Introduction:
Osteoarthritis (OA), a degenerative joint disease that severely impairs mobility and negatively affects quality of life, is linked to the most notable effects of obesity on the musculoskeletal system. The osteoarthritis (OA) pathophysiology of osteoarthritis involves altered biomechanical patterns, increased joint loading, and dysregulation of hormones and cytokines. Obesity is linked to the onset and advancement of osteoarthritis (OA) in weight-bearing and non-weight-bearing joints, as well as the frequency of joint replacements and surgical complications. Losing weight can slow the advancement of joint structural degeneration and provide clinically meaningful pain relief in people with osteoarthritis.
What Is the Effect of Overweight on Joint Health?
Obesity is a well-known global epidemic. According to WHO estimates from 2008, more than 1.4 billion adults are overweight, with over 300 million women and 200 million men being obese. The alarming trend is that obesity has doubled in number globally during the last 30 years. Many chronic diseases are linked to an increased risk in obese individuals. Both inflammatory and degenerative diseases impact the musculoskeletal system, with osteoarthritis (OA) bearing the most impact. Greater than all other joint diseases, osteoarthritis (OA) is a clinical condition characterized by joint deterioration, pain, and dysfunction. As people age, the prevalence rises to approximately 10 percent of the population currently affected.
The most modifiable risk factor for OA is obesity. According to Coggon et al., patients with a BMI greater than 30 kg/m2 had a 6.8-fold higher risk of developing knee OA than normal weight controls. According to a recent meta-analysis, obese people had a pooled odds ratio of 2.63 (2.28, 3.05) for developing OA compared to controls who were of normal weight. Mobility limitations and discomfort impact every part of life for individuals with OA. According to a direct cost analysis of obesity, diabetes is the obesity-related illness with the second-highest economic impact in the United States. Similar negative economic effects from UK analyses have been revealed. Given the rising incidence of obesity and longer life expectancies, it is anticipated that the burden of this illness will rise.
What Are the Causes?
Obesity-related OA is believed to be multifactorial. Obesity also raises the risk of osteoarthritis (OA) in non-weight-bearing joints like the hands. These mechanical and metabolic factors are thought to contribute to structural joint damage. Mechanical factors include increased forces on the joint, reduced muscle strength, and altered biomechanics during routine activities.
Low-grade inflammation, which is a hallmark of obesity, has an impact on numerous organ systems. The importance of metabolic vs. mechanical "initiating" processes and the proportional contributions of mechanical and metabolic factors to joint structural alterations are unknown at this time. The growth of adipose tissue may be the first step in the etiology of primary OA in obese individuals. The growth and modifications in these tissues will result in the alterations observed in OA. This may lead to a higher production of endocrine hormones, such as leptin, that affect other tissues. Additionally, changes in cartilage properties could be attributed to the systemic inflammatory response of obesity-related excess adipose tissue.
Some writers have proposed that OA is a metabolic condition in which multiple interconnected lipid, metabolic, and humoral mediators play a role in the onset and progression of the disease process. Fat mass was linked to more bone marrow lesions (BMLs) and cartilage defects, both indicators of early-stage knee OA, in an adult cohort without symptomatic knee OA.
One significant mechanical factor that may be connected to the onset of knee OA is the knee adduction moment. Due to their larger body masses, obese individuals have higher absolute knee adduction moments. They also exhibit compensatory walking patterns, such as a slower gait and a larger toe-out angle.
How Does Weight Loss Help With Joint Health?
There are numerous things doctors may do to help arthritis patients practice safe and efficient weight management. First, acknowledge that managing weight is a crucial part of managing arthritis. Advise all patients who are overweight or obese to reduce their weight. Second, review the health advantages of modest weight loss with patients, highlighting how activity and lower body weight might help with OA symptoms like pain. Third, recommend a 10% first weight loss target. If patients meet this objective, they can try to lose more weight. It is advised to lose one to two pounds of weight per week. Fourth, talk to patients about the most effective ways to lose weight.
Reducing calories, increasing physical activity, and using behavior therapy to change food and exercise behaviors are all effective weight-loss techniques.
In particular, doctors intend to advise patients who are overweight or obese to:
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Engage in moderate physical activity, gradually increasing to 30 minutes or more most days of the week.
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Reduce the amount of overall calories and fat in your diet. Although cutting dietary fat is good for the heart and can aid calorie reduction, weight loss cannot be achieved with this strategy alone.
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Give weight maintenance top consideration once the initial six months of weight-loss therapy are over.
Whether the community has an organized weight control program that provides information and assistance may be beneficial. Most communities have various affordable options (i.e., commercial or hospital-based programs). Clinical weight management therapies could be offered in larger centers. Clinical programs include thorough evaluation and treatment methods administered by a multidisciplinary team. It is frequently possible to choose among additional treatments, including medication, gastric surgery, or highly low-calorie diets. Those who are significantly overweight or have co-occurring medical issues should particularly consider these programs.
Conclusion:
Obesity has a significant impact on the development and progression of osteoarthritis, particularly at the knee. The available data indicates that hormone and cytokine dysregulation and increased joint loading are factors in obesity-related osteoarthritis (OA). The relative roles of mechanical and metabolic variables in the etiology of knee OA need to be further investigated.
