Weight Reduction Tools

Weight Loss for Knee Pain / Arthritis – Before Knee Replacement Surgery

Weight loss is not easy; however it remains one of the most effective treatments for knee arthritis. Research has shown that weight loss correlates with improvement in knee pain and function. It is recommended to lose a minimum of 5% of your total weight if your BMI is > 28.

Dietary change is the key aspect of weight loss as arthritis limits your ability to ‘exercise the weight off’. Muscle strengthening and exercise are recommended to improve knee pain, however will have a limited effect on your weight loss. There is not a single effective method to lose weight and different methods are effective for different people. However, some key concepts that should be incorporated are:

• Eat 3 small (entree sized) meals per day. Aim to use a smaller plate to limit portion size, with 1/4 lean meat / chicken/ fish, 1/4 brown carbohydrate and half the plate for non starchy vegetables as a guide.
• Fasting is effective – aim to eat your 3 meals in an 8 to 12-hour window. For example, aim to fast between 7pm and 7am. If you can tolerate a longer fast, it is more effective (e.g. from 5pm to 9am)
• Reduce sugar and sugary drinks (alcohol, fruit juice, soft drink, energy drinks, flavoured milk, etc). Aim to not have calories from these drinks. Aim to not have more than 2 alcoholic drinks on any given day and a minimum of 2 alcohol free days per week.
• Eat a lower carbohydrate diet. Swap white carbs (bread, pasta, rice, etc.) for smaller serves of brown carbs (brown bread, pasta, rice, etc.). Eat lean protein such as fish, chicken or beef. Eat good fats such as nuts, avocado, etc.
• Eliminate ultra-processed foods (foods containing more than 4 ingredients that come out of a packet)
  Eat a diet rich in non-starchy vegetables (e.g. avoid potatoes) and moderate amounts of fruit.
• Meal replacement (e.g. Optifast) can be a good solution to kick start your weight loss. For example, taking an Optifast shake or bar for breakfast and lunch, combined with a 150-gm fish/chicken or beef + salad dinner will result in 1 – 2.5kg of weight loss per week for most people.
• Snacking – If you need to snack try a piece of fruit or 1/4 cup of nuts or 170g high protein, low sugar yoghurt.
• Hydration – Aim to drink 2L of water per day. Drink a glass of water 10 minutes before a meal as this makes you feel full faster.
• Plan meals in advance to assist in making healthy choices and to limit takeaway foods.
• The above advice is a basic guide only. See your GP or Dietitian for assistance with tailoring a diet specific to your needs.

Maintenance Diet

• In the long term, 3 small meals per day (entree size) will enable continued weight loss at a slower rate, and weight maintenance. Your total calorie intake should be restricted to 1500 calories per day.
• Less carbohydrates and more healthy fats must be incorporated into your diet as lean protein will decrease hunger.
• A ‘cheat’ day is allowed once per week. It is recommend to carefully select food and drink that you enjoy and consuming it in moderation. It is still important to count calories and aim for 2000 calories on a cheat day. For example, 2-3 slices of pizza with 2 glasses of wine will contain around 1000 calories, as opposed to the whole pizza which may contain more than 3000 calories.
• Maintain physical activity, aiming for a minimum of 180 minutes per week. The CSIRO’s Low Carb Diet book is recommended for healthy weight loss, as it has been clinically shown to improve weight loss and blood sugar control. It can be purchased from all good bookstores or online from BIG W.

Below are videos from

1. Studio 10 about the CSIRO’s Low Carb Diet book.
2. Dr Michael Mosley on the benefits of fasting.

The CSIRO Low-Carb Diet

The benefits of Intermittent Fasting With Dr Michael Moseley

Do you need help with Weight Loss??

For assistance with weight loss, see your GP or Dietitian to start the conversation about the best way for you to lose weight. Another great weight loss service is Healthy Weight for Life. This service is FREE for most patients with private health insurance (excluding HBF) and involves an 18-week program of meal replacement combined with dietary changes. The program has published excellent results, showing most patients lose 5-10 % of their weight over the 18-week period.

360 Health & Community run a healthy lifestyle program, which focuses on providing education regarding healthy choices to reduce the progression of your chronic musculoskeletal conditions, such as knee arthritis. A referral from your GP is required to access this free service which is run at multiple locations across Perth. For more information click here.

Fuel Your Life is a provider of dietetics advice, with a network of experienced dietitians and multiple locations across Perth. They have a special interest in weight loss in the ageing patient, diabetic management, athletic performance and veterans care. For more information click here.