Osteoarthritis and obesity: What is the link?

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Yes, OA and obesity have links. Obesity can raise the risk of OA, and having OA can make it more difficult to treat obesity, depending on the joints it affects.

A 2022 review identifies obesity as the most important risk factor for the development of OA. This is because a higher body weight increases pressure on the joints.

Obesity can also create an inflammatory state that raises the risk of inflammatory conditions, such as arthritis.

Additionally, obesity can impact the severity and progression of OA symptoms. In a 2020 study of people with overweight or obesity, researchers found a clear correlation between the degree of weight a person carries and OA symptoms.

The Centers for Disease Control and Prevention (CDC) states that the following percentages of people have a diagnosis of arthritis:

• 23% of people with overweight
• 31% of people with obesity
• 16% of people with an underweight or moderate BMI

Obesity has the most significant effect on weight-bearing joints, such as the knees and the hips. Over time, these joints can wear down. Excess weight accelerates the process.

Obesity also causes chronic inflammation. This can affect any joint, including those that do not bear significant weight. For example, hand arthritis is about twice as common in people with obesity, according to the Arthritis Foundation.

Having a moderate weight can help with OA. According to a 2023 article, each pound of weight loss in people who have overweight or obesity can decrease the load the knee bears by three to six times. This reduces pressure on weight-bearing joints, which may reduce OA symptoms.

In addition, weight loss may help reduce systemic inflammation. Fat tissues release substances that can cause inflammation. Reducing the amount of excess fat a person carries may therefore help reduce inflammation.

Becoming more physically active may also improve mobility and strength independently of weight loss, which may enhance a person’s mobility and allow them to move more easily.

Having OA can make some approaches to weight loss more challenging. For example, pain and difficulty moving certain joints may make exercising or cooking homemade meals difficult. However, some strategies can help.

Diet

Diet is one of the most important components of obesity treatment. Even if certain factors affect a person’s ability to exercise, they may still be able to alter their diet to induce gradual, sustainable weight loss, if needed.

Experts typically recommend people do this by eating a calorie-controlled diet, consuming fewer calories than they need daily. This may involve reducing the intake of carbohydrates, fats, or both. A dietitian can help a person understand which approach is best for them.

As a general guide, the CDC recommends:

• focusing on fruits, vegetables, whole grains, and lean proteins
• replacing high calorie drinks with water, sparkling water, or unsweetened tea or coffee
• avoiding foods with added sugars
• avoiding foods high in saturated fat

Exercise

Exercise may be more difficult with OA. However, it is also potentially helpful for improving mobility and reducing pain. When a person combines exercise with dietary changes, it can enhance weight loss.

It may help to try types of exercise that put less pressure on the joints, such as:

• water aerobics
• swimming
• walking
• yoga
• tai chi
• using an elliptical machine

If possible, people who experience pain from exercise may wish to consult a physical therapist for a personalized plan. Alternatively, a doctor may be able to make a referral to a physical therapist.

Medication

In cases where a person with a high BMI has tried lifestyle and dietary interventions that have not helped with weight management, a doctor may suggest medical treatments to aid with weight loss.

Weight loss medications may help some people. Certain medications may also help with metabolic syndrome and systemic inflammation, potentially reducing some of the effects of obesity, including OA.

GLP-1 medications, for example, may offer anti-inflammatory benefits. This could help reduce some of the pain of OA, although more research is necessary to prove this.

Losing weight can be challenging, especially for people managing multiple conditions. A person may seek support and advice from a doctor or other healthcare professional specializing in weight management if needed.

Additionally, a rheumatologist may be able to help improve a person’s OA treatments to make weight loss easier. A dietitian can provide guidance on food, meal size, and overcoming any potential obstacles in making dietary changes.

There are also a range of support groups for people with arthritis and obesity. The following resources may be beneficial:

• The Arthritis Foundation’s Your Connect group
• The Arthritis Foundation’s resource finder
• The CreakyJoints list of arthritis support groups and resources
• Overeaters Anonymous, an organization for people experiencing difficulty managing eating habits

Obesity and osteoarthritis (OA) often occur together. Obesity is one of the most important risk factors for OA and can raise the chances of developing it in joints that bear weight and other joints around the body, such as the hands.

Sometimes, joint pain may lead to difficulty exercising, which can make adding this to a person’s treatment plan more challenging. However, there are ways of managing this that may help.

Doctors, physical therapists, and dietitians can offer guidance on diet and exercise strategies. In some cases, medications or other treatments may also be an option.