Healthy Weight Loss with Rheumatoid Arthritis

When joints ache, it’s hard to find comfort in a plate of celery sticks. But slimming down doesn’t have to mean tasteless foods, and it’s crucial for women with rheumatoid arthritis. Start losing weight with these 16 rheumatoid-arthritis diet and exercise tips. Plus, how much do you about the types of arthritis? Take our quiz to find out…

With rheumatoid arthritis (RA), the last thing you need is extra weight on your throbbing joints. It adds pain and could eventually cause worse damage.

“Weight directly affects bone structure with grinding pressure that can also lead to osteoarthritis,” says Peter Vash, M.D., M.Ph., executive medical director of the Lindora Clinic in Costa Mesa, Calif.

On top of that, fat cells secrete inflammatory hormones and other chemicals that hasten RA’s destruction of bone and cartilage.

But regular exercise is difficult if you’re in pain, and some RA medications, such as corticosteroids, can increase the likelihood you’ll pack on pounds. Plus, many of us turn to food for comfort, says Vash, a weight-loss expert who treats RA patients.

So how do you maintain a healthy weight with rheumatoid arthritis?

Whether you’re heavy, or even one of the few RA patients who’ve lost weight due to pain and fever from inflammation, it’s important to build up your body and get better nutrition, notes Nathan Wei, M.D., director of the Arthritis Treatment Center in Frederick, Md.

Do both with these 16 RA expert tips:

1. Get daily exercise.
While strenuous activity may be too painful at times, the old mantra that exercise harms people with RA no longer stands. In fact, you should do some form of exercise every day, Wei says.

For best results, combine stretching and strengthening exercises with low-impact cardiovascular exercise like walking or swimming.

Swimming is particularly good, Vash adds. “It’s easy to move in water, and it takes the weight off joints like hips and knees.”

2. Build lean muscle.
Strengthening exercises are particularly important for women with rheumatoid arthritis, helping them hold on to – or increase – lean muscle mass, says Maura Daly Iversen, S.D., D.P.T., chair of the Department of Physical Therapy at Northeastern University in Boston.

And the more muscle you have, the more calories you burn.

To maintain muscle mass, lift light weights or use resistance bands for 15 minutes twice a day, Iversen suggests. Cuff weights are easier on joints if you have hand or wrist pain.

3. Eat like a Greek.
A Mediterranean diet is the best way to lose weight if you’re concerned about health, says chef-turned-weight-expert Timothy S. Harlan, M.D., medical director at Tulane University Medical Group and author of Just Tell Me What to Eat (Da Capo Lifelong Books; June, 2011).

That means eating veggies, fruits, whole grains, fish and lean meats, legumes (such as beans), yogurt and unsaturated fats like olive oil.

“You lose weight eating these foods because they’re less calorie-dense – you can eat more and still be satisfied,” he says.

4. Seek help to stay motivated.
Work with a nutritionist or ask your doctor to recommend a weight-loss program. Either one can provide structure, support and motivation, says Vash.

“People with RA tend to feel discouraged because pain wears them down,” he says. “So it helps to get support from a dietitian or program that can encourage them to eat good food, stay away from alcohol [which is calorically dense] and take their medications.”

Some insurance plans cover weight-loss treatments if they’re tied to the treatment of a chronic disease like RA, Vash says.

5. Keep a food diary.
Write down everything on your plate. You may be surprised by how much more you’re eating than you thought.

“It’s a good method of tracking what you eat,” Harlan says. “It keeps you honest.”

It also makes it easier for a dietitian to create a meal plan that lets you eat the foods you like while including a wider range of nutrients.

6. Drink more water.
Drinking six to eight 8-ounce glasses of water a day is a simple weight-loss technique, Iversen says. You feel fuller, so you eat fewer calories.

"People tend to eat when, in reality, they’re only thirsty,” Vash adds.

Make it easy by toting a water bottle, and keep a pitcher of cold water in your fridge. (Add fresh cucumber or fruit slices to make it more appealing.)

7. Eat breakfast.
People who regularly eat a morning meal are more likely to keep pounds off, according to the National Weight Control Registry, which tracks people who’ve maintained their goal weight for years.

In fact, skipping breakfast is the worst way to save on calories, Harlan says.

“By noon, you’ve been 18 hours without food,” he says. “Your metabolism is lower and your body works to store calories as fat. And, now, you’re starving, so you scarf Krispy Kremes and then eat lunch.”

But don’t go overboard: Eating a large breakfast didn’t lower calories people ate at lunch and dinner, according to a 2011 study at the Technical University of Munich in Germany.

Instead, focus on protein and quality carbs, like a piece of whole-grain toast, Harlan recommends.

8. Map out your meals.
Eat three balanced meals a day to avoid random grazing, Vash says. And if you always get hungry in the afternoon, keep a healthful snack on hand to avoid the lure of the office vending machine.

“Plan what you’re going to eat, along with when and where,” Harlan adds. “That’s half the battle.”

9. Pack your lunch.
Even some relatively healthful takeout options are loaded with calories and sodium, Harlan says. Bringing your own meal to work helps you control food intake. Plus, you’ll save a few bucks.

10. Eat protein at every meal.
Protein builds strength and muscle mass, and can help weight-loss efforts by giving you a sense of fullness.

“And it keeps your blood sugar up, which boosts energy and mood,” Vash says.

So slip skinless chicken into brown rice, add tofu to a veggie stir-fry and sprinkle toasted walnuts on your salad.

11. Give your fridge and pantry a makeover.
Buying good-for-you food in advance can keep your diet on track. “If you have healthy things in your cupboard, you’ll eat them,” Harlan says.

Toss the cheese curls, chips and other diet-derailing snacks. Replace them with canned and dried beans, jars of tomatoes or tomato sauce, brown rice, whole-wheat pasta, nuts and high-quality olive oil.

Fill your freezer with frozen vegetables and the fridge with fresh fruits and vegetables that keep, such as leeks, onions, apples and pears.

“Everything in your cupboard should be fresh and real,” Harlan says. “If you need to know Latin to understand an ingredient list, something’s wrong with the food.”

12. Nix nighttime noshing.
Pain and depression can get the best of you in the evenings, tempting you to turn to high-calorie comfort foods. One reason: Cortisol, a stress hormone that’s also an anti-inflammatory, sinks low after the sun goes down.

“That’s why everything appears worse at night,” Vash says. “Worries and concerns are magnified, and friends aren’t around to help.”

When night-time aches or the blues hit, don’t reach for cookies. Instead, pour yourself a cup of warm broth or green tea – it doubles as a soothing hand warmer.

13. Brighten your plate.
White flour, pasta and rice are nutritional wimps. Fiber and nutrients such as potassium and magnesium have been stripped away to give them that light color.

Fiber is particularly important for women with rheumatoid arthritis, Harlan says, because it slows digestion and adds bulk so you stay full longer.

But to get the full range of nutrients, eat a rainbow of vegetables and fruits, he says.

14. Watch your meds.
Corticosteroid medications like prednisone, commonly given to patients with rheumatoid arthritis, can cause weight gain by increasing fluid retention and body fat, says Iversen. They can also increase appetite.

If you have these side effects, talk to your doctor, Vash suggests. “There are good alternative medications that can be used for RA.”

15. Skip shortcuts.
Fad diets that promise fast results don’t work over the long term.

“Let your physician recommend a reputable plan,” Vash says. “It will be high quality and safer than wasting your money and hopes on [sketchy] cures.”

16. See a specialist.
When struggling with RA-related issues, including weight gain or excessive weight loss, see a rheumatologist, a doctor who specializes in inflammatory conditions (such as RA).

“It helps to work with a caring physician who will be positive and up on the latest treatments and advances,” Vash says.

Ask your doctor for a recommendation.

To learn more, visit our Rheumatoid Arthritis Health Center.

How Much Do You Know About the Types of Arthritis?
About 46 million American adults – nearly one in five – suffer from some type of arthritis. It’s estimated that number will rise to 67 million by 2030. Do you or someone close to you have arthritis?