Why Weight Loss Improves Arthritis- A Complete Guide

Physicians around the world are emphasizing weight loss more than ever for the treatment of arthritis. The guidelines of the American College of Rheumatology recommend a combined therapy of diet, exercise, and weight loss. The reason behind this approach is the evident improvement in arthritis with weight loss due to decreased stress on the joints and reduced inflammation.

Introduction to Arthritis

Arthritis is defined as the inflammation of joints. It is a painful condition in which your joints swell and become immobile. Based on the type of arthritis, it can be due to a variety of reasons:

  • Osteoarthritis- due to joint degeneration
  • Rheumatoid arthritis- due to the attack of the body’s immune cells on joints
  • Psoriatic Arthritis- related to a skin condition
  • Gout- due to the accumulation of uric acid
  • Septic arthritis- due to infection in joints by bacteria

Osteoarthritis is the most common form of arthritis prevalent in the world. However, in any of these types, the mechanism and symptoms are largely similar.

Whatever the cause may be, when your joint health is compromised, it manifests itself as the following problems:

  • Pain
  • Swelling
  • Redness
  • Stiffness
  • Limited mobility

So, if you wake up in the morning and feel rigidity or pain in your joints, it is likely to be due to inflammation.

This condition is often debilitating because the movement is severely affected. Sometimes you may not be able to walk let alone exercise or jog. Occasionally, the pain is excruciating and needs a visit to the emergency room.

Considering the seriousness of the condition and its impact on the quality of life, extensive research has been conducted on the topic. Most of these document a positive role of weight loss in the progression of the disease.

Obesity And Arthritis- Are they linked?

Obesity and arthritis are correlated and happen to occur cyclically. Since the inflammation of joints leads to an inability to perform physical activity, more weight accumulates. Therefore, the inflammation aggravates further and the cyclical pattern goes on.

Research suggests that overweight or obese individuals are prone to worsening of arthritis due to mechanical and chemical changes in the body.

The body mass index (BMI) is a scale used to find if an individual is obese. It is calculated by using body weight and height.

BMI 18-25 Normal range
BMI > 25 Overweight
BMI > 30 Obese

A randomized control trial study conducted in three health districts of England followed 525 men and women from the age group higher than 45 years. A comparison with the control group showed that the risk of developing arthritis increased from 0.1 to 13.6 for individuals with a BMI of 36 and higher. It also established that bringing weight in the recommended BMI range could decrease the likelihood of severe arthritis, needing surgical intervention, by 24%.

Another research shows that obesity is linked with the rapid progression of diseases, especially in the patients of rheumatoid arthritis. It intensifies disability, especially movement of joints, and increases the chances of arthritis becoming a chronic illness.

The weight gain is also associated with the early onset of arthritic symptoms. It is more prevalent in weight-bearing joints such as leg joints and women are considered a high-risk group. One study shows that those who suffer from juvenile obesity can develop arthritis earlier than those with normal BMI in childhood.

How does Obesity Aggravate Arthritis?

The mechanism by which obesity worsens arthritis is well-established. It alters your body chemistry and metabolism. These changes collectively create an unfavorable environment for the health of joints. The effects of obesity on your body are enlisted below:

#1 It Increases the Inflammatory Markers in Blood

Emerging research suggests that the link between body weight and arthritis extends way beyond the obvious. The research suggests that obesity is a pro-inflammatory condition. It leads to heightened levels of chemicals circulating in the blood that affect several body organs including the joint surfaces. The damage done to the joints by inflammatory chemicals leads to arthritis.

The inflammation is a protective response of your body towards disease. It is a result of the sequence of events in your body that are driven by the inflammatory chemicals known as cytokines.

These are substances released by your immune system in an attempt to kill viruses and bacteria. In arthritis, your immune system makes a mistake. It pins your healthy joint as a foreign agent and starts releasing inflammatory markers. These, in turn, let your immune system attack the tissue. Obesity intensifies this process by increasing the amount of these chemicals in your body.

Your body fat is made up of special cells called adipocytes. These fat cells release adipocytokines which induce inflammation. These are numerous in quantity and types; some of the adipocytokines include:

  • Leptin
  • Adiponectin
  • Visfatin
  • Chemerin
  • Apelin

Other cytokines responsible for inducing arthritis are:

  • Interleukin-6 (IL-6)
  • C-reactive protein (CRP)
  • Tumor Necrotic Factor (TNF)

These chemicals are released in the blood and disrupt the bone and cartilage health in joints. According to research, in patients of arthritis, they markedly increase the inflammatory episodes.

More the fat stored in your body, prolific the amount of these substances. Therefore, obesity is no good news for arthritis patients.

#2 It Raises the Likelihood of Metabolic Dysfunction

Metabolic dysfunction means disturbance of chemical reactions taking place in your body. In obese individuals, the damage is extensive, but the reaction most worth mentioning is carbohydrate breakdown.

The carbs you eat are converted into energy and insulin is involved in this metabolism. Obesity causes insulin resistance, a condition in which your cells cannot detect and absorb insulin from the blood. This leads to the onset of diabetes as well as exacerbation of osteoarthritis.

The research indicates that insulin resistance causes elevated levels of tumor necrotic factor (TNF) which in turn increases the likelihood of joint inflammation. As obesity is involved in causing insulin resistance, it indirectly but effectively also leads to the aggravation of arthritis.

#3 It Causes Mechanical Stress on Joints

Obesity takes a significant mechanical toll on your joint health. This effect is especially prominent in weight-bearing joints like knees and ankles.

When you gain weight, your joints have to bear more than their capacity; as a result, their cartilage gets damaged. Every time you walk, your joint endures a micro-injury. These small impacts accumulate over time and lead to speedy deterioration of your cartilage.

When arthritis patients gain weight, it also leads to significant pain because your cartilage health is already compromised. This effect of obesity is particularly problematic in symptomatic irritation. To put it simply, weight gain not only contributes to structural damage but also increases the pain. When your joints are aching, the movement automatically reduces, making your daily activities a struggle.

How does weight loss Improves Rheumatoid Arthritis?

To break the cycle of obesity and its resultant devastating effects on joints, you need to get yourself in shape and lose extra pounds. Weight loss has become an important non-pharmacological intervention for arthritis around the world.

 #1 It Improves the Quality of Cartilage

There is increasing evidence that losing weight improves the health of cartilage in your joints by elevating levels of proteoglycans in the cartilage.

Proteoglycans are the proteins that make up the connective tissue in your body. The accumulation of proteoglycan ensures healthy cartilage and weight loss does exactly that. When structural proteins build up in your cartilage, it regains its strength and performs better in the face of inflammation.

Leptin levels, an inflammatory chemical, are higher in obese people. This is associated with destruction of cartilage cells. Losing weight reduces leptin levels in the blood and protects cartilage cells. This results in a reduction of loss of cartilage thickness that happens normally with age.

The cartilage health especially improves if you are using exercise as a means to lose weight. Regular exercise offers mechanical stimulation to the cartilage and the surrounding bone. The mechanical stimulation is crucial as it strengthens your bone and joint architecture.

In short, weight loss slows down the degeneration of joints by maintaining their structural integrity. This is particularly marked in osteoarthritis but other types also have a positive impact.

#2 It Slows the Progression of Disease

The rapid deterioration of joint health is a poor prognostic indicator of arthritis. This progression is dependent on the number of inflammatory markers in your body. In obese individuals, these chemicals are abundant but weight loss can help alleviate their levels.

When you lose fat, you cut back the production of adipocytokines in your body. This puts a major dent in the development of inflammation. However, these are not the only chemicals affected by weight loss.

Losing weight decreases the amount of interleukin-6 and C- reactive protein (CRP) as well. These are potent inflammatory chemicals and their reduced levels diminish the advancement of arthritis.

Also, losing body weight improves the flow of blood in your body. It also means an improvement in the flow of blood to your joints, which can improve joint health and relieve arthritis symptoms.

#3 It Gives Symptomatic Relief

The first positive sign you notice while losing weight is the alleviation of your symptoms, particularly pain.

TNF present in your blood causes pain. IL6 and other inflammatory substances also have a minor role. With weight loss, their levels decrease so, your pain gets better considerably.

Another reason is that losing weight takes the mechanical load off your joint. It gives your joint a break from over-working and helps it heal. The effect is in 1:4 proportions. It means that with 1 kg loss of weight, you experience a drop of 4kgs in the load exerted on knees.

With the improvement in pain, your range of movement increases; hence, physical function enhances quickly. You can walk and move around without difficulty which brings a notable positive effect on your quality of life.

How Much Weight Loss is Recommended?

The cut-off line for weight loss in arthritis is 5kgs. Above this, you start observing alteration in the intensity of your disease. However, to experience significant progress, you need to set a higher target.

The National Institute of Health (NIH) recommends a realistic goal of losing 10kgs over six months. The idea is to avoid the rush and prevent excessive physical activity that can be potentially harmful.

For achieving this goal, NIH suggests an approximate caloric cut in the form of diet or exercise. The calories along with expected weight loss according to respective BMI are tabulated below:

BMI Caloric restriction/day Expected weight loss/week
27-35 300-500Kcal 250-500g
More than 35 500-1000Kcal 500-1000g

You should be cautious about sudden changes in weight. If you are looking for explosive weight loss, it might make things worse by putting extra stress on your body and making you prone to injury. The key is to take it slow.

The Final Verdict

Arthritis is a disabling condition and affects your quality of life badly. There is abundant evidence available that proves the harmful effect of your excess weight on this disease.

However, weight loss can turn the table and improve the efficacy of your treatment. Owing to this, it has become imperative for healthcare workers all around the world to counsel people about the importance of weight loss. Weight loss not only enhances the physical activity and health of your joints, but also improves your quality of life. This, however, does not point towards an aggressive intervention. The experts endorse to take it slow and expand the weight loss over time to

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