Is your extra weight hurting you?

• Joint pain is strongly associated with body weight. The Johns Hopkins Arthritis Center in Baltimore, USA, says being only 10 pounds overweight increases the force on the knee by 30 to 60 pounds with each step. That’s a lot of force on those joints. Being overweight puts pressure on all your weight-bearing joints – your back, knees, ankles, feet and hips.
• Too much body fat may increase inflammation in the body and make your joints more painful. Arthritis Research UK says achieving a healthier weight can reduce inflammation, for example in rheumatoid arthritis.
• Being overweight or obese is a clear risk factor for developing osteoarthritis, according to the Johns Hopkins Arthritis Center.
• Being underweight can be a problem for people with conditions such as rheumatoid arthritis. If you have RA you may find that your appetite is reduced and food doesn’t seem very appealing. Tender finger joints may make it difficult to eat, while depression and drug treatments may also take away your appetite. But that means your body isn’t getting enough fuel and you may suffer more from fatigue, weakness and infections.
• It’s important for general health. The NHS says being obese increases your risk of developing a number of serious and potentially life-threatening diseases such as type 2 diabetes, heart disease, and some types of cancer. Obesity can also damage your quality of life and can often trigger depression.

You can use this NHS tool to find out your Body Mass Index, which is a more accurate indication of whether you are a healthy weight for your height, age and gender.

BMI is only one way of checking if your weight is healthy though – you can also look at your waist circumference. The ideal waist circumference for men is less than 37 inches, while for women it’s less than 32 inches.

You know the basic theory – fruit and vegetables are good, burgers and chips are bad, right? But the good news is that you don’t have to punish yourself endlessly to maintain a healthy weight and keep yourself feeling great.

Michelle Oliver is 27 and has had juvenile idiopathic arthritis (JIA) since she was eight. She says: “Maintaining a healthy weight is important regardless of if you have arthritis or not. It is especially important when you have arthritis, as eating healthily has a lot of benefits, such as ensuring you are getting the right vitamins to support your immune system and bones.

“I try to eat a lot of food with calcium to strengthen my damaged bones and iron-rich food such as green vegetables and red meat which can help with the fatigue associated with arthritis – it’s also a good excuse to eat chocolate!”

Michelle has found that long-term steroid medication affects her weight, though. “The steroids can increase your appetite and they have given me a rounded face, which I feel makes me look fat. Even though I know it’s just the drugs, I make a conscious effort to watch what I eat.”

Eating well can help you maintain a healthy weight and can also help alleviate some of the symptoms of arthritis. Don’t be mean to yourself – if you try to be too strict, you won’t stick to it. You can still enjoy a take-away every so often, just maybe not every night.

Jo Travers is a registered dietician who runs The London Nutritionist. She says: “Making sure you are the right weight for your height will mean that your joints won’t be under any unnecessary pressure – particularly important if you get pain in your hips, knees and ankles.”

Jo says people with arthritis should make sure they get enough fish oils, which are anti-inflammatory. She recommends eating around two portions of oily fish per week – such as sardines, mackerel, fresh tuna, salmon or herrings.

“Cutting down on saturated fats, mainly found in animal products such as meat and full-fat dairy, may help the pain as these fats can add to the inflammation,” says Jo.

“Cutting down on saturated fat is also good for another reason: sufferers of arthritis are at increased risk of other inflammatory conditions such as heart disease, and cutting down on saturated fats can lower your cholesterol, reducing your risk of developing cardiovascular problems.”

On the flip side of the coin, some people with conditions such as rheumatoid arthritis find they become underweight. Appetite can be reduced by the condition itself and also by some drug treatments.

Being underweight might not sound like a huge problem but it can mean you may get ill more often and you may also feel tired and weak. If you have rheumatoid arthritis, it’s important you get enough calcium as the condition can put you at increased risk of osteoporosis.

You may find that certain foods make your arthritis worse or trigger a flare-up. Wheat, dairy and citrus are some of the most common culprits. If you suspect this is happening, talk to your medical team and try keeping a food diary for a few weeks to try to identify the problem foods.

If you need to gain weight, you should speak to your doctor who may refer you to a nutritionist. There are a few simple tips you can follow, such as eating several small meals during the day instead of attempting one or two large ones, drinking milkshakes or eating soups with added milk or cream instead of solid food, eating nutritious snacks between meals, and adding butter or cheese sauces to vegetables.*

There’s always a new diet craze – from cabbage soup to Atkins to Paleo to the 5:2 diet. The reason there’s always a new one? Because the old ones didn’t work for everyone!

If you do want to embark on a particularly strict diet, you should speak to your doctor first. Some arthritis drugs need to be taken with food, which might make following a fasting diet more difficult. If you suffer from fatigue, fasting might make this worse.

If you need to lose weight, the conventional advice is “slowly does it”. Set yourself realistic goals and look at losing between one and two pounds per week. Even losing a small amount of weight may have benefits in terms of your arthritis symptoms, so don’t be discouraged if it seems like you have a mountain to climb.

Jo Travers recommends a Mediterranean-style diet, full of fruit and veg, whole grains, olive oil and fish.

“Eating a ‘Mediterranean Style’ diet has been shown to benefit people with rheumatoid arthritis, particularly lessening stiffness in the joints in the morning,” she says.

“This style of diet means eating about six portions of fruit and veg every day; include nuts and seeds; choose fish rather than meat; eat plenty of wholegrain foods such as wholemeal bread and pasta and brown rice; and use oils such as olive oil rather than butter.

“Getting enough calcium is also important so make sure you have plenty of low-fat dairy in your diet and taking a vitamin D supplement will help your body absorb the calcium. There is also some evidence that vitamin D works as an anti-inflammatory – so a double-whammy!”

Always consult your doctor before taking vitamins and dietary supplements.