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Obesity is bad for your joints

Published on 01 October 2009
Source: Arthritis Today

We’ve known for a long time that obesity is bad for us, but a new Arthritis Research UK report reveals that very overweight people are a staggering 14 times more likely to get osteoarthritis of the knee than those in a healthy weight range. Coloured xray of obese person's lower leg

Tram conductor Dean Collier was forced to give up work five years ago after starting to suffer from severe pain in his knee, diagnosed as osteoarthritis.

Tall at 6ft 2ins, but at 17 stone Dean was also classed as overweight. As the pain from standing for long periods of time was becoming unbearable, Dean was moved to driving the trams and later to an engineering role, but when the pain got so bad Dean had to give up work, and was treated for depression.

But an appointment with a nurse at his local GP surgery signalled a new start when Dean, from Nottingham, was advised to attend a local exercise programme. The one-hour circuit training classes were held twice a week at his local leisure centre, and combined with regular swimming, and cutting out fizzy drinks, chocolates, sweets and cakes, he soon lost a stone.

“It was difficult at first, but after a few weeks the exercise and good diet came naturally. It was a complete lifestyle change and the change was incredible,” says Dean, now 42. The pain in his knee reduced, became less stiff and aching, and more flexible.

Dean is just one of millions of people in the UK for whom weight is a serious issue. The rise in obesity and the resulting increase in the number of people suffering from osteoarthritis – particularly of the knee – as a result, has prompted Arthritis Research UK to produce a new online publication to warn the public of the hitherto little publicised dangers to their health and quality of life of obesity.

In fact, obese people are four times more likely to develop osteoarthritis of the knee as they are to develop high blood pressure or type-2 diabetes.

Worn cartilage cannot currently be repaired

But whereas high blood pressure and diabetes may be substantially improved on losing weight and are relatively easy to control with therapy, the changes resulting from osteoarthritis are irreversible, as worn cartilage cannot currently be repaired.

However, according to Professor Alan Silman, Arthritis Research UK medical director, there is good news for the obese and overweight whose knees become painful due to osteoarthritis as a result of their weight. “Research shows that losing weight, however modest, when combined with exercise, is a panacea at every stage,” said Professor Silman.

“Achieving a healthy weight reduces the risk of developing the disease in the first place, relieves existing symptoms and helps to prevent further deterioration. And weight loss with exercise has been shown to achieve the same level of symptom relief as joint replacement surgery.”

Osteoarthritis has been, if not ignored, then certainly underestimated

Arthritis Research UK is concerned that while rising rates of obesity have been linked to a number of serious disorders and health concerns, the risk of potentially crippling osteoarthritis has been, if not ignored, then certainly under-estimated.

The true impact of obesity in the development of knee osteoarthritis has only recently become clear, said the charity, pointing to a study which revealed that at the most extreme, very obese people with a body mass index (BMI) of 36 or more have a 14-fold higher risk of knee osteoarthritis compared to those in the healthy BMI range.

Professor Silman warns there was a real concern that unless rocketing rates of obesity were tackled, the numbers of people needing joint replacement surgery would soar, which would have a considerable impact on the NHS.

"There are two major risk factors for developing osteoarthritis – ageing and obesity – and as both these factors are on the rise in the UK, it’s an obvious prediction to make that the outcome could be a massive cost to the health service,” he adds.

Joint replacements are more likely to fail earlier in obese patients, and the heavier the patient the less likely it is that surgery will bring about an improvement in symptoms.

Very obese women are 19 times more likely to need knee replacement and four times more likely to need hip replacement surgery compared to women of a healthy weight.

A series of studies has shown that even modest weight loss and exercise can help to reduce not only pain but also mobility and the ability to perform everyday activities.

Certainly Dean Collier can vouch for the difference exercise and weight loss has made to his quality of life – and to his knee pain. “I feel so much more positive, and I’m planning to carry on exercising and eating healthily – in the hope that I can lose even more weight,” he says.

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