YOUR PHYSIO
Condition directory
Weight Loss
A 10% reduction in body weight has been demonstrated to improve symptoms of osteoarthritis, and improve function also, particularly if you have a BMI above 25. If you are overweight, bringing your Body Mass Index (BMI) within the healthy weight range is one of the best things you can do to significantly reduce the risk of worsening or progressive arthritis.
How and why weight loss helps with arthritis development and symptoms is likely due to multiple reasons, including:
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Reducing strain on your joint
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Reducing the amount of inflammatory chemicals and hormones in the body which are bad for cartilage health.
A bit about BMI measurement
BMI measurements are a quick and simple method of estimating whether someone is overweight because they are carrying excess body fat, by comparing their height to their weight. Research demonstrates that BMI values correlate well body fat percentages in most people. The exception to this is people who have a very high muscle bulk (like athletes, weight lifters or body builders) where BMI may be over-estimated For the rest of us, BMI is a good basic measure which does correlate well with our percentage body fat.
There are many online BMI calculators that you can use to check your own BMI (e.g Calculate Your BMI - Metric BMI Calculator (nih.gov)).
Alternatively, waist circumference can be used as a measure (such as in those populations who have very high or very low muscle bulk): for men your waist circumference when measure around your belly button should be equal or less than 94cm (37 inches), whereas for women it should be equal or less than 80cm (31.5 inches).
See this useful article on body fat calculation methods on the British Heart Foundation website for further information about the accuracy of these methods: 12 ways to measure body fat - BHF
BMI and surgery
If your BMI is above 30, and your symptoms are severe enough to require surgery (now, or at a later date) the CCG will not fund that surgery unless your BMI is below 30 (or waist circumference is below 37” for men and 31.5” for women), which is another good reason to try to reduce your weight if required.
The commissioning statement from the Vale of York CCG for elective surgery can be seen here.
With hip and knee replacement, there are additional commissioning restrictions that mean that surgery may be denied altogether if your BMI is above 35. Please see the commissioning statement for hip and knee replacement for further information.
Weight loss methods
You should aim to eat 600 calories (kcal) less than you burn in energy each day in order to lose around 2lbs of weight each week. Most adult men burn 1900 – 3000 calories a day, depending on their age and activity levels. Most adult women burn 1400 - 2500 calories a day, depending on their age/activity levels. Remember that from the age of 40, for every decade that you age, your daily metabolic rate (the amount of calories that you need to survive on a daily basis) will reduce by at least 50 calories, even if your activity levels remain the same. From the age of 70, the amount of calories your body requires every day reduces even further still. This is one common reason why people tend to gain weight as they age, because the amount of calories we need each day to survive reduces as we age, but our eating habits often stay the same. This is even more noticeable when our activity levels also reduce because of joint problems or pain.
There are websites you can use which help to estimate how many calories you are likely to be burning every day depending on your age, gender, height, weight, and activity level (e.g. BMR Calculator - Metabolism Calculator (Basal Metabolic Rate) (diabetes.co.uk)).
Activity tracker watches are useful for helping you to monitor how many calories you are burning on a daily basis as well. The aim is to try to make sure you consume 600 calories less than this amount every day to allow you to lose weight at a steady rate.
In terms of which approach you take to lose weight, there is no “magic diet”. Different diets work for different people. The diet that works best for us is one we can sustain, and one which helps us to make life-long changes that will help to keep us healthy into old age. Diets rich in real foods (not processed of packaged) including high quantities of vegetables, fruit, lean meat, complex carbs, and whole grains appear to be best. The Mediterranean diet is a good example. The NHS has a lot of weight loss resources available, including a weight loss app, that may be helpful and can be accessed here.
Your GP will be able to give you more weight loss advice, and it is sensible to check with your GP before you make any significant change to your diet to ensure they feel it is a sensible change for you as an individual, especially if you have other health conditions. If your Body Mass Index is over 35, then your GP may be able to refer you into the Tier 3 weight loss programme at York Hospital, or may be able to discuss other weight loss strategies with you.
Weight loss programmes such as Slimming World, or Weight Watchers also seem to be effective methods for losing weight, and there may be a local programme near to you that you can sign up to.
Next Section:
Treatment options: Medication & Injections
Treatment options for Knee Osteoarthritis
Treatment options: Exercise & Activity