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Weight Loss: Effective Treatment For Osteoarthritis?
That weight loss is an effective treatment for osteoarthritis is demonstrated here by Dr Matthew Constantin
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Weight Loss: Effective Treatment For Osteoarthritis?

Last modified 2014-03-28 22:43

is the most common form of arthritis in the United States, affecting almost 10% of the population. OA is also the leading cause of chronic disability in this country. Obesity is the one of the strongest risk factors for the development of osteoarthritis, with bilateral affliction of the knee joints being the most common type of OA seen in overweight individuals.


Two Ways That Obesity Causes Osteoarthritis

  • Excess force upon a joint
    The most logical way for obesity to cause OA is by the force exerted upon a joint due to the excess weight. This would account for the common scenario of OA in both knees of overweight persons, whereas OA due to injury generally occurs in one knee joint. The extra force bearing down upon the knee joint of an obese individual leads to degradation of the cartilage. This would also account for the fact that the knees of obese people are more often afflicted than the hip joints.
  • Systemic factors
    Obese individuals also have an increased risk of developing hand OA . Since the hand is a non-weight bearing joint, the inference is that some circulatory factor is at work in the system that affects all joints, not just those that provide support. Adipose (fatty) tissue has been shown to play a role in the secretion of endocrine substances, which may lead to a breakdown in cartilage and the subsequent development of OA.
  • Adipose cells generate peptides, such as leptin. The presence of leptin is a signal to reduce appetite. Paradoxically, obese people tend to have high circulatory levels of leptin, suggesting that obesity promotes leptin resistance. Another peptide generated by adipose cells is TNF-alpha (tumor necrosis factor.) This substance regulates immune cells and initiates systemic inflammation. High levels of TNF-alpha and leptin may account for the chronic inflammation experienced by obese individuals . One hypothesis states that sustained inflammation may have a negative effect on articular cartilage, resulting in OA.

Weight Loss Reduces The Symptoms of Osteoarthritis

To investigate the effect of weight loss on the symptoms of OA, a was conducted in 2007 that collected the results of prior studies for review. The objective of the meta-analysis was to measure reduction in pain and increase in functionality when overweight patients suffering from knee OA achieved weight loss.

After analyzing the data of the prior randomized controlled trials, the major finding was that a moderate weight reduction regime results in improved functionality and pain reduction for overweight people.

Obesity specialists recommend that overweight individuals aim for a 10% reduction in body weight, using a rate of 1 to 3 pounds per week. However, the meta-analysis found that symptomatic relief began at 5% weight loss. Clinically proven weight loss programs such as Nutrisystem and Medifast can help achieve those targets. Dietary supplements that contain glucosamine sulphate and chondroitin sulfate, have been shown to further help reduce OA symptoms.


Can Weight Loss Prevent Osteoarthritis?

The Framingham Heart Study was a comprehensive, longitudinal study conducted in England between the years 1949 and 1985 . Data collected from that study showed the following:

If obese men with a body mass index (BMI) greater than 30 lost sufficient weight to be considered merely overweight with a BMI between 26 and 29.9; and if overweight men lost sufficient weight to be considered normal with a BMI under 26; then their chances of developing OA of the knee would be decreased by 21.4%. That percentage would improve if obese men lost enough weight to join the normal weight category.

For women, a parallel drop in weight from obese to overweight, and from overweight to normal, would result in a decrease of 33% of the total rate of osteoarthritis of the knee.


Conclusions

It is well understood how excess weight creates mechanical stress, resulting in osteoarthritis of the knees. Further studies are required to comprehend exactly how obesity causes osteoarthritis of non-weight-bearing joints via secretions from adipose tissue—a tissue which is now recognized as a major endocrine organ.

Nevertheless, it is already clear that being overweight is the single greatest modifiable risk factor for OA. Weight reduction of young people is considered the best course of prevention against later life OA. Weight reduction is the most effective treatment for pain reduction and improved functionality for current obese sufferers of osteoarthritis.


References

  1.  Obesity as a risk factor for osteoarthritis of the hand and wrist: a prospective study. Carman WJ, Sowers MF, Hawthorne VM, Weissfeld LA. Am J Epidemiol 1994;139:119-29
  2.  Obesity and osteoarthritis: is leptin the link? Sandell LJ. Arthritis Rheum. 2009 Oct;60(10):2858-60.
  3.  Weight and osteoarthritis. Felson DT. J Rheumatol 1995; 22(suppl 43):7-9.




 

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