Weight Loss
What is it and why?
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Losing weight through diet and exercise has multiple benefits for knee arthritis patients.
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Every 1 pound of weight increases the force through the joint by 3 - 6 times.
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Losing weight will slow down the joint wear, decrease pain and improve function.
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Obesity increases the risk of osteoarthritis (OA) and, once developed, worsens it.
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It also increases the surgical and anaesthetic risks when these interventions are considered later on in treatment.
- Applicable stages 2-6
- Best stages 1-3
- Cost Very low cost
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Home/self-help
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Hospital
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Daycase procedure
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Inpatient procedure
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Local anaesthetic
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General anaesthetic
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Regional block / Spina
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Pain
No more than usual
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Mobility
No more than usual
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Daily activities
No more than usual
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Driving
No more than usual
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Leisure activities
No more than usual
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Light exercise
No more than usual
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Heavy exercise
No more than usual
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Light work
No more than usual
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Heavy work
No more than usual
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Intimate
No more than usual
Overview
What does it involve?
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Bringing BMI and waist circumference down.
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Aim to bring weight down by 5% in a 20-week period.
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Commitment to a balanced, low calorie and low-fat diet.
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Self-control and behavioural changes including monitoring portion size and avoiding snacking.
Effort/burden
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Consistent adherence to a diet plan.
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Avoiding temptation, succumbing to cravings and losing control.
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May require co-operation from family members.
Benefits
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Losing even a few pounds can improve arthritis symptoms.
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Studies say you can experience between a 21% and 33% decrease in arthritis symptoms just with weight loss
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Weight loss slows down joint wear, the progress of arthritis, improves pain levels, activities of daily living (ADL) and overall mobility.
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Other health benefits include decreased risk of cardiovascular and respiratory diseases and the development of type 2 diabetes.
Chances of cure
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May reverse the effect of arthritis in the early stages.
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May not completely cure arthritis, but will slow down its progress.
Limitations and side effects
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Difficult to achieve significant weight loss in a short period of time.
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Inability to tolerate changes in diet habits.
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Immediate side effects include lack of energy, headaches and irritability.
Risks
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No major risks identified.
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May crave food and find difficult to stick to the plan
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Extreme sudden dieting may result in an electrolyte imbalance. It may also affect internal organ function (especially kidneys and liver).
Cost
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This is a low-cost option for both the patient and the NHS
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These changes are unlikely to increase weekly shopping cost. This is especially true if you use available resources, shop intelligently and change habits.
What if no treatment is done?
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Arthritis will continue to deteriorate.
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Symptoms will get worse; sometimes rapidly.
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Will have a negative influence on other management options, e.g. surgery, in the future.
Videos

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Energy balance and fad diets in weight management

10 Top tips for healthy eating
References
Obesity: identification, assessment and management
https://www.nice.org.uk/guidance/ph5
Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF: Obesity and knee osteoarthritis: The Framingham study. Ann.Int.Med.1988;109:18
Role of Body Weight in Osteoarthritis
Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis.