A Weight-Neutral Approach to Improving Joint Pain
People of all body sizes can experience joint pain from time to time. If you live in a larger body and your joint pain is interfering with your daily life, you’ve likely received the advice to “just lose weight”. But is it even true that losing weight will help your achy joints?
If you’re new here, hello and welcome! My name is Hannah and I am a non-diet dietitian here to help you improve your relationship with your food and exercise through a weight-neutral approach.
Before we proceed, I want to acknowledge my thin privilege. Although I have worked closely with hundreds of people in larger bodies, I have limited personal experience with fatphobia from medical providers, family members, or strangers. I too am a victim of diet culture and have felt the pressure to lose weight, but never from the perspective of someone who is experiencing weight stigma. While I am a HAES-aligned dietitian, I recommend learning more about HAES and fat activism from others in larger bodies. I have a list of some of my favorites in this post.
Table of contents:
Causes of joint pain
There are many different causes of joint pain, including:
Osteoarthritis, rheumatoid arthritis, and other forms of inflammatory arthritis.
Ehlers-Danlos syndrome
Fibromyalgia
Referred pain (a type of pain is felt in a different location than where the pain originates)
Injury
Viral and bacterial infections
This is not an exhaustive list and the possible causes of joint pain are extensive. It is important to have a thorough evaluation of your symptoms by a medical professional (preferably one with a weight-neutral approach).
It is important to note that any and all of these causes of joint pain can be experienced by people of varying body sizes. There are not any causes or symptoms that solely occur in larger bodies.
Does weight loss actually improve joint pain?
As mentioned, people of all body sizes get joint pain. Being thin is not an automatic prevention or cure. So why is weight loss often recommended to those in larger bodies?
There are a few common claims that come from those prescribing weight loss for joint pain.
Claim 1: joint pain and injury is caused by too much weight and pressure on the joint
This is one of the most common statements about how weight is hypothetically causing joint pain. You may have been told that the “excess weight” is causing wear and tear. But if this is the case, then why don’t all people in larger bodies have joint issues?
There are many factors that impact joint “wear and tear”, including access to healthcare throughout one’s life, access to supportive footwear, and participation in athletics along with the knowledge that your trainers and coaches have on joint health.
Claim 2: the heavier you are, the more likely you are to get joint pain
Perhaps, but is this because of “too much weight” on the joints, or because higher weight people have less access to healthcare and are often denied the same treatment that those in smaller bodies receive? Or maybe because they have been dieting for years and the weight cycling has damaged muscle and bone over time, weakening the joints? It is not as simple as heavy = bad joints.
Because many people in larger bodies are made to wait longer for treatment after being advised to “try losing weight first”, they end up with more advanced injury prior to starting treatment (physical therapy, surgery, etc.). These same individuals may have also put themselves through rigorous exercise routines in the spirit of intentional weight loss, which may have increased their pain and/or caused injury.
Claim 3: weight loss will improve joint pain
There is no promise that weight loss will improve joint pain. In some cases, pursuing intentional weight loss may even make joint pain worse.
Weight loss often comes with decreased muscle mass and bone density, both of which can weaken the joints and make them more prone to injury. Dieting and the pursuit of weight loss is also very stressful and difficult to maintain over a long period of time. In fact, most dieters end up gaining the weight back and then some.
Even if weight loss was a known cure for joint pain and injury, there is currently not a method of intentional weight loss that is safe and universally effective. Yet even healthcare professionals who know this will still often prescribe weight loss. If medical providers wish to improve the health of fat people, might I suggest focusing on their actual health rather than just trying to make them thin before offering true solutions?
Related post: “But What if I Need to Lose Weight for Health Reasons?”
What to say to your doctor when weight loss is recommended
If both a fat and a thin person go to their doctor with the same joint pain symptoms, it is highly likely that the fat person will be told to lose weight while the thin person will be offered alternate options ranging from physical therapy to surgery. This is only one example of how people in larger bodies face weight bias and discrimination in healthcare.
In some cases, practitioners will refuse to provide surgical care for patients above a certain BMI. They may even refer them to a weight management center to consider weight loss medications or bariatric surgery to “speed up” the weight loss process. Let me get this straight - the doctor will not provide knee surgery because their weight makes it “too dangerous”, but it is safe for them to get bariatric surgery? A procedure that mutilates a healthy digestive system and has potentially horrific side effects? Make it make sense.
Ask your doctor what treatment they would recommend for someone in a lower-weight body. You will likely find that treatment recommendations for them are similar to what you will see below.
For more in-depth tips on discussing weight with your doctor, check out this post.
Weight-neutral strategies to prevent and treat joint pain
If not weight loss, then what? There are various approaches you can take to prevent and treat joint pain that don’t involve pursuing intentional weight loss.
Strength train
Building up the muscles around your joints is a great way to strengthen them and increase their longevity. It is important to practice proper form and to progress at an appropriate rate. If possible, I recommend working with a weight-inclusive HAES-informed personal trainer (@nondiet_trainer is a great one).
Related post: Feel the Difference of Joyful Movement
Invest in high-quality, supportive shoes
Supportive shoes can go a long way in keeping your joints happy. If you engage in walking or running, be sure to replace your shoes regularly, as the tread and support starts to deplete.
It is a privilege to be able to buy pricey, supportive shoes! This is yet another reason why people with joint pain are not to be blamed or shamed.
Exercise on joint-friendly surfaces
Different surfaces can have different effects on how they make your body feel during and after physical activity. Hard surfaces with little give, such as concrete, may be tough on your joints.
If you prefer to walk indoors, find a treadmill that depresses with each step. Exercising in water is also a great option for those with joint pain.
Talk to your doctor
The following may be recommendations that you can discuss with your doctor:
Physical therapy
Massage therapy
Medications
Joint braces
Joint injections
Surgical treatment
Bottom line
Joint pain is a common symptom in people of all body sizes and everybody deserves the same ethical treatment with proper testing and interventions. There may be methods to treat joint pain that do not involve the risky pursuit of intentional weight loss and dieting.
What did you think of this post? Leave a comment below!
More HAES and weight-neutral resources: https://haeshealthsheets.com/resources/
Note: I use the word “fat” as a neutral descriptor as used by the fat activist community. “Fat” is nothing more than a neutral descriptor, though diet culture has assuredly turned it into a word with negative connotations.
Disclaimer: this post is for informational and educational purposes only and is not a substitute for professional medical advice.