not only make you feel better, keep your heart and metabolism happier, and maybe lead to a new wardrobe, but also certainly take some significant stress off your joints.

Anyone care for a stalk of celery?

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By Alfred Casale

To Your Health

Dr. Alfred Casale, a cardiothoracic surgeon, is Associate Chief Medical Officer for Geisinger Health and Chair of the Geisinger Cardiac Institute. Readers may write to him via [email protected]

Dr. Alfred Casale, a cardiothoracic surgeon, is Associate Chief Medical Officer for Geisinger Health and Chair of the Geisinger Cardiac Institute. Readers may write to him via [email protected]