Hip Osteoarthritis
Weight Management for Hip Osteoarthritis
Weight management forms a part of most recommended guidelines for people with hip osteoarthritis. Weight management refers to the steady maintenance of your weight (i.e., not fluctuating between high and low). For some people, the goal will be to reduce weight, for others the goal will be to maintain their current weight, or a healthy weight.
How does being overweight or obesity contribute to hip pain?
The risk of developing hip osteoarthritis is higher in people who are overweight or have obesity. There are two ways carrying extra weight raises your risk of hip pain.
- Extra weight results in higher loads through the joint.
- Stored fat also leads to more inflammation in the body.
Inflammatory factors released by stored fat causes more cartilage breakdown in our joints and changes to the underlying bone. Fat stored around the waist can be harmful and more likely to have negative health effects.
Does weight loss help with hip osteoarthritis?
If you are overweight, maintaining your weight, in combination with exercise, will likely help with your hip osteoarthritis.
While the research shows that weight loss may be more important for knee osteoarthritis compared to hip osteoarthritis, maintaining a healthy weight through diet and exercise is very beneficial for your overall health!
What if I can’t lose weight?
It is not all about pounds on the scales. Researchers in the US have recently discovered that people who exercise regularly have ‘healthier’ fat stores. Regular exercise, as well as building muscle to help support the joints, makes the fat stored around our waistline and our organs less harmful and less inflammatory, meaning it will cause less health complications, like joint pain and osteoarthritis. This happens even if there is no change in weight. There is more information on why weight loss is so challenging in the Read More section at the bottom of the page.
What type of exercise is recommended for weight management and will not worsen hip pain?
A wide range of exercise is safe and will not worsen hip pain in people who are overweight or living with obesity. The key with any new exercise or physical activity is to start small and build up gradually- you are much less likely to aggravate symptoms with this approach. The focus of exercise should be to promote fitness, overall health and general well-being, not to burn calories.
Aerobic exercise, such as walking, cycling or rowing has been found to be beneficial for hip pain in people who are overweight or living with obesity.
Strength training, in the gym or at home, is also recommended.
Both types of exercise are effective at reducing fat stored around the waistline.
Exercise alone typically accounts for a small amount of weight loss, and it should be combined with dietary changes and/or medical interventions for obesity.
What types of diets and food plans for hip osteoarthritis have been tested?
No diet has been proven by research to cure any type of arthritis. Be cautious of special diets or supplements that make these claims. The best diet for osteoarthritis is a healthy, balanced one to maintain your general health and prevent other medical problems.
Similarly, there are no specific food or drinks that you absolutely need to avoiding if you have osteoarthritis. However, high levels of alcohol intake and processed foods may increase inflammation.
The two main types of diet that have been tested for osteoarthritis are low calorie diets and low inflammatory diets.
1. The most effective diet for reducing pain in people with knee OA is a low-calorie diet combined with exercise. This type of diet involves restricting calories to about 1,200 to 1,500 a day. Weight loss especially with calorie restriction can result in loss of lean body mass. For this reason, it’s important to combine this diet with exercise to build or maintain muscle.
2. A low inflammatory diet like the Mediterranean diet has been found to lower inflammation in people with knee osteoarthritis. This type of diet focuses on food that reduce inflammation (fruit, vegetables, wholegrains, olive oils, pulses, oily fish). There is no evidence to date suggesting it changes knee pain, but research is ongoing.
Seeking support from a health professional, such as a dietician, increases your chances of success with either of these approaches. It is important to note that most of this research has been done on knee osteoarthritis and the research on weight loss for hip osteoarthritis is ongoing.
Read more about how you think and approach weight loss in the HSE’s “Talking about weight – A guide to developing healthy habits”.
If you want more information on adopting a sustainable approach to healthy eating, head over to the “Healthy Eating” section of the Safefood website by clicking here.
There is also a Safefood 12-Week Weight Loss Programme for people with a BMI of between 25 and 30.
Why is rapid weight loss not recommended if you have hip pain?
When people lose weight quickly, approximately 20-30% of the weight lost can be muscle (this will vary depending on factors like diet, exercise, and individual metabolism). Slower, more balanced weight loss approaches. If people regain this weight in the future (which often happens after rapid weight loss), it is likely they will regain fat not muscle mass. Generally, a slower approach is recommended, weight loss should be gradual, about 1-2lbs (approximately 0.5-1.0kg) a week. This way, the weight is more likely to stay off.
What is weight creep & why preventing it is important for hip pain?
- Even with weight loss we can’t reverse osteoarthritic changes to joint structure. That’s why preventing weight gain in the first place is an important focus.
- Weight maintenance is more realistic and achievable than weight loss.
- Make small lifestyle changes now to maintain your current weight and halt any further gain will help prevent further joint changes.
During our middle-age we tend to accumulate weight slowly. On average, at a rate of 0.5–1 kg per year (1–2lbs), meaning over a decade we can gain 5 to 10kg. For those already overweight, it’s important to aim for weight loss, but without taking some action now you will probably gradually gain more weight over the next 5–10 years.
To slow down gradual weight gain, research shows very small lifestyle changes focused on diet and exercise are effective. Cutting back by about 7 calories a day (equates to two biscuits a week) or walking an extra 15 minutes weekly creates a small energy deficit that can successfully slow or prevent weight gain. This works for people who are a healthy weight and people carrying excess weight.
Do supplements help with osteoarthritis?
There is no strong evidence to suggest that different supplements will help with clinical improvements in osteoarthritis. Supplements on the market that commonly claim to help with joint pain include glucosamine, chondroitin and turmeric but be aware that these claims are often overstated. However, if you feel that supplements are helping you then you are probably safe to continue using them as supplements are harmless, unlike some medications. Always speak to your GP or pharmacist if you are unsure.
IRISH RESOURCES FOR WEIGHT MANAGEMENT
Now you have an understanding of Weight Management and all of the core recommended treatments, let’s move up the treatment pyramid to learn about the second line or add-on treatments.