Author: Dr Aifric Boylan
Read Time: 8-10 minutes
Living with arthritis is not easy- pain, reduced function and impaired mobility can have a big impact on day to day life. However, there are practical steps you can take to help ease symptoms and improve daily life. One important area to consider is weight management.
Arthritis affects the joints, causing pain, stiffness, and sometimes swelling- and extra weight can make these issues worse. This article looks at why weight matters for people with arthritis, the benefits of managing it, and some safe, evidence-based ways to approach it. Remember, everyone's situation is different, so it's always a good idea to chat with your doctor before making changes.
Arthritis comes in many forms, like osteoarthritis (the most common type, often due to wear and tear on joints) or rheumatoid arthritis (an autoimmune condition). No matter the type, research shows that weight plays a key role in how arthritis progresses and feels day to day.
Why Does Weight Matter in Arthritis?
Extra body weight puts more stress on your joints, particularly those that bear your weight like the knees, hips, and lower back. For example, when you walk, the force on your knees can be three to six times your body weight. If you're overweight, that means even more pressure, which can speed up the breakdown of cartilage—the cushioning tissue in your joints.
Studies have consistently linked being overweight or obese to a higher risk of developing arthritis, especially osteoarthritis in the knees. In one large population study, obese women had nearly four times the risk of knee osteoarthritis compared to those at a healthy weight, while for men, the risk was almost five times higher. Another long-term study found that people who were overweight in their 30s were more likely to develop knee arthritis later in life. Interestingly, extra weight isn't just about mechanical stress; it's also linked to inflammation in the body. Even hand arthritis, which isn't weight-bearing, is more common in people with higher body weight, suggesting that factors like increased inflammatory chemicals from fat tissue may play a role.
If you're already living with arthritis, carrying excess weight can make pain and stiffness more noticeable and limit your mobility. On the flip side, this means that managing your weight can be a powerful tool in your toolkit.
Benefits of Weight Management
The good news is that even modest weight loss can make a real difference. Guidelines from organisations like the American College of Rheumatology recommend weight loss for people with osteoarthritis who are overweight or obese, as it can improve pain, function, and quality of life. For instance, losing just 5% of your body weight (so, 5kg if you weigh 100kg) can reduce the stress on your knees and lower your pain levels. In one study, women who lost around 11 pounds saw their risk of developing knee osteoarthritis drop by more than 50% over 10 years!
Bigger losses can bring even greater benefits. Research shows that losing 10-20% of your starting weight leads to better improvements in pain, daily function, and overall well-being compared to smaller amounts. For people with knee arthritis, this could mean less reliance on pain medications and easier movement. Weight management also helps with other health issues that often come alongside arthritis, like heart disease or diabetes, by reducing inflammation and improving energy levels. Clinical practice guidelines for osteoarthritis emphasise that combining weight loss with exercise is key for the best results.
It's worth noting that if you're at a healthy weight already, the focus shifts to maintaining it through balanced eating and activity to prevent future issues.
How to Manage Weight Safely with Arthritis
Managing weight when you have arthritis isn't about quick fixes or extreme diets, it's about sustainable changes that fit your life and don't add stress to your joints. Usually, the aim is for a gradual loss of 500g-1kg per week, with an initial goal of 5-10% of your body weight, as recommended in obesity guidelines.
Always start by discussing your plans with your GP or a healthcare professional, especially if you have other health conditions.
Here are some practical steps:
Assess Your Starting Point: Use tools like body mass index (BMI) to see where you stand. A BMI of 25-29.9 is overweight, and 30 or above is obese. It is calculated as “weight in kg divided by height in meters squared”. You can use an online calculator <here>. Also, it is definitely worth measuring your waist: over 102 cm (40 inches) for men or 88 cm (35 inches) for women increases health risks.
Focus on a Balanced Diet: Eat a variety of whole foods to support joint health and weight loss. A Mediterranean-style diet, rich in fruits, vegetables, fish, nuts, and olive oil, has been shown to reduce inflammation and help with weight management in people with arthritis. Cut back on processed foods, sugary drinks, and saturated fats. Some tips:
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Fill half your plate with veggies and fruits for fiber and nutrients.
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Choose lean proteins like chicken, fish, beans, or tofu.
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Include whole grains such as oats or brown rice for sustained energy.
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Watch portion sizes, use smaller plates to help!
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Stay hydrated with water; it can curb hunger and support joint lubrication.
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Low-carbohydrate diets combined with exercise have shown promise in reducing symptoms in some studies, with 10-20% weight loss leading to better joint function. But find what works for you.
Incorporate Joint-Friendly Exercise: Physical activity is essential, even if arthritis makes it tricky at first. It builds muscle to support joints, boosts mood, and burns calories. Guidelines suggest at least 150 minutes of moderate activity per week, like walking or swimming. Low-impact options are best to avoid joint strain:
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Swimming or water aerobics: The buoyancy reduces weight on joints.
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Cycling: Stationary bikes can be more gentle on knees.
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Walking: Start slow, and make sure you wear good, supportive shoes.
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Strength training: Use light weights or resistance bands 2-3 times a week to strengthen muscles around joints.
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Tai chi or yoga: These improve balance and flexibility while being easy on the body.
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If pain flares up, rest, perhaps take some pain relief or anti-inflammatories (discuss with your doctor or chemist) , then ease back in. Working with a physiotherapist can help properly tailor a plan.
Weight loss medication: In the past few years, GLP-1 agonists are increasingly prescribed by doctors to assist with weight loss. They can be very effective in many people, though are not suitable for everyone and can have side effects. Also, weight gain often occurs on stopping these treatments, so maintaining healthy lifestyle changes is still a key focus. Discuss with your doctor to see if these treatments could be right for you.
Other Strategies:
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Track your progress with a journal or app to stay motivated.
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Get enough sleep (7-9 hours), as poor sleep can affect hunger hormones.
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Be aware of screen time and social media use. Better sleep and overall mental health often goes hand in hand with reducing screen time and“doom-scrolling”, not to mention the fact we are often more sedentary when we are online.
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Work on meditation, mindfulness practice and/or nurturing your hobbies, since stress-reduction can lead to a reduction in emotional eating.
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Community fitness or other well-being programs may be available in your area- this is well worth researching, as having a group to share and connect with often leads to better long term outcomes.
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Have you fully considered specialists and allied health?
If you're struggling to lose weight or if arthritis symptoms are getting in the way, talk to your GP who can refer you to other healthcare professionals who may be able to assist, for example an endocrinologist (hormone specialist), rheumatologist (joint specialist) or pain specialist.
In Australia, you can self-refer to an allied health professional such as a dietitian, exercise physiologist, osteopath or physiotherapist. If routine or motivation are a problem, a psychologist may be a useful option.
If you suffer from long term conditions such as arthritis or obesity, you’ll probably be eligible for a GP chronic care management plan (GPCCMP), which offers Medicare rebates for 5 allied health sessions per year. The Medicare rebate for each session is currently $61.80, but increases to a higher percentage (often 80%-100% of the total cost) once you have reached your Medicare Safety Net threshold. You’ll need to see your local GP to organise this (this needs to be in person, not via telehealth, due to Medicare rules!). If you have private health insurance, don’t forget to check your policy as often there are some allowances for allied health sessions.
The bottom line
As with most things in health and life, a holistic approach which takes in your mental well-being, sleep, movement and nutrition as well as proactive management of medical conditions is likely to deliver the best results. While no single change may dramatically improve weight or arthritis by itself, often making incremental improvements in a few areas will make a noticeable difference.
Key takeaway points:
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Ensure underlying medical issues are fully discussed and managed with your GP.
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Get checked for additional weight-related health problems such as diabetes, sleep apnoea, thyroid problems and PCOS, as these may be holding you back.
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Set clear, achievable weight loss goals, in conjunction with your doctor (500g-1kg a week is good for most), and discuss your treatment plan, medications etc.
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Consider the role of various allied health professionals for incremental improvements that can add up to better all round well-being. Dietitians, osteopaths, physios, exercise physiologists and psychologists can all add meaningful value (as well as accountability and motivation).
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Ask your GP for a care plan to reduce the cost of allied health sessions (and/or check your private health insurance policy to see if you have allied health allowances).
This information is general and based on current evidence- it's not a substitute for personalised medical advice. Consulting a healthcare professional to ensure the best approach for your own circumstances.
References
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Felson DT, et al. Obesity and knee osteoarthritis: The Framingham study. Ann Intern Med. 1988;109:18-24. Available at: https://www.acpjournals.org/doi/10.7326/0003-4819-109-1-18
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Anderson J, Felson DT. Factors associated with osteoarthritis of the knee in the First National Health and Nutrition Examination (HANES I). Am J Epidemiol. 1988;128:179-189. Available at: https://academic.oup.com/aje/article-abstract/128/1/179/56581
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National Institutes of Health. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. 1998. Available at: https://www.nhlbi.nih.gov/health-topics/clinical-guidelines-identification-evaluation-and-treatment-overweight-and-obesity-adults
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Arthritis Foundation. Weight Loss Benefits for Arthritis. Available at: https://www.arthritis.org/health-wellness/healthy-living/nutrition/weight-loss/weight-loss-benefits-for-arthritis
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Centers for Disease Control and Prevention. Talking to Patients About Self-Management. Available at: https://www.cdc.gov/arthritis/hcp/self-management/index.html
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Johns Hopkins Arthritis Center. Role of Body Weight in Osteoarthritis. Available at: https://www.hopkinsarthritis.org/patient-corner/disease-management/role-of-body-weight-in-osteoarthritis/
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Kolasinski SL, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Rheumatol. 2020;72(2):220-233. Available at: https://onlinelibrary.wiley.com/doi/full/10.1002/art.41142
