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Should overweight youth and adults with osteoarthritis be encouraged to lose weight or not?

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Obesity, which is on the rise, is a risk factor for, as well as a possible negative outcome mediator of multiple forms of painful disabling osteoarthritis. At the same time, social forces prevail that view this possible association and others that show body weight and its reduction as a disease mediator as a form of bullying rather than focusing on whether the disability can be reduced by accepting a role for excess weight as this affects one or more joints. To examine this issue the PUBMED and GOOGLE SCHOLAR data bases were sourced for relevant data published between January 2020 and mid May 2023 as aspects of this topic largely emerged during the COVID-19 pandemic and thereafter. These data bases show that while most current publications tend to portray a negative impact of obesity on osteoarthritis prevalence and outcomes, others seek to focus more on ‘fat acceptance’ and body positivity at any size. While research is limited in this regard, it appears salient to provide patients who might be benefitted with information to make an informed decision. Many calls that focus simply on stigma reduction, might fail to appreciate how painful osteoarthritis can be and how it can lead to further weight gain and basic physiological challenges, even if mental health is preserved. Social media need to review what is espoused and whether messages will reduce or increase widespread harm.


fat acceptance, obesity, osteoarthritis, overweight, stigma, prevention