8 Ways to Lose Weight When You Have Rheumatoid Arthritis

A weight loss diet for rheumatoid arthritis is based on the same principles recommended for just about everyone. Basically, you want to follow the Mediterranean Diet, which not only promotes health with its mostly plant-based, clean-eating approach, but has the added benefit of helping with weight loss, says Juan J. Maya Villamizar, MD, a rheumatologist in Lake Worth, Florida.

You want to eat fewer calories by choosing mostly fruits and vegetables, lean meats, and low-fat dairy products:

• Foods that are rich in fiber will help you feel fuller and thus help you eat less.
• Avoid processed foods and foods that are fried.
• Minimize sugar, salt, and unhealthy fat in your diet. (Don’t be fooled by products labeled low-fat or “lite.” They are often loaded with salt or sugar to make up for the lack of taste when the fat is removed. Read your labels.) For example, you can substitute blackstrap molasses for sugar. While molasses still is a form of sugar, it also contains the antioxidant magnesium.
• Healthy fats include anti-inflammatory omega-3s, found in fish such as salmon, herring, mackerel, sardines, anchovies, and trout.

Just because you are eating healthier foods doesn’t mean you can overeat. These foods still contain calories. “There are still some healthy fats in there, so you still need to watch your portion size,” says Dr. Maya Villamizar.

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Some medications given for rheumatoid arthritis, such as methotrexate (Trexall), can cause liver damage. If you’re taking methotrexate, certainly steer clear of alcohol, also a threat to liver health. Alcohol has calories — empty calories, the kind you want to avoid on a weight loss diet. If you do drink on occasion, do so in moderation and stay away from beer, which is very high in carbs, says Maya Villamizar. The American Heart Association recommends no more than one to two drinks a day for men, and one drink a day for women.

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It’s not always easy to get motivated to exercise when your joints ache and you are fatigued, but exercise can help to boost weight loss and is often recommended because it can actually ease rheumatoid arthritis symptoms. You might find exercising easier if you choose low-impact activities, such as walking, riding a stationary bike, ballet barre workout, or Pilates. Doing water aerobics in a heated pool is an excellent choice because the warm water can be soothing and help relieve pain and stiffness from arthritis. Also, the water provides some resistance, which helps you tone and build muscle strength. A trainer or physical therapist can help you devise a safe workout, but don’t wait for that to start exercising, says Maya Villamizar. Just listen to your body in terms of pain feedback.

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In addition to low-impact aerobic exercises, you want to strengthen the muscles around joints affected by rheumatoid arthritis. Strengthening your muscles will improve joint stability and allow you to perform daily tasks more easily. Equipment choices for strengthening exercises range from lightweight therapeutic bands to medicine balls, dumbbells, and resistance machines. Start with 5 to 10 minutes three times a week, and do more as you build strength. Remember, the more you move, the more calories you burn, and the more calories you burn, the more weight loss you’ll achieve. Maya Villamizar points out, “This is definitely important for people with RA. Building muscle helps support and prevent injuries to your joints.” If you’re unsure of how to begin a strength-training program, hire a personal trainer who can map out a regimen tailored to your ability level.

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If you’re not satisfied with your own low-calorie, healthy weight loss plan, ask your arthritis doctor to recommend a registered nutritionist who can help you. Together, you can develop a rheumatoid arthritis diet that includes the foods you like to eat, but in quantities that will enable you to lose weight and that contain the nutrients you need.

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Many weight loss experts recommend keeping a food diary. It helps to write down everything you eat — including how much and when — and review it carefully; you could be eating much more than you realize, which could explain why the bathroom scale isn’t moving. As you write in your food diary, be honest with yourself. A food diary is also helpful in tracking foods that may lead to flare-ups of your symptoms. Also, if you decide to work with a nutritionist, a diet journal could be a good starting point.

RA medications such as steroid prednisone (Deltasone) can lead to weight gain. “It is linked to fluid retention and increased appetite,” explains Maya Villamizar. Talk to your doctor if prednisone is keeping you from reaching your weight loss goals. It’s important to treat inflammation from rheumatoid arthritis, but your doctor may be able to adjust your medications or find alternatives so that you have an easier time achieving weight loss. Other medications may also lead to weight gain — some that you may be taking for conditions other than RA — so it is important to go over all your meds and supplements with your doctor.