Help from the Nutritionist
During the last few years and especially while recovering from my knee replacement surgery last year, I have gained some extra pounds that I wanted to shed. As many people with RA experience, prednisone and other medications make it extremely difficult to lose weight and very easy to gain.
One thing I have found troubling is that none of my doctors ever expressed a concern about the extra pounds. Through my own research and education I knew that I was over the ideal weight. Although it is not my goal to be skinny, I don’t want to carry any additional pressure on my arthritic joints or raise my risks for heart disease or other health conditions.
The first phase of my knee replacement recovery involved strengthening. After I had regained most of the functionality in my leg and felt more normal, I could turn my attention to losing some weight.
I started by first tracking what I eat and physical activity. My chosen tool was an app on my mobile called “My Fitness Pal,” but any method will work as long as you are relatively accurate and keep a regular log. The benefits of an app are that you can get estimates of calories burned with just about any type of exercise, even walking. I also like the help with measuring foods, how a lot of foods are already programmed in, and that you can estimate and build recipe calorie counts.
Tracking and doing some reading about eating better for weight loss helped me to identify some of the low hanging fruit to eliminate, namely my greatest food weaknesses—sweets and soda. I also found that I did better by exercising a little every day because it helped me to get into the habit. While it was not easy and took some time, I gradually lost some pounds.
Then came the plateau. It was so aggravating! Finally I had made some progress and for weeks the scale would not budge (actually, seven weeks with the exact same total, down to the tenths). I started to wonder if it was broken…
During my physical, I finally broached the subject with my new internist about my work to lose some weight and the frustration that I had made some progress, but was now stuck. She suggested I see another doctor who provides counsel on weight loss and nutrition.
I was anxious, but determined, so I made the appointment. He turned out to be really friendly and reasonable. We talked about my goals, how I had been tracking, and my current diet and exercise practices. One of the challenges we talked about is physical activity.
While I exercise every day, it is very difficult for me to do aerobic activity due to my rheumatoid arthritis. I can’t run or bike because I don’t have the strength and range of motion they require. Walking is very difficult and I can do only small distances before one joint or another screams. So a lot of my exercises are stretches or movements with lifts. I used to do yoga, which I love, but am not back to this condition yet since my surgery. However, I enjoy going to the pool and can do aerobic type exercises there. The doctor encouraged me to visit the pool at least once a week, but twice would be even better.
Then we moved on to examining my diet. He seemed impressed that I had cut sodas, sweets and the like. While I expressed my frustration, he pointed out that I had made some good progress and it was understandable for me to hit a rough patch now that I was getting closer to my goal. The “easy” phase was over and now I had to work harder.
He recommended that I change my eating some by eliminating some of the starches from my diet and substituting more protein (which he explained would keep me fuller, longer) and vegetables. Out went toast and fruit for breakfast and in went low-fat greek yogurt or eggs.
After a few weeks of my new diet and exercise I am finally starting to see the scale nudge downward again. My hope is that persistence will pay off against the frustrating combination of RA, prednisone and exercise limitations. Everyone is different, so my experience will vary from others, but good counsel from a doctor on nutrition and exercise can help with weight loss or maintenance.