Making an Osteoarthritis Weight Loss Plan

Osteoarthritis (OA) Is the most common type of arthritis affecting the joints, mainly the joints of the hands, knees, hips, and back. OA is often the result of wear and tear on articular cartilage—the cushion between the bone and joints.

No medication can slow down the wear and tear process. The one thing that does help slow down OA is weight loss, which can ease OA pain and lower the chances of joint damage and the need for joint surgery down the road.  

It is unclear how weight influences OA, but many doctors agree that being overweight can increase the load placed on the joints. According to one 2014 report in Obesity Reviews, losing as little as 10 pounds can decrease the progression of knee OA by up to 50%. One major reason for this is a reduced burden on your joints.

Studies have consistently shown people affected by being overweight have higher rates of OA than people who are not overweight. One study reported in 2016 in Arthritis & Rheumatology found people with a body mass index (BMI) of between 30 and 35 were up to five times more likely to have knee arthritis than people with lower BMIs.

Being overweight can also increase inflammatory OA— joint inflammation caused by an overactive immune system. Hand OA is the most common type of inflammatory OA and is much more common in people who are overweight.

One study reported in 2017 found the lifetime risk for hand OA was 47.1% in people who were classified as obese compared to 11% for people who were not overweight.

In this article, we will discuss the benefits of weight loss for people with OA, how extra weight increases joint pain, how your doctor and other health professionals can help, setting goals, and exercising for OA.  

Benefits of Weight Loss for Osteoarthritis  

Losing weight and maintaining a healthy weight have many health benefits. Both can prevent OA and treat it in people who already have it. Below are some of the benefits that can be gained from losing weight with OA.  

Prevention or Delays in Progression 

According to a 2014 review of studies, weight loss can reduce the risk for OA in people assigned female at birth. In one study cited, researchers found an 11-pound weight loss over 10 years decreased the likelihood of symptomatic knee OA by 50% in this population. Another cited study reported weight loss was linked to a significant reduction of OA risk in people with a high baseline BMI.  

Pain Reduction 

Less bodyweight with OA means less pain. Research shows people who lose weight with diet and exercise report less OA pain.  

One study report in 2013 in the Journal of the American Medical Association (JAMA) found losing at least 10% of body weight could significantly improve pain levels. In this study, the people who followed a diet and exercise program had the most improvement in pain and function.

The study also found weight loss improved inflammation, especially in the participants who used both diet and exercise in their weight loss plan compared to exercise alone.

Better Joint Function

Weight loss can also improve your joint function, as noted in the 2013 JAMA study. In that study, the researchers found that mechanical pressure inside and around the knee joints improved with weight loss. The study’s authors noted weight loss alone was enough to significantly improve knee function.  

Less Inflammation  

While OA is considered a wear and tear disease, it can also cause inflammation from prolonged, excess pressure on joints. Research also suggests inflammation might be a risk factor for OA in addition to a consequence.

According to a 2013 report in Arthritis & Cartilage, obesity can increase inflammation in the body, which can lead to joint pain. Losing weight can reduce the body’s ability to trigger inflammation.

A systemic literature search reported in 2018 looked at case studies involving “weight loss, inflammation" and "restricted diet, anti-inflammatory effect." Among the articles reviewed, 76 involved 6,742 patients with an observation period from three weeks and two years who lost an average of around 2 pounds per month.

In most of the studies, weight loss contributed to a significant reduction of inflammatory cytokines (proteins that regulate the inflammatory response), as evidenced when checking their levels in the blood plasma of the study participants.

Better Overall Health

Weight-related body damage from OA is not just limited to joints. Both obesity and OA are linked to heart disease, high blood pressure, diabetes, and depression. The same inflammatory process linked to OA also contributes to these conditions.

Exercise is one of the best ways to reduce whole-body inflammation and prevent heart, blood sugar, and cholesterol problems.  

Better Sleep  

Living with OA joint pain can interfere with your sleep and might lead to sleep problems over time. One study reported in 2014 in the journal Rheumatology that weight loss could lead to better sleep.

Getting enough quality sleep can be beneficial to a healthy weight loss program and the lack of sleep can deter weight loss. In fact, studies have shown that losing sleep while you are dieting can reduce weight loss efforts and encourage overeating.

Healthcare Cost Savings  

OA can be a costly condition. According to the Centers for Disease Control and Prevention (CDC), OA was the second most costly health condition treated in American hospitals in 2013. It accounted for $16.5 billion (4.3%) of the combined costs for hospitalization.

Additionally, OA is one of the most expensive conditions to treat when joint replacement is necessary.  

Some of that cost burden also falls on people with the condition. For example, OA leads to increased medication costs, copays (payment required for a medical service before insurance picks up the rest), and declining income due to a disability.

Weight loss might lead to improved joint function and less pain, which in the long term could save you a lot of money and keep you gainfully employed for years to come.  

Extra Weight Increases Joint Pain  

Extra weight puts stress on your hips, knees, ankles, and other weight-bearing joints. The hips, ankles, and knees are your primary weight-bearing joints. The joints of your spine, pelvis, and feet are also considered weight-bearing, but they do not take on as much stress.  

Your weight-bearing joints are responsible for holding you up and supporting your movement. They carry your full body weight and the more they are forced to carry, the more damaged they can become.

Articular cartilage is primarily affected by excess body weight. It sustains more damage in daily use when there is more body weight. When cartilage is worn away, the bones cannot move easily and there is rubbing of bone against bone.

In addition, it can also break down from overuse, injury, and daily wear and tear over time.  In some instances, genetics might be to blame for the breakdown of joint cartilage, especially when it affects younger adults and children.

Both obesity and inflammation contribute to OA pain. People who are affected by being overweight have more joint pain than those at a healthy weight. But weight loss can help to improve pain and joint function, and lower inflammation. 

Doctors Who Can Help 

There are plenty of healthcare professionals that can help you get started on your OA weight loss journey including your general practitioner, a physical therapist, and a nutritionist. Enlisting the help of these people can make basic exercise and nutrition much easier and also help you get started.  

Primary Care Professional 

A general practitioner (family doctor) or the nurse practitioner or physician's assistant who is a primary care professional can be a starting point for weight loss help. They can offer advice on healthy weight loss, exercise, and dieting.  

A primary care professional can also provide you weight loss information specific to age, OA, and other medical conditions, safe exercises, and foods to eliminate from your diet. They can also give you referrals to a physical therapist and a nutritionist.

Physical Therapist

Physical therapy exercises are a good place to start to combat OA pain and stiffness safely. A physical therapist can be a helpful resource for people struggling with weight loss due to OA.

This person can help you better understand OA, its complications, how to lessen the pain with exercise, and improve your function and movement. They can also offer education about weight and making healthy lifestyle choices.  

Nutritionist  

Making healthy diet changes helps you lose weight, ease inflammation, and relieve the pressure on your joints.

One study reported in 2015 found people who ate a whole-food, plant-based diet significantly improved OA joint pain. Improvement occurred as early as two weeks and by the end of the six-week study, the study participants were reporting improved energy levels and better physical functioning.  

Enlisting the help of a nutritionist can help you achieve your weight loss goals. A nutritionist is an expert on improving health and managing diseases through food and nutrition.

A nutritionist with a background in arthritis conditions can answer your specific questions about managing your OA weight loss and give you advice on the best ways to lose weight and manage arthritis symptoms.  

Goal-Setting and Diet Changes

Losing weight isn't easy, but it will help to reduce your joint pain, stiffness, and swelling. Here are eight tips to get you started.  

1. Set a goal. It is important to set weight loss goals you believe you can accomplish. Remember, every small amount of weight loss helps. 
2. Take it slow. People whose weight loss is steady and gradual, around 1 to 2 pounds a month, are more likely to keep weight off. For example, if your goal is to lose 10 pounds, you should aim to meet that goal over a few months.
3. Make lifestyle choices. If you want to lose weight and keep it off, it is important to find a plan that works for your unique health situation and that you can stick with. Lifestyle choices can include eating a healthy diet, staying active, not smoking, and managing stress levels.
4. Enlist help. Making changes to improve your health and help you lose weight can be tough if you do it alone. Enlist the help of family or friends to support and join you on your weight loss journey.
5. Keep moving. Weight loss is the most successful with both diet and exercise. For people with OA, adding exercise can help to relieve their joint pain. Try low-impact exercises (ones that do not involve repetitive joint stress) such as swimming and walking to keep you moving and building strength.
6. Make small changes. You don't have to make too many changes at once. Pick one thing and focus on it for a few weeks. For example, start taking a 15-minute walk each day. Once it is comfortable, gradually increase the time. Rather than diving into a specific diet plan, replace unhealthy snacks with fresh fruits and vegetables.
7. Stay hydrated. Dehydration, regardless of how mild it is, can be masked as hunger. So, before you grab a salty or sweet snack, consider drinking a glass of water and see if the hunger stops. Staying hydrated can also improve weight loss, keep you energized, and manage your appetite.
8. Celebrate every win. Every pound lost gets you closer to your weight loss goal and improved OA pain, so celebrate each victory. Reward yourself with a new book, a new outfit, or a new water bottle for every 5 or 10 pounds lost. 

Osteoarthritis Exercises  

The best exercises for OA are those that help you manage your weight and strengthen your muscles. Good choices for OA weight loss include walking, swimming, biking, and using an elliptical trainer.

You will want to avoid exercises that put too much stress on your joints, such as running and activities that involve jumping, quick turning, and sudden stops.  

You might also consider stretching exercises that target your lower body—mainly your hips and knees.  

Hip Exercises  

The following hip exercises can help you manage OA hip pain and stiffness.  

Clock Tap  

The clock tap can help improve your balance and stability while strengthening your hip muscles. to do it:

1. Start by standing next to a wall for support.
2. Balance on your right foot while holding the wall for support. Keep your knee straight over the ankle, slightly bending your foot.
3. Tap your left foot towards your right one. The right foot should be like the centerpiece on a clock and your left would be touching the numbers on the clock’s face. Start at 12 o’clock and tap back at 11, 10, and 9.
4. Retrace back to 12, tap to 1 and 2, and retrace back to 12.
5. Repeat four times on each foot.

Standing Iliotibial Band Stretch  

The standing iliotibial band stretch stretches the inside of your hip. To do it:

1. Start by standing next to a wall for support.
2. Pull the leg closest to the wall behind your other leg.
3. Lean your hip toward the wall until you feel stretching at the outside of the hip. Hold for 30 seconds and come back to standing position.
4. Now cross the leg farther from the wall behind your other leg.
5. Repeat the same on the opposite side.
6. Repeat the same steps four times on each side. 

Knee Exercises

Stretching can reduce flexibility loss in and around the knees. And some exercises also target your knees to help limit declines in the muscle that supports your knee. Try the following exercises.  

Bodyweight Squats  

To do it:

1. Start with your feet shoulder-length apart, with your feet turned out slightly.
2. Keep your heels firm to the ground and bend the knees while dropping your butt and lowering your body.
3. Pause for at least 10 seconds before going back to a standing position.
4. Repeat 10 times.

 Leg Extensions

To do it:

1. Sit in a sturdy chair.
2. Slowly straighten your knee forward until your leg is straight, and then slowly return to the bent position.
3. Do up to 15 repetitions on each leg.

Stair Climbing  

If you have stairs at home, try tackling the steps a few times daily. If you don’t have steps in your home, try stepping up and down using a stool or block. Do 10 steps per leg a few times a day.  

Summary

Osteoarthritis is the most common type of arthritis. It is caused by excess body weight, aging, joint injuries, repetitive movement from sports or certain occupations, excess body weight, and genetics. OA gets worse with time if its symptoms are not addressed.  

No medication can slow down OA and its effects. However, weight loss can ease OA pain and reduce the chances of someone needing joint repair surgery.

If you don’t know where to begin, start by talking to a general healthcare practitioner. They can help give you advice on OA weight loss and referrals to other providers to get you started.

A Word From Verywell

When you start an OA weight loss plan, there are some things to keep in mind. You should be careful where you get your weight loss advice, and your weight loss plan should be safe. Talk to a doctor about how to manage your weight and any obstacles you face along the way.

You should continue to talk to a healthcare professional while on your weight loss plan. If you struggle to lose weight or find that you are experiencing new health challenges, they need to know. A healthcare professional can also help you stay focused on your goals and offer support on your way to the finish line.