RA and weight loss: giving it a kick-start

Six-thirty a.m. I sit up, struggle from under the covers and roll out of bed. I hobble, my joints stiff and achy, to the bathroom. During morning ablutions, I gaze at my knuckles. They’re only a little swollen this morning, I note. I flex my hands. Only a little stiff and a little sore, too. This is nice.

As I get dressed, I look at my body in the full-length mirror (that evil thing!). I make a face at my wide hips. I know I haven’t gained any weight! In fact, since the middle of August, I’ve lost eight whole pounds. Maybe, I grumble, my hips look extra-wide this morning because they’re swollen. My here-again, gone-again hip bursitis is definitely here again this morning. Still, those teensy bursae over my hip-joints probably aren’t swollen enough to make my already-wide hips look even wider. I can thank my Scandinavian ancestors and 30 years worth of chronic cookie-binges for that.

THE ABOVE BEHAVIOR does not strengthen joint-supporting muscles or rev up weight loss.

THE ABOVE BEHAVIOR does not strengthen joint-supporting muscles or rev up weight loss.

Mondays are my weigh-in days, so with my breath held I step onto the bathroom scale. To my disappointment it shows the same weight as Monday a week ago. I sigh again. OK, Saturday night I splurged and had fish and chips instead of salad for dinner when Mom and I went out. But I only ate half the meal—and I’d been mindful and disciplined all week up to that point. The fish and chips undoubtedly put me over my daily calorie-quota, but I’d gone right back to it Sunday.

Waiting for my breakfast egg to boil, I think about exercise. Because exercise

BROWN BASMATI RICE and a quick stir fry of tomatoes, zucchini, yellow crookneck squash, onion, garlic and chunks of chicken breast is a healthy, low calorie meal. Fruit is good for you, too.

BROWN BASMATI RICE and a quick stir fry of tomatoes, zucchini, yellow crookneck squash, onion and garlic make a healthy, low calorie meal. Season to taste. And fruit is good for you, too.

can jar the body into burning off fat and help sink the number on the scale. I know this.

But of all the things I’ve done to improve my health over the years—including tossing out the smokes—exercise has always been the hardest. Like others who battle rheumatoid arthritis, it seems like a lot of the time I’m just plain too sore and achy to exercise. And when I’m not, I’m afraid to rock the boat. If I exercise, I convince myself, I’ll just bring on a new flare. It’s a catch-22.

But I know better. I only trigger new flares when my enthusiasm overflows my good sense. If I stick to gentle exercise, like stretching, using resistance bands and walking—not too far, at first—I’m fine. When I do that each day, exercise jump-starts my weight loss. I know, because I’ve done it.

There are lots of RA-friendly types of exercise that not only increase muscle strength (which helps to support the joints), but also promote heart health, safe weight loss, balance and even mental health. Click this slide-show at Healthline.com: http://www.healthline.com/health-slideshow/8-essential-everyday-exercises-for-RA-pain for a great overview.

13 responses to “RA and weight loss: giving it a kick-start

  1. I know exercise is hard when the joints are sore, but I always try to do gentle yoga or swimming if i can. Swimming is really good if you have the resources, as it keeps the pressure off the joints. And walking is great too. I always say if you’re happy and healthy (or as healthy as one can be with arthritis) then that’s the most important thing. We are women, we are born with curves, so if we can’t beat them, we can try to learn to love them.
    Stay well,
    J.G. (hugs).

    • It sounds like you’ve found an exercise regimen that works well for you, J. I keep reading about others with RA who are, like you, doing yoga and/or swimming with good success. I’ve thought about yoga often, but I’ve been a little afraid to try it, mainly because of my weak, sore wrists and, I’ll admit, some self-consciousness and embarrassment about my overall plumpness. In all the yoga class photos I’ve seen, the people participating are all sleek and bendy and beautiful!

      As for swimming, I would like to do that. I’ve had trouble finding a good, local public pool for gentle exercise, though. While there is one at a local gym, the gym fees are beyond my pocketbook these days.

      Stretching and walking are my choices. And you’re right–we’re born with these curvy, hippy bodies. Might as well learn to love them!

      I hope this finds you feeling good and enjoying the season, J.!. :)

  2. RA, 55+ and taking pregnisone. Three strikes….I am out :-) I am not sure what else there is to do to try and shed the pounds. Wish I were a banana and I could just peel them off. Good luck on your journey. I will be cheering you on.

    • Thanks! Wish you were a banana … heheheheh. If you’re interested, do try the Mediterranean diet–basically a low-carb, high protein diet that’s frankly delicious and fairly easy to do, even if you’re cooking for your family while you’re on it. And do read Eileen’s comment, below. She’s had terrific results from the 5:2 diet, and it sounds even easier than the one I’m following.

      Here’s wishing you a lovely fall season. Feel good! :)

  3. As most of you looking in know, I have PMR – only treatment pred and really not helpful with allowing exercise either way. To start with the weight gain was the undiagnosed PMR stopping me managing the exercise I’d done for years to keep the weight in bounds. I’m a whole 5’2″ on a tall day but getting under 150 lbs has always been a major struggle (if my legs were in proportion to the rest of me I’d be a few inches taller and the overweight problem would be much less) but just plain pred didn’t make me put on weight, it just redistributed it.
    Nearly 2 years ago I was switched from simple prednisolone to Medrol – which didn’t work as well and caused a whole load of side-effects, from a very healthy dark beard (I’ve been pretty much totally white since I was 40) to worsening atrial fibrillation which eventually led to me spending 3 weeks in hospital and spending 9 months on crutches. I put on a LOAD of weight.

    A year ago my medication was changed to Lodotra – and I decided I HAD to lose some weight. The 5:2 diet book by Michael Mosely was a daily deal on KIndle, 99 pence, so I thought “Why not?”. Coincidentally a couple of others on the PMR forum I’m a member of thought much the same though none of us said anything to the others. A couple tried the 5:2 diet, two went to Weight Watchers and used their format. All of us have lost weight successfully.

    We were all on about 10mg pred a day, all of us with either hip bursitis or other PMR joys that made exercise difficult. But all of us have lost weight – it can be done, even on pred. As we have lost weight the other bits have also improved. A year ago I struggled to walk half a mile with crutches. One day last week I walked a total of a good 5 miles – even if it was with a long lunchbreak and a cafe break half way back. And of course, the being more mobile helps weight loss too.

    At my last weighing in August I had lost 12 kg/26+ lbs – mostly from around my middle and shoulders where the pred weight had lodged and I’m well below 170lbs. Another 7 kg would be heaven!

    I’d say to anyone to try the 5:2 diet (unless they are diabetic). Two days a week, not consecutive, you keep to 500 cals, the rest of the week you can eat a normal sensible diet. On the day you “deprive” yourself you know you can have that icecream tomorrow so eating a whole lettuce doesn’t feel bad. And you do genuinely start to feel less hungry on the other days too after a couple of weeks. Probably the biggest plus is that the guilt feeling of that “fish and chips” treat doesn’t figure. It doesn’t mean you binge for 5 days, starve for 2 – you need a sensible healthy diet too – but the once in a while treat is part of living. You don’t catch up the missing calories on the other days, you are more aware of what you are eating – and there are other biological benefits that help you long term that I won’t go into here. After all, one plate of fish and chips won’t make you put on weight – unless you eat it or its equivalent every day!

  4. Oh, my dear Eileen! You’ve really been through the wringer with that malicious PMR! I’m glad there is a drug that works to relieve the pain for you, though. As you may recall, I have taken prednisolone twice in week-long, tapered doses, for the hip bursitis. It did help–temporarily. But I’ve read so many accounts written by others with rheumatoid disease, including PMR, about the ugly side-effects of prednisone/prednisolone that I’ve decided I will never take the stuff on any regular basis, even if my RA goes seriously over to the Dark Side. I can pack the pounds on perfectly well without it, thank you! ;)

    All that said, I’m in awe that you’ve lost more than 25 lbs. while taking it. Your story gives me a great deal of hope–and I’m sure that it will for others who read your comment here. What you’ve accomplished is no small feat.

    I’ve gone back to a low-carb, low calorie, very nutritious diet that has worked well for me in the past. And I have read about the 5:2 diet; it makes sense, doesn’t it? This time around I wasn’t sure I could gin up the willpower to cut back to 500 cals twice a week, though, so I went back to what I knew worked. Since reading your comment, however, I think once I’ve lost the weight I’m trying to drop, I’ll take the 5:2 up to help me maintain it. Thank you for reminding me about it!

    As of yesterday morning, I’ve now lost 12 pounds. I was delighted with what I saw on the scale! I’m averaging about two pounds a week, which is just fine. Overall, I’m feeling good. RA-wise, about the same. That’s okay; even if I hurt from the RA, being lighter on my feet helps tremendously, mental-health-wise. I’m looking forward to fitting back into my smaller-size clothing!

    Thank you for your excellent comment today (as always!). You’re such a friendly teacher–I always learn something from you–and I’m sure others do as well. Take good care and enjoy the fall season, Eileen. I’ve no doubt you’ll lose those last seven kgs. :D

  5. Thank you Wren – 2 lbs a week is amazing! I’m more like 2 lbs a month – but for me that is good given how difficult I have always found it to lose weight. In fact I do use the low carb Mediterranean diet (as per your side link :-) ) as a basis for the rest of the time but hadn’t really lost weight on it until I added in the 5:2 and that seemed to kick start things. What I do note though is that as soon as I increase the carb load to about 40-50g or over per day I retain fluid – and that adds weight of course!

    My main point for posting was to discourage the claim “I can’t lose weight because I’m on pred”. There are even some lucky people who lose weight when taking pred (I know a few) but for most of us it just needs more discipline

  6. Well, Wren, OBVIOUSLY the reason your hips look wide is that your midriff is now so much more svelte by comparison (because of the 12 pounds lost)! (That’s my story and I’m sticking to it.) Today was supposed to be the first of my fitness sessions with my physical therapist, but she called in sick. Rather than re-educate another PT with my background and limitations, I’ll start with her on our next scheduled appointment. Congratulations on the weight loss!

    • (laughing) I love it, Carla! :D

      Good for you, starting those fitness sessions with your PT. I agree that this sort of therapy ought to be more readily (and cheaply!) available to all of us. Perhaps the ACA will help to “make it so.”

      Thanks for the congrats. I’m pleased and motivated, but I’ve a long way to go, yet. Hope you’re feeling well and that your knee is improving… :)

  7. Carla – I like your thinking! May I borrow it?

  8. Good for you Wren, I think I have picked up your eight pounds though. Just let me know when you want them back. I have always enjoyed working out up until about a year and half ago. I have struggled so much the last year and a half, I (like you) am afraid of bringing on a flare on my days I feel up to it. I still walk every day but weights and cycling not so much any more.

  9. Hi Wren, I got an email of your ‘nightshade nightmares’ post which I thought was great – but where’s it gone?!

    • Ach! It’s coming, Penguin! I posted it, then noticed I needed to do a little more work on it, so I de-posted it. Won’t be long… ;)