When discussing health conditions caused by obesity, we most often hear about diabetes and heart diseases. But did you know your weight can have a significant impact on your muscles, bones and joints, too? With 135 million obese individuals in India alone, it has become one of the most common conditions to adversely affect bone and joint health.
The percentage of adults with obesity has more than doubled over the past 30 years, and at the current rate, 50% of Indian adults are expected to be diagnosed as obese by 2030. With such staggering statistics, it is time to take a closer look at the impact of obesity on bone and joint health.
Obesity, Orthopaedics and Outcomes
There are two ways in which being overweight can raise the risk for developing osteoarthritis – the most common joint disorder, resulting from the wear and tear of a joint.
- First, excess weight puts additional stress on weight-bearing joints (for example, the knee)
- Second, inflammatory factors associated with weight gain might contribute to trouble in other joints (for example, the hands)
Let’s look at weight and your knees:
When you walk across level ground, the force on your knees is equivalent to 1½ times that of your body weight, indicating that a 90kg man will put approximately 135kg of pressure on his knees with each step. In case of an incline, the pressure is greater: the force on each knee is twice or thrice your body weight when you walk up or down the stairs, and four to five times your body weight when you squat to pick up an item you’ve dropped or to tie a shoelace.
Childhood Obesity and Musculoskeletal Health
Childhood obesity, too, can have a harmful effect on the body in several ways. Bones grow in size and strength during childhood. Excess weight can damage the growth plate — the area of developing cartilage tissue at the end of the body’s arm, leg and other bones. Growth plates regulate and help to determine the shape and length of a bone during maturity.
Too much weight places excessive stress on the growth plate, leading to early arthritis, a greater risk for broken bones and other conditions, such as Blount’s disease and slipped capital femoral epiphysis.
Bariatric surgery is usually not recommended by doctors for children, however, in rare cases, it may be advised for youngsters with BMIs of 40 or above to avoid long-term musculoskeletal complications. In most children, a diet rich in calcium and other nutrients, alongside regular physical activity for at least 35 minutes can help minimize weight gain, while helping maintain strong bones.
How Obesity Affects Orthopaedic Surgery
Obese patients have a higher risk of arthritis of the knee and hip, as well as a much greater risk of lifetime disability from back pain, arthritis and spinal stenosis.
Even though obese surgical patients often have good results from orthopaedic surgery, they are also at a higher risk of complications in pre- and post-surgery, including:
- Increased blood loss
- Increased length of surgery
- Increased risk of wound infections and wound non-healing
- Hip or knee implant complications such as pain, loosening and infection
- Spine implant breakage and non-unions of fusion due to increased loads
- Postoperative pneumonia
- Blood clots and pulmonary embolism
- Peripheral swelling
- Lengthy recovery periods and poorer progress in rehabilitation
- Increased need for personal assistance after surgery
How Weight Loss Improves Arthritis
Improved quality of life is probably the most impactful and tangible effect. Even if you lose just a few kilos, you will be able to walk better, with much less pain. Benefits of weight loss include the following:
- Reduced joint pain and inflammation: Less body weight means less pressure and often less pain. According to a study published in the Journal of the American Medical Association, adults with osteoarthritis who lost weight through a combination of diet and exercise over a period of 18 months reported less knee pain. The study also showed inflammatory compounds associated with arthritis decreased.
- Better joint function: Weight loss improves joint function in obese people with osteoarthritis because compressive forces inside the knee joint improve.
- Lower risk of co-morbid conditions: Cardiovascular disease may be the result of both arthritis and obesity. The same holds true for diabetes and depression. Losing weight can help mitigate the risks.
- More energy: As counterintuitive as it sounds, exercise is the best thing you can do to improve fatigue. It releases endorphins, which not only increases energy but also improves your mood. Staying within recommended BMI is best pain medication and energy giver of all.
- Sounder sleep: Musculoskeletal pain interferes with sleep, leading to insomnia. Weight loss helps improve sleep.
How to Lose Weight and Keep It Off
Studies show that a sustained 5-7 kilo weight loss in obese people can result in a lower risk of osteoarthritis and other bone and joint-related problems later in life. You can begin by:
1. Setting Realistic Weight Loss Goals
If you’re overweight or obese, start out with a goal of lowering your weight by 5%. Once you reach the first goal, set another one of losing another 5%. Setting doable goals is important, especially if you have arthritis as you may be limited in the number of physical activities you can carry out.
2. Finding Your Diet Strategy
There is no one-size-fits-all approach. Indeed, those who have been successful have tried several approaches before they found the one that worked best for them. If you’ve tried and failed, think about the method that worked and those that didn’t.
3. Dining In and Reducing Calories
Restaurant meals are usually loaded with excess salt, fat and calories. If you go out for your meals, divide oversized portions in half before eating and maybe, pack the rest. Better still; try cooking and eating at home because when you cook at home, you control how much you eat and what you eat.
4. Exercising for Weight Loss
Cutting back on the calories you eat is half of the weight-loss equation. The other half is expending calories through physical activity. Exercise poses challenges for people with arthritis, of course. Bad knees, especially, can make many activities painful. Still, there are activities that even people with osteoarthritis can do such as light resistance exercises.
5. Finding a Weight Loss Buddy
Enrolling in a weight loss programme or forming your own support group can help you lose weight.
Losing a few kilos can go a long way toward reducing the pressure on your knees — and protecting them.
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