Weight loss shouldn't be the first recommendation for knee problems

[nancylebov]

If a doctor tells you to lose weight to solve your knee problems, either find another doctor or ask them what advice they'd give a thin person with the same knee problems.

I recommend reading the comments for both facebook links and the dances with fat link.

The overview is that knee problems have many causes, and careful examination and physical therapy are the best starting points for people of all weights. Evidence that weight doesn't necessarily matter is that there are people who have the same knee problems at a variety of weights, and people with congenital knee problems who have relatives of various weights with the same problem.

Medical neglect of fat people is a serious thing-- they are frequently told to lose weight to solve problems and not given other treatment, including problems which aren't conceivably related to weight. In many cases, fat people suffer for decades from problems which are easily solved when they get proper treatment-- or find out that the problem can no longer be solved. The worst case I know of in at the Dances with Fat link-- a fat woman whose back pains turned out to be bone cancer, and it was too late.

I'm not going to say losing weight never works-- it may have done my knees some good*-- but a lot of the time, it doesn't work, and other solutions do work.

*Hard to tell-- it might have been the qi gong.

https://www.facebook.com/nancy.lebovitz/posts/10217032489746888

https://www.facebook.com/ragenchastain/posts/10219692429652553

https://danceswithfat.org/2015/05/20/fat-people-and-our-knees/?fbclid=IwAR18vhgnM5GynXpKgkx1W-YLc7SCW-oylmGmZ3Pmdra081MHuFnFdj6Xgc4

Comments

[noelfigart]

I am terrified of going to the doctor and not showing at least a small weight loss, as I am afraid I will no longer be treated.

I've been told to exercise more for an ear infection. (Swimmer's ear.... yeah....)

Obviously I Believe in being active. I've had arthritis of the knee since I was in my early twenties, and I truly believe that it is from ballet, not weight.

Maybe carrying less weight might cause less pain. I mean, okay, when you think of a mechanical system, that might be one of the stressors.

I'm not really in less pain than 35 lbs ago and I think my blood sugar improvement is more about the strict restriction of carbs than any weight loss.

[theandrewhickey]

I thought I was the only one who'd had an ear infection blamed on my weight!

[noelfigart]

Nope. I think what irritated me the worst was that I was training for a long-distance open water swim at the time. Only triathletes and people swimming the English Channel would have been exercising more!

[theandrewhickey]

Oh, I know this one very well. I started getting agonising back pain when I stood up for more than five minutes back in 2011, when I was thirty-two. The doctor told me to lose weight and take painkillers.

From about 2013 I was suffering from fatigue so bad I could barely stay awake. In late 2015, I started getting oedema and joint pain. The doctors finally determined this was because of psoriatic arthritis -- a disease which comes along in 1/3 people with psoriasis (which I have), which usually starts developing in one's early thirties, and which usually has lower back pain as an early symptom. Given that the GP saw the psoriasis patches on my back, it should have been the first thing she thought of.

Except that's not the worst of it. I was prescribed meds for my arthritis in early 2016, and have been on them for four years, but they've done nothing for the back pain -- the consultants were still insistent that despite the back pain being a classic symptom of psoriatic arthritis, it was probably more due to my weight and posture.

In October last year, I saw another consultant, who told me that the meds I was currently on wouldn't affect any inflammation in my lower back, so they would do nothing for my back pain. He also, unlike any other doctor I'd seen up to that point, considered the possibility that my lower back pain might be caused by the chronic condition with which I'd been diagnosed and which causes lower back pain. He sent me for an MRI, which confirmed that yes, the lower-back-pain-causing chronic illness that developed around the same time I got the lower back pain was causing my lower back pain.

So on Monday, only nine years after first going to a doctor about it, I finally got prescribed some medication that might actually make my back hurt less.

And of course, in the intervening time, I've put on a load of weight, because when you're not able to stand up for more than a few minutes at a time you tend to walk a lot less...

[ritaxis]

I have somehow lucked into a care team that barely even mentions weight,though they do weigh me regularly and write the number down in my file, and the file also has my BMI (which as we all know is a meaningless number, not relatively meaningless but absolutely meaningless). They're interested in diet for controlling blood sugar and blood lipids, and exercise for almost everything else I've got going on, but those are specific therapy things. I only wish I'd learned about the magic of physical therapy when I was 14 and first tried to get a doctor to tell me what to do about my pains...