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Canadian Arthritis Report Targets Obesity



Yesterday, the Arthritis Alliance of Canada together with the Canadian Arthritis Network released The Impact of Arthritis in Canada: Today and Over the Next 30 Years, a 50-page report that provides a detailed look at the impact of arthritis in Canada and offers solutions on how to mitigate and manage the situation.

According to this report, there are currently more than 4.4 million people living with osteoarthritis (OA) in Canada. In 30 years, more than 10 million or one in four Canadians is expected to have OA. Within a generation (in 30 years), there will be a new diagnosis of OA every 60 seconds.

Currently OA drives about $10 billion in direct health care costs and about $17 billion in indirect costs (lost wages, lost taxes, etc.) – together with other forms of arthritis (especially rheumatoid arthritis) the total cost of arthritis amounts to an estimated $33 billion annually. These numbers will on only grow.

Recognising that excess weight is one of the prime (modifiable) drivers of the OA epidemic, the report suggests that targeting obesity should be a priority (along with better access to joint replacements and adequate pain management) in reducing the burden of arthritis on Canadians.

As the report points out:

If a prevention program was available to reduce obesity rates by 50% in the Canadian population over the next 10 years:

• 45,000 new cases of OA could be avoided over 10 years and over 200,000 cases of OA could be avoided over 30 years;

• 25,000 workers could avoid OA over 10 years and over 136,000 cases of OA in the labour force could be avoided over 30 years;

• $3.8 billion could be saved in cumulative direct health care costs over 10 years and $48.3 billion over 30 years (2010 dollars); and

• $14.0 billion could be saved in cumulative productivity losses over 10 years and $163.7 billion saved over 30 years (2010 dollars).

(Limitation: Costs attributable to obesity-reduction interventions were unavailable and, therefore, not considered in the model.)

While this conclusion stresses the importance of obesity as a key driver of arthritis costs, this assumption of course is rather optimistic.

To my knowledge, there is no known prevention strategy that comes even close to reducing obesity prevalence by 50% in 10 years. Indeed, for those at the highest risk of OA, namely, those who are already obese, ‘prevention’ strategies come too late – you would actually have to look at ‘treatment’ strategies.

The authors are certainly aware of this as they concede that:

“Further research is needed to improve on current strategies for preventing and treating obesity.”

Fortunately, we’re already on it.

AMS
Edmonton, Alberta

7 Comments

  1. I think they are wrong about that. I think they have a common cause, namely sugar, grains, and omega 6 oils. Consider the non-load bearing arthritis as in the hands. When I quit sugar and wheat, my hands started to work before I lost much weight.

    The target should be no wheat, no sugar, and to do that, we need to eliminate Omega 6 oils, get or blood glucose into like, and learn to eat to control appetite.

    Implying obesity is the cause is very wrong. All it shows is a correlation. The obese deserve the truth and a workable solution that many of the ex-obese have found.

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  2. Don’t several of the arthritis medications in turn cause weight gain?

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  3. Since one of the most common side effects of dieting is further weight gain, shouldn’t we be giving priority to other options to increase mobility and decrease pain, for instance, physiotherapy that targets and strengthens the muscles around the affected joint? Getting people up and moving–though not a total solution–is certainly a lot more helpful and a lot more “health creating” than simply recommending weight loss, which in 95% of cases is not sustainable.

    Once again, by stressing weight loss, we are blaming the arthritics while doing nothing to help them fight the disease. “If they only stopped eating Big Macs, fries and Coke all the time, they wouldn’t be fat and wouldn’t get arthritis!”

    Funnily enough, today I was thinking about the ever lithe Jane Fonda and the fact that she too has had a hip replacement…

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  4. The main weakness in that back-of-the-napkin estimate isn’t the neglected costs of intervention. It’s the assumption that arthritis that’s associated with obesity is caused by obesity. In reality, the causality might be either reversed or mixed. For example, when my left hip went out due to trauma induced osteoarthritis that was primary the result of a car accident, I became less active and gained 15 pounds. If I’d been suppressing my weight to begin with, then I probably would have gained even more.

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  5. The biggiest flaw with this report was in your preamble–RA is an outoimmunie desease not at all like its cousin OA. As a suffer of RA in my right hand I would like to know just how weight issues are causative. Both RA and OA are ugly cousins.

    As far as fredt commented that removing wheat and sugar helped his OA, there many different types for foods that can cause an alerigenic type of responce in circulation there are many books that can expound on this topic. Obesity and arthroitis have one thing in common the patient must be patient and educate him or herself on what works best for the individual.

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  6. There are lots of good arguments against obesity but it’s not so clear when it comes to orthopaedics. How many contact sports athletes end up having hip and knee replacements as well as those super thin ballerinas, skaters and gymnasts? High impact aerobics and training for long-distance marathons are also brutal on joints. What about all those occupations known for repetitive stress injuries or trades that require a lot of lifting of heavy objects, kneeling, crawling, etc. Actually extra fat can be associated with good outcomes with it comes to statistics for who gets osteoporosis as load bearing strengthens bones and the extra padding around bones and organs can be advantageous in falls and accidents. Of course if it comes to actually needing surgery, the obese patient places health care workers at greater risk of being injured because they are lifting, carrying, supporting their own weight plus that of the patient.

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  7. Of course if it comes to actually needing surgery, the obese patient places health care workers at greater risk of being injured because they are lifting, carrying, supporting their own weight plus that of the patient.

    I don’t think people who are in the hospital for joint replacements ever necessarily need to be lifted. Nobody ever had to lift me when I was in for my hip replacement. I was on a wheeled gurney, before, during and right after, I was able to transfer myself to the bed in the recovery room, and was able to use the toilet by using a walker the next morning. This might not be true of everyone though, I guess…

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