If you’re overweight and have osteoarthritis, you may wonder: How much weight do I have to lose before I see any benefits? Here’s the answer and it’s encouraging.
At Johns Hopkins we recently completed a five-year study that demonstrates that even small amounts of weight loss can result in significant improvements in osteoarthritis symptoms and functioning. We placed about 40 overweight and obese adults (average age 58) with knee osteoarthritis on a four-month program of lifestyle change. At the beginning of the study, participants with osteoarthritis experienced pain in one or both knees more than 50 percent of the time, causing difficulty in daily activities such as driving, climbing stairs, and getting in and out of bed.
The lifestyle changes we recommended for these osteoarthritis patients included moderate adjustments in both diet and daily exercise. The dietary changes emphasized principles of healthy eating (plenty of whole grains, fruits and vegetables) while limiting amounts of high calorie or nutritionally empty foods. The women were asked to eat between 1,400 to 1,600 calories a day; men were asked to stay within a range of 1,600 to 1,800 calories.
We also asked the study participants with osteoarthritis to gradually increase the number of steps they walked each day. They started at around 3,500 steps a day and gradually built up over the course of four months to around 10,000 steps a day, which was accumulated over the course of the day (10,000 steps is the equivalent of four to five miles, depending on stride length).
We were looking for a modest amount of weight loss. The average person with osteoarthritis in the program lost only about 15 pounds. However, with this modest weight loss, we saw significant improvements, both in the amount of osteoarthritis pain our subjects experienced and in their ability to function. Their reductions in pain averaged 41%; their improvements in functioning averaged over 50%. Again, that was from a weight loss of only 15 pounds. That degree of improvement exceeds the benefit we typically see in people who use even the strongest prescription anti-inflammatory medications.
We consider that degree of benefit from a relatively minor weight loss to be very encouraging news. Some of these people with osteoarthritis may still be heavy enough to be defined as obese, and yet they experienced impressive benefits. The anecdotal evidence from the trial was also very impressive. A number of osteoarthritis patients in the study were people who love to garden, but they’d essentially stopped gardening because it was just too painful and too difficult. After the weight loss, these osteoarthritis patients resumed gardening and they were thrilled. Did that mean they never had pain? No, it didn’t. After a day of gardening, they did experience some pain. However, their baseline level of pain was much lower, and they seemed much more able to tolerate the pain that they had in the past. I think, in part, this is because they felt so much better. They were recovering some of their zest for life.
