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Osteoarthritis & Obesity
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The human skeletal system is an integrated framework of more than 200 bones and connective tissues that maintain body structure and facilitate movement. Over time, the joints that connect the bones in our skeletal system undergo wear and tear that limits their flexibility. Abnormal or excessive strain on the joints can lead to arthritis, an umbrella term used to characterize inflammatory diseases that affect one or more of the body’s 360+ joints and surrounding structures.

The most common form of arthritis is osteoarthritis (OA), a condition in which the protective cartilage that normally prevents bones in a joint from rubbing together is slowly eroded. In advanced stages of OA, a collapse of the joint space causes bones to rub directly against one another, rendering any movement of the joint extremely painful. Osteoarthritis is the leading cause of long-term disability and ambulatory care costs paid by private U.S. insurers. Between 2008 and 2014, per-person annual U.S. medical costs directly attributable to OA averaged $11,052. A large proportion of persons affected by OA report severely diminished quality of life across multiple domains of functioning.

Osteoarthritis risk is 4 times higher among women, and 5 times higher among men with obesity, relative to adults with BMIs in the normal range. The obesity epidemic and the aging of the population is expected to double the prevalence of OA by 2040, increasing the number of affected adults from 32.5 million to more than 78 million. Two distinct mechanisms contribute to the association between obesity and OA:

  1. Obesity increases the risk for osteoarthritis through added stress on weight-bearing joints. Basic movements such as walking and bending put pressure on the bones and joints in our lower extremities. The largest joint in the human body, the knee joint, bears the brunt of force during locomotion and is especially prone to injury. The force exerted on the knee joint is directly proportional to body weight. For a 200-pound adult, a 10-pound weight gain translates to an additional 15 pounds of force on the knee joint when walking, 30 pounds when climbing stairs, and 50 pounds when squatting to tie a shoe. Two-thirds of adults with obesity are expected to develop knee OA, with considerable variation in the severity and progression of disease.
  2. Obesity increases production of inflammatory factors that may exacerbate osteoarthritis in non-weight-bearing joints. Adipose tissue (i.e. body fat) is now recognized as a metabolically-active tissue that synthesizes and secretes hormones and cytokines. Cytokines are the key regulators of inflammatory processes throughout the body. Increased expression of these molecules likely mediates the association between excess body fat and development of arthritis in upper extremities (e.g. hand, shoulder).

Treating obesity will not reverse the damage done by osteoarthritis—orthopedic surgery is currently the only method of restoring cartilage in affected joints in humans (Figure 1). Despite shorter hospital stays (8.9 vs. 3.4 days), hospital charges related to knee replacements increased five-fold between 1998 and 2013 ($8.4 billion vs. $41.7 billion, inflation-adjusted USD). Importantly, the average age of persons receiving knee replacements dropped by nearly 2 years during this time period, suggesting that obesity may be increasing premature morbidity. Racial and ethnic minorities are less likely to receive surgical treatment for OA despite a greater disease burden, further exacerbating obesity-related health disparities. New research suggests that the combination of obesity, metabolic syndrome, and OA should prompt careful attention from health professionals, because this subtype of “metabolic OA” is associated with significant increases in cardiovascular disease risk, severity of pain, and need for total joint replacement surgery.


 Figure 1


Healthy weight management is the frontline strategy for primary and secondary prevention of OA. A decrease in 2 BMI units can decrease OA risk by 50%, and 5-10% reductions in excess body fat can significantly slow OA progression and prevent long-term functional impairments. Medical obesity treatment strategies such as very-low-calorie diets, pharmacotherapy, and/or bariatric surgery are particularly appropriate for individuals with OA and severe obesity. Because physical activity is critical to healthy weight management but can be painful for individuals with comorbid OA and obesity, primary care providers should connect clients with physical therapists or professional trainers who can prescribe exercise regimens that minimize pain and additional damage to joints.


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Upcoming Events

Aug 10: Obesity Competencies @ AADE
Sept 16: Obesity Communications WS
Sept 15-21: Access to Care Week
Nov 3-7: ObesityWeek 2019

Study on Self-Directed Weight Shaming
TROA Surpasses 100 Co-Sponsors
WA Job Discrimination for Obesity Illegal
OAC Step Challenge
AADE Presentation: Interprofessional Core Competencies for Obesity Treatment and Conversations about Weight
When: Saturday, August 10 | 10:30 AM CT
Where: AADE 2019 Conference | Houston, TX

We encourage all those attending the annual meeting of the American Association of Diabetes Educators (AADE) to join expert Jan Kavookjian, MBA, PhD, FAPhA, as she presents the interprofessional core competencies for obesity treatment and real-world examples of person-centered communication strategies for starting and maintaining difficult conversations about weight and weight loss with clients.

Visit the conference website to learn more or register to attend:
Upcoming Workshop: Advancing Effective Obesity Communications
When: Monday, September 16 | 8:30 AM-4:00 PM ET
Watch: This event will be webcast live [REGISTER]

On September 16, the Roundtable on Obesity Solutions will host a workshop that will provide an overview of the current communications environment and its impact on delivering information on obesity solutions. Invited presenters will discuss strategies to reach specific audiences (e.g., different publics, decision makers, and policy makers), as well as examine best practices in the development of effective messages. The workshop will explore the complexities of communicating solutions to obesity, such as addressing issues of equity and unintended consequences, and lessons that have been learned to inform future efforts.

Visit the National Academies website for additional information.
Support National Obesity Care Week: Become a Champion Today!
National Obesity Care Week (NOCW) is a national awareness week aimed at raising awareness of the disease of obesity, its treatments, weight bias, access to care issues and most importantly – CHANGING THE WAY WE CARE ABOUT OBESITY. 

NOCW was launched with a vision to create a society that understands, respects and accepts the complexities of obesity and values science-based care. NOCW will achieve this vision by:
  • ELEVATING societal awareness of the disease of obesity, those affected by it, its science-based treatments and weight bias.
  • BUILDING a fact-based understanding of obesity among individuals impacted by the disease, healthcare professionals, medical societies, policy makers, payers, and other stakeholders.
  • FACILITATING a shift to science-based treatments for those living with obesity.
Being a Champion of NOCW is one of the most powerful ways your organization can lend its voice and support this national effort to raise awareness of obesity, its treatments, weight bias, access to care and more! 

As we transition to a global-focus for NOCW in 2020, we are excited to announce that for 2019 we will host a NOCW-SPECIAL EDITION: Access to Care Week  (Sept. 15-21, 2019). Signing on as a Partner now will lend support for both NOCW events.

To become a Champion of NOCW, please contact Katie Thrasher at
Experiences of Weight Stigma Linked to Self-Directed Weight Shaming, Increased Disease Risk
Some individuals who struggle with weight may internalize the stigma directed toward them, blaming and devaluing themselves because of their weight. Research has found that, beyond the effects of BMI and depression, self-directed weight stigma is associated with increased risk for cardiovascular and metabolic disease, but it isn't clear who is most prone to this internalization.

In a new study, researchers at Penn Medicine and the University of Connecticut Rudd Center for Food Policy and Obesity surveyed more than 18,000 adults enrolled in the commercial weight management program WW International (formerly Weight Watchers Inc.) to identify key characteristics and experiences of people who internalize weight bias. They found that participants who internalized weight bias the most tended to be younger, female, have a higher body mass index (BMI), and have an earlier onset of their weight struggle. Participants who were black or had a romantic partner had lower levels of internalization.

Read the full study HERE
Treat & Reduce Obesity Act Surpasses 100 Co-Sponsors
The 2019 Treat and Reduce Obesity Act (TROA) (S595) (HR1530) has surpassed 100 co-sponsors in the U.S. House of Representatives with a total of 112 legislators supporting the Act. This critical legislation will provide Medicare beneficiaries with additional tools for weight management and obesity treatment. Specifically, this bill expands Medicare coverage of intensive behavioral therapy for obesity and allows coverage for obesity treatment medications under Medicare's prescription drug benefit.

Advocate for the passage of the 2019 TROA by contacting your legislators directly or through
WA State Rules Job Discrimination for Obesity Illegal
Research indicates that weight discrimination increased by 66% from 2006 to 2016, but there is hope on the horizon. As a result of a 7-2 Supreme Court ruling earlier this month, obesity is considered a disability in the state of Washington  This court decision means that obesity is protected under state anti-discrimination law. According to the court filing, "it is illegal for employers in Washington to refuse to hire qualified potential employees because the employer perceives them to be obese.”

For more information about the facts and important implications of the case, see coverage by Forbes and the Obesity Action Coalition
The 37th Annual Meeting of The Obesity Society at ObesityWeek
The Obesity Society will hold its 37th Annual Meeting at ObesityWeekSM—an international scientific conference—bringing together world-renowned experts in the field of obesity. This year’s meeting will take place Nov. 3–7, 2019, at Mandalay Bay in Las Vegas, NV.

ObesityWeek 2019 will feature scientific sessions hosted by The Obesity Society and the American Society for Metabolic and Bariatric Surgery, pre-conference continuing education, policy and public health discussions, co-sponsored programming with leading associations and government agencies, industry-sponsored symposia, and networking events.

Attendees will find a comprehensive conference schedule on obesity research, treatment, surgery, prevention, population health, public policy, and more. No matter what your specialty, you will find your niche in more than 100 sessions and 1,000 abstracts. New sub-tracks for pediatric obesity, diabetes, and obesity medicine exam prep make finding targeted content easier than ever.

For more information, visit the ObesityWeek website or send email to to learn more.
Step-up for Change with the OAC Step Challenge
Are you looking for a fun and exciting way to commit to your health goals, including getting more active? How about a way to make a difference in the world at the same time, just by taking steps? If you are, join the Obesity Action Coalition (OAC) Step Challenge!

"Stepping-up for Change" is a unique and easy way to fund-raise for the OAC and make change in the world for people impacted by obesity. You'll also make strides toward your personal wellness goals! All funds raised will help the OAC fight key issues like:
  • Ridding the world of weight bias
  • Giving more people access to safe and effective obesity treatment
  • Sharing educational resources
  • Raising obesity awareness
Learn more about the OAC Step Challenge or Start Stepping Now
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