That’s the conclusion of a new study published today, June 18, 2018, in the journal Arthritis Care & Research, by researchers at Wake Forest University. “For overweight and obese adults with knee osteoarthritis (KOA), substantially greater weight loss, achieved safely, brings with it additional benefits,” says study coauthor Stephen Messier, PhD, professor of health and exercise science at Wake Forest University, in Winston-Salem, North Carolina.
Extra Weight Loss Equals Fewer Osteoarthritis Disease Markers
While everyone who lost weight got some benefits, people dropping 20 percent or more of their body weight saw an extra 25 percent reduction in some osteoarthritis disease markers compared with people losing from 10 to 20 percent, he says.
Knee Arthritis Improvements Were Substantial With Weight Loss
The study tracked 240 overweight and obese adults who had knee pain and documented osteoarthritis. Those who lost at least 10 percent benefitted in a number of ways: They reported significantly less pain, had better knee function, were able to walk farther in a six-minute test, and had decreased inflammation and bone-on-bone compression. The improvements exhibited what researchers call a “dose response,” which means the more people lost the better they did.
Losing Weight Correlated With Better Walking Ability
For example, those dropping between 5 and 10 percent could walk an average of 1,713 feet (522 meters) in six minutes by the end of the study, while those losing 10 to 20 percent went 1,778 feet (542 meters). Meanwhile, the over 20 percent group were able to get as far as 1,834 (559 meters).
Weight Loss Is Difficult When You Carry Extra Pounds
Of course, nobody is saying this level of weight loss is easy to achieve. Of the 240 people enrolled in the study, only 76 of them shed 10 to 20 percent, and just 31 people lost 20 percent or more.
Osteoarthritis Tends to Worsen Over Time; Improvements Are Key to Overall Disease Management
Osteoarthritis is a condition where the joints become painful and stiff, especially in the morning. Depending on the severity, treatment options typically include medication, physical and occupational therapy, physical activity such as stretching, or surgery. Often, symptoms get worse over time. Knee pain that gets in the way of everyday living may possibly even lead to depression. Weight loss has long been known to play a role in improving the disease. For example, observational data from a study known as the Osteoarthritis Initiative linked greater weight loss with less cartilage damage, according to a study published in July 2016 in the journal Osteoarthritis Cartilage. But whether extra weight loss brings added gains hadn’t been documented in a clinical trial before.
Excess Weight Harms Many Body Parts
In addition to the benefits to knee arthritis found in this study, losing weight has been found to be helpful for overall health, as well as for many body parts. A report published by the National Institutes of Health described how weight loss leads to decreased blood pressure, fewer unhealthy blood fats, more good cholesterol, and better balance for blood sugar levels, among other things. The only downside of the weight loss found in this study was a slight reduction in bone-mineral-density (still above troublesome thresholds) — a finding the authors suggest is more than outweighed by the boost in lifestyle and reduction in pain.
Dropping Weight Slowly Is Important
Participants in this study lost their weight over an 18-month period. Because this was a reanalysis of the authors’previous study, published in September 2013 in the Journal of the American Medical Association, which examined whether diet, diet plus exercise, or just exercise resulted in the most weight loss (the first two groups did better than the last), participants lost the weight in a variety of ways. Still, a program that combines the right diet plan and appropriate exercise along with learning tools to change ingrained behaviors is best for any significant weight loss effort, according to the NIH report. Medication and even weight loss surgery should also be considered for some people, the NIH says. Losing weight slowly is best for the body. The NIH suggests that a reasonable time line is six months to drop 10 percent. Decreasing what you eat by 300 to 500 calories a day (500 to 1,000 calories if you’re severely obese) leads to a 1- to 2-pound weekly weight loss, a healthy rate.
Tips for Eating Better, Shedding Pounds
Mikel Bryant, RD, with the Mayo Clinic in Jacksonville, Florida, suggests that a good way to lose weight is to think about what you can add to your diet, rather than what you must take away. “Adding fruits, vegetables, and healthy grains can make you feel full,” she says. The best diets remain the Mediterranean diet and the Dietary Approaches to Stop Hypertension, or DASH diet, which are full of these healthy foods. Bryant also recommends distributing calories more evenly throughout the day. “Rather than the typical American approach of skipping breakfast, grabbing a quick lunch, and then eating a big dinner because you’re hungry, eat more at the earlier meals and less at night,” she says.
Find Support to Help Achieve Weight Loss
Talk to your doctor about best strategies for you and your personal health challenges. And if you’re not finding weight loss success, don’t be afraid to reach out to a dietitian. “Weight loss is a tricky thing, with genetics, medication, and your environment all playing a role. Dietitians take everything into account and can individualize a plan, helping a person see what they’re doing right and where they can improve,” Bryant says. A trained nutrition expert located near you can be found on the website of the Academy of Nutrition and Dietetics.
Don’t Shortchange Exercise and Movement to Help You Lose Weight
Exercise (with your doctor’s okay) should start gradually, eventually working up to 30 minutes or more of moderate intensity activity most or all days a week, the NIH report declares.
Consider Physical Therapy if You’re in Pain
Of course, if you have painful knee arthritis, you might fear working out. Getting assistance from a physical therapist can be helpful.
Weight Loss and Exercise Will Help Reduce Pain
“There may be an initial increase in pain, but if you slowly increase your exercise time, pain should be reduced and mobility increased,” Dr. Messier says. “The research is clear: Exercising and losing weight will reduce your pain by 25 percent,” the amount found in his study, he says. Once the weight is gone, you’ll need to continue the combination of exercise and healthy eating in a maintenance plan in order to successfully keep it off, the NIH report advises. For a chance for people living with knee osteoarthritis to gain more mobility and a better quality of life, the effort (and it certainly is effort) is surely worth it.
