by: Kathleen A. Hogan, MD
People who are obese (body mass index -BMI >30) have an almost seven times increase in the incidence of knee arthritis compared to those with a normal body mass index (BMI 18.5-25). Weight loss has been shown to reduce the pain associated with knee arthritis and improve function. However, many of my patients with severe knee or hip arthritis tell me that they are unable to lose weight because they cannot exercise due to their arthritis pain. How can you lose weight when you cannot exercise?
This article is meant to give you some suggestions and ideas on how to lose weight when your joints hurt too much to exercise. You should talk with your medical doctor before starting a weight loss program, and about specific dietary or physical limitations you may have.
Keep a Food Diary
My first suggestion is to keep a food diary. There are many free apps that you can download to your phone or computer which determine the caloric content of what you eat. For some people, just keeping track of calories can prevent over eating. Some patients tell me they do not eat very much but still gain weight.
Sometimes it is not how much you are eating but what you are eating. For example, 200 calories can be a plate overflowing with broccoli or carrots, half a hamburger, or half a candy bar. Which is going to fill you up the most? Unfortunately the candy bar tastes the best! Keep in mind that 200 extra calories take approximately an hour of walking to burn off!
Use Calorie Information to Make Healthier Choices
Many restaurants now list calories which can help you make healthier choices. The cafeteria at Catholic Medical Center lists “better alternatives” to high calorie foods. For example, who would have guessed that Baked Potato chips have less calories and fat (130 cal, 2g fat) then French Fries (300 cal, 15 g fat)? A bagel with cream cheese has over 400 calories compared to only 170 calories in a slice of french toast. Small changes in food choices can sometimes make a large difference in the number of calories consumed throughout the day.
Be Active Throughout the Day
Being active throughout the day is also important. This increases the number of calories you burn. If you are very sedentary, you will need to consume considerably less calories each day to avoid gaining weight compared to someone who is more active.
Many patients with arthritis complain that their joints feel stiff when they get up from sitting. Your joints are made to move. Movement lubricates all joints, even those with arthritis. Just because your knees hurt too much to run on the treadmill does not mean that you cannot exercise.
Do Low Impact Exercise4>
Swimming, water aerobics, biking, and the elliptical trainer all put less impact on your joints then walking. Strength training builds muscle and burns calories. It also builds bone density. The stronger your muscles are, the better they support your joints which reduces pain from arthritis. If you have never lifted weights before, you may want to start off by working with a sports trainer or physical therapist to learn how to do it correctly.
Barre, pilates, and yoga classes can also improve your flexibility, strength, and balance in addition to burning calories. Some gyms and senior centers offer classes specifically designed for people who have arthritis. Exercising with other people can help you stay motivated. Even thirty minutes a day of exercise can have a positive effect.
Don’t Give Up
Do not give up. Just because you had a cupcake and sat on the couch tonight watching television does not mean you cannot exercise or lose weight. Try not to be too hard on yourself and set realistic goals so that you will achieve them. Arthritis may make weight loss more challenging, but nothing is impossible. The first step is always the most difficult.