Monday, May 31, 2010

Weight Loss: An Effective Treatment For Osteoarthritis (OA)

Matthew Papa, PhD

The surge of obesity in the US, especially among the elderly population, has contributed significantly to the increase in osteoarthritis (OA) rates. Among people over 65 years of age, 70% of them have developed OA with the knee joints experiencing the greatest impact. It has been repeatedly shown that being obese contributes heavily to the possibility of suffering from OA later in life.

As researchers today are struggling to identify the most beneficial solutions, the topic of obesity continues to be at the forefront of their discussion. They believe that effective weight management programs will save countless lives, through the reduction of chronic disease development, along with the reduction of OA incidence. Ultimately, their aim is to reduce morbidity and mortality rates.

Obesity Causes Arthritis: What Is The Mechanism?

Obese individuals typically have an increased amount of strain on their joints from the load they carry, eventually wearing them down. The weight bearing joint of the knee, primarily, and the hip, secondarily, may be the most distressed, while the non-weight bearing hand is usually less distressed. This mechanical strain has been suggested as a direct contributor to the development and progression of OA.

Similarly, obesity is a risk factor of OA due to an elevated bone mineral density, present in most overweight individuals. It is the opposite of osteoporosis and may actually contribute to a circulating, bone, and/or cartilage growth factor triggering accelerated cartilage degeneration.

This may actually clarify some of the mystery and intrigue in the progression of hand OA. Obese people exhibit an increased incidence of hand OA, despite the fact that hands are non-weight bearing joints. It is this circulating factor that reaches systemically all joints and causes the development of OA even in joints that are not mechanically stressed.

Low-grade, chronic inflammation is also found in most obese individuals, contributing to articular cartilage deterioration, initiating the development of OA. This adipose tissue (body fat) acts as a nutrient cache and is part of the integumentary system, which includes the skin, and is necessary to protect the internal organs, store energy, and provide insulation against heat or cold. However, excess adipose tissue may also be a contributing factor in the development of OA, especially among postmenopausal women.

Can Weight Loss Improve the Symptoms of OA?

Weight loss programs that provide assistance in the weight reduction process will inevitably serve to reduce the risk of developing OA and aid in the treatment of advanced OA symptomology.

Results from a 2007 review study measuring the effect of weight loss in improving pain and functional disability among patients with knee OA, indicated that participants who reduced their body weight by 5-10% at a progressive rate of 1.1-3.3 pounds per week experienced a more significant reduction in knee OA symptoms, than those who did not. Clinically studied weight loss programs, such as Medifast and Nutrisystem, can typically achieve this rate of weight loss. Such weight loss programs, when utilized in conjunction with pain relief supplements for the joints, such as Joint Advance, can assist obese individuals to lose up to 3 pounds or more each week and see great improvements in their OA condition.

Can Weight Loss Prevent The Development of OA?

Study results reveal that prevention is the most vital component in mitigating your risk of acquiring OA. The Framingham OA study found that if men in the overweight or obese BMI categories would only lose weight to the extent that they would drop to a lower category (move from the obese level to the overweight level, or from the overweight level to the normal level) their chances of developing OA would be reduced by 21.4%. Likewise, women would decrease their risk by 33%.

However, the most significant dilemma facing those who need to reduce their body fat percentage is that only 5% of them actually do. Although the specific amount of weight needed to lose will differ according to each individual’s needs, it is apparent that motivation is lacking in most instances. For this reason individualized coaching and successfully participating in a multiple behavior lifestyle intervention program, addressing diet, physical activity, and the elimination of at-risk behaviors (smoking, alcohol, drugs, etc.) has proven to provide the most significant benefit. This will also provide the accountability needed to achieve the participant’s desired results.

Final Thoughts

Now that obesity has been identified as a major contributor in the development and progression of hip, knee, and hand OA, it becomes apparent that maintaining a healthy weight and learning to make beneficial choices at an earlier age will effectively protect against OA. The effect that this will have in reducing chronic inflammation and the prevalence of obesity will be phenomenal. Its impact will provide an invaluable remedy among those suffering from the excruciating challenges associated with OA.

About the Author

Specializing in the study of obesity and its relationship to osteoarthritis, Matthew Papa, PhD, monitors the most up-to-date scientific publications on the benefits of diet and weight loss programs. He makes a Medifast coupon and Nutrisystem discount code available in his blog.

References

1. Obesity and inflammation--targets for OA therapy. Iannone F, Lapadula G. Curr Drug Targets. 2010 May;11(5):586-98.
2. Felson DT. Weight and osteoarthritis. J Rheumatol 1995; 22(suppl 43):7-9.
3. Comparing two low-energy diets for the treatment of knee osteoarthritis symptoms in obese patients: a pragmatic randomized clinical trial. Riecke BF, Christensen R, Christensen P, Leeds AR, Boesen M, Lohmander LS, Astrup A, Bliddal H. Osteoarthritis Cartilage. 2010 Feb 17