The Effect of Excess Weight on Your Joints

Joint pain can occur for many reasons and excess weight can be a contributing factor. But you’re not alone and there are things you can do today to help.

If you're affected by aching, stiff, tender, and painful joints, you're in good company. According to research, approximately 100 million Americans are living with chronic pain, and a majority of these people are dealing with chronic pain specifically affecting their joints.1

Why is joint pain so common? While many factors influence who is affected by it and who isn't—including genetics, lifestyle, and the environment—one of the most common and controllable risk factors for joint pain is excessive weight and obesity.2

Carrying excess weight has a big impact on your joints— in a few ways

Excess weight is associated with everything from heart disease to diabetes to poor body image. But the potential ramifications of carrying around excess body fat on joint health—especially in the knees, hips, ankles, feet, and spine—are significant and often overlooked.

According to the Centers for Disease Control, 1 in 3 Americans who are overweight or obese are living with arthritis (joint inflammation).3 Osteoarthritis, the most common type of joint inflammation, occurs when the protective cartilage lining inside the joints wears down. Over time, this leads to significant pain, stiffness, swelling, and decreased range of motion.

Why are arthritis and other types of joint pain so common among people who are overweight? The first reason is largely self-explanatory: 

"Having a higher bodyweight increases the amount of load imposed on the joints, and loading a joint beyond its safe stress tolerance causes damage.3"

Consider what happens during normal walking. Biomechanical studies show that a load equal to about 1.5 times your bodyweight passes through your knees as you walk on a flat surface.4 If you walk quickly, walk up or down an incline, or carry extra weight, then the amount of force becomes even greater.

The implication of this data is clear for people who are overweight and obese: simply functioning in day-to-day life can impose excessive strain on the joints and lead to pain and dysfunction. This is particularly true for overweight people who have other risk factors for arthritis (such as genetics and a history of joint trauma).

And it's not just the extra weight itself that can lead to joint pain. Research suggests that the widespread systemic inflammation associated with obesity can further damage joints.3,5 Plus, painful joints can make it difficult to exercise—and exercise is essential for not only sustainable weight loss, but for improved joint health, as well. 

Peter's Patient Story – Partial Knee Replacement

Even a little counts a lot: how weight loss can improve joint pain

By losing excess weight, people struggling with joint pain have so much to gain.

Research shows that a weight loss program focusing on healthy diet and exercise can reduce chronic pain and drastically improve joint function. This is largely because weight loss will decrease the amount of load imposed through the joints during weight-bearing activities.

"For instance, at least one study found that for every 1 pound of weight lost there is a 4 pound decrease in the amount of forces imposed on the knee while walking.3,6"

This is encouraging news, because it suggests that even modest weight loss can result in significant improvement in joint function and pain—a pretty decent return on investment.

Additionally, lifestyle factors associated with losing excess body fat can minimize systemic inflammation, which we know can exacerbate joint damage.7,8 And the better we feel overall, the more likely we are to maintain healthy habits that protect our joints and help us maintain a lean body mass.

Building Strength Before Joint Replacement Surgery

Getting started on a weight loss journey

Not sure where to begin on your weight loss journey? These simple suggestions may help:

  • Talk to your physician. Remember to never start or stop medications, exercise programs, or dietary changes without consulting with your physician first.
  • Consider working with a personal trainer. While it may seem counterintuitive to exercise when your joints hurt, an exercise program designed for you might reduce pain by improving blood flow, increasing range of motion, and maximizing the strength of joint-supporting muscles. But not all exercises are created equal, and it's important you find a plan that will be helpful for your specific condition and enjoyable so you'll stick with it. A personal trainer or physical therapist can be a great resource for ideas on lower-impact exercises, especially in the beginning.
  • Ramp up. Set yourself up for success by setting small reasonable goals in the beginning and building off of these. You want to reinforce your newfound healthy habits with positivity and growing self-confidence—not guilt over setting the bar impossibly high and then missing the mark.
  • Focus on food. No matter how much you're exercising, your success in the gym will be limited if you're not establishing healthy dietary choices. Knowing what to avoid, like some unhealthy sugars and processed grains, is as important as knowing what to get more of, including quality protein, healthy fats, and produce. You also want to make sure you're eating enough to support physical activity and muscle strength, but not too much to slow fat loss. 
  • Recruit your tribe. Surround yourself with like-minded friends and family members who can share in your commitment to a healthier lifestyle. This increases your accountability, adds more enjoyment to your efforts, and can help you stick to (and celebrate) your goals. Science shows—and you may intuitively know—that excess body weight increases the risk of joint pain.2 So consider this year as good as any to shed excess weight, improve your well-being, reclaim your health, and stand more confidently in your day-to-day life.
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References
  1. Institute of Medicine Report from the Committee on Advancing Pain Research, Care, and Education (2011). Relieving Pain in America, A Blueprint for Transforming Prevention, Care, Education and Research. The National Academies Press. http://books.nap.edu/openbook.php?record_id=13172&page=1.
  2. Bliddal, H., et al. (2014). Osteoarthritis, obesity and weight loss: evidence, hypotheses and horizons – a scoping review.  Obesity Reviews. 15:578–586. www.ncbi.nlm.nih.gov/pmc/articles/PMC4238740/
  3. Kane, Andrea. How fat affects arthritis. Arthritis Foundation. http://www.arthritis.org/living-with-arthritis/comorbidities/obesity-arthritis/fat-and-arthritis.php
  4. Why weight matters when it comes to joint pain (2019). Harvard Medical School – Harvard Health Publishing. www.health.harvard.edu/pain/why-weight-matters-when-it-comes-to-joint-pain
  5. Powell, A., et al. (2005). Obesity: a preventable risk factor for large joint osteoarthritis which may act through biomechanical factors. Br J Sports Med. 39:4–5. www.bjsm.bmj.com/content/39/1/4
  6. Messier, S., et al. (2005). Weight loss reduces knee‐joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis & Rheumatism. 52(7). www.onlinelibrary.wiley.com/doi/full/10.1002/art.21139
  7. Forsythe, L., et al. (2008). Obesity and inflammation: the effects of weight loss. Nutr Res Rev. 21(2):117-33. www.ncbi.nlm.nih.gov/pubmed/19087366
  8. Alemán, J., et al. (2017). Effects of Rapid Weight Loss on Systemic and Adipose Tissue Inflammation and Metabolism in Obese Postmenopausal Women. Journal of the Endocrine Society. 1(6):625-637. www.ncbi.nlm.nih.gov/pmc/articles/PMC5686624/

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