Achieve a Healthy Weight

Overview

Obesity is the most important patient-controlled risk factor for chronic musculoskeletal disease. Obesity is a risk factor for unhealthy tendons, muscle, bone, and joints. For instance, research suggests that if you are an obese man, then you are five times more likely to manifest osteoarthritis. If you are an obese women, it is four times more likely.

The 2011-2014 National Health and Nutrition Examination found that 36% of Americans are obese, a foreboding statistic in the fight against musculoskeletal dysfunction. 

In the context of this discussion, obesity is defined as a body mass index of 30 kg/m2 and being overweight is defined as a body mass index of 25 kg/m2. Body mass index is defined as your weight in kilograms divided by your height in meters squared. Multiple websites can calculate your BMI using values easily known to you, such as your weight in pounds and height in inches. Another common metric for obesity is a waist circumference. A measurement of 40 in. or greater for men, and 35 in. or greater for women is considered obese.

Obesity and musculoskeletal disease are a sinister combinations. Medical studies have revealed that individuals who are obese and also have musculoskeletal disease are more likely to be inactive, weak, and experiencing more pain when compared to nonobese individuals with musculoskeletal injury.

The Muscle, Bone, Tendon, & Joint  Problem with Excess Fat

Obesity causes increased biomechanical loading. Biomechanical loading can be thought as the stress experienced by tissue. The greater the load, the greater the stress. Experts estimate in certain phases of walking, the knee experiences the force of three to six times your body weight. For an added perspective, if you are 20 lbs. over weight, your poor knee joints can experience up to 120 additional pounds.    

Additionally, fat is not metabolically inactive. Rather, fat cells continuously release pro-inflammatory chemical signals called adipokines. Adipokines catalyze whole-body inflammation that triggers a destructive state in joint, muscle, bone, and tendon tissue.

Selected Evidence:

 Research on British middle-aged twins revealed that for every 2.2 lbs increase of weight, the risk of developing osteoarthritis increases by 9 to 13 percent. The twins with knee osteoarthritis were generally 6 to 11 lbs. heavier than the co-twins with no disease. ((1998). Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: The evidence report. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK2003/)

 A study in which obese men reduced their weight a sufficient amount to qualify for the normal weight category concomitantly reduced their risk of knee OA  by approximately 20%. For women with similar weight loss achievement, the risk fell by 33%. (Johns Hopkins Arthritis Center [Internet]. Baltimore (MD): Johns Hopkins Medicine. Role of body weight in osteoarthritis; 2012 Mar 27 [cited 2014 Jul 11]. Available from: http://www.hopkinsarthritis.org/patient-corner/disease-management/role-of-body-weight-in-osteoarthritis/)

 Investigators in North Carolina evaluated the effectiveness of  weight loss on osteoarthritis symptoms. Study participants who lost 10% or more of their baseline body weight had significant reduction in injurious forces acting on the knee joint, reduction in markers for whole body inflammation, reduction in pain, and improved function. (Messier SP, Mihalko SL, Legault C, Miller GD, Nicklas BJ, DeVita P, et al. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial. JAMA [Internet]. 2013 Sep 25 [cited 2014 Jun 27];310(12):1263-73. Available from: http://jama.jamanetwork.com/article.aspx?articleid=1741824)

Key Takeaways:

  1. Target a 10% reduction in body weight to reap the gains of weight loss.
  2. Incorporate the Daily Dose strategy into your weight loss plan. 
  3. Less calorie consumption is a core principle for any successful result. Aim for a calorie deficit of 500 to 1,000 kcal/day to achieve a weight loss of 1 to 2 lbs. per week.
  4. Weight loss is most effective for symptom relief when it is combined with a physical activity program.

The 10 Pillars strategies were designed to help you achieve a healthy weight that promotes joint, muscle, bone, and tendon vitality.

 Lucas J. Bader MD

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