Obesity connects to numerous diseases beyond the commonly known associations with sleep apnea, high blood pressure, and diabetes. One less-discussed but impactful condition is osteoarthritis, the wear and tear of joints that affects daily functioning.
Two Pathways of Harm
Obesity damages health through two distinct mechanisms:
Fat Mass Disease
Fat mass disease refers to the direct physical force excess weight places on joints and body systems. Extra weight on knees, hips, and feet accelerates cartilage breakdown. Research shows dropping body weight by 10% reduces force on each knee by approximately 40% with every step.
Sick Adipose
Sick adipose describes how fatty tissue promotes systemic metabolic damage including insulin resistance, fatty liver disease, and chronic inflammation — mechanisms that harm joints distant from where fat accumulates.
Beyond Mechanical Stress
Obesity promotes hand arthritis symptoms despite hands bearing no extra weight, suggesting metabolic rather than purely mechanical causes. Circulating free fatty acids stimulate joint bone cells, producing inflammatory signatures similar to rheumatoid arthritis. Additionally, obesity increases M1 macrophages that release CCL2, a signaling molecule that communicates joint pain to the brain.
Connection to Inflammatory Diseases
Adipose tissue releases inflammatory cytokines — interleukin-1, interleukin-6, and tumor necrosis factor-alpha — at elevated levels in obese individuals. Research associates obesity with higher inflammation markers, more active rheumatoid disease, and lower remission likelihood in patients.