Not one of these books or articles ever mentions the need to lose weight when you have structural problems with your hips / knees / legs / feet. It's not an issue of metabolism, or biochemistry, or social pressures to be thinner, or whether or not being fatter affects the development of different diseases, or feminism, or whether the process of dieting harms you, or if curvier ladies are more or less attractive, or anything like that.
It's the weight. Weighing more puts a lot more stress on your joints. Cos it's weight. Mass. Every step you take loads multiple times that weight through your joints. It's. The. Weight. Full stop.
If you have hip dysplasia, osteoarthritis in your hips or knees, other structural abnormalities, or even some types of foot pain — weighing less will be better for you. And if you have an artificial hip or knee, the same thing goes. Those babies don't last forever, especially if you've had joint replacement at a younger age, like me. And trust me, the longer you can avoid revision surgery (replacement of the prosthesis) the better. Revision surgery is no picnic, and is usually less successful.
|Pelvis — illustration © Denise Sutherland|
But I can't just go all body positive and 'accept myself at the weight I am' — I really need to lose weight to help the longevity of my hip prosthesis, avoid my next lot of hip surgery for as long as possible, mitigate the decline of my other dysplastic hip and crappy knees, and maybe even have less joint pain if I'm extra lucky.
|Hip prosthesis — illustration © Denise Sutherland|
I go for walks, and am about to get back in the pool (just for hydrotherapy at the moment, but hopefully I'll be able to work up to swimming). Exercise bike when my knee is cooperating (it isn't at the moment). Halving my mirtazapine dose (which I take for sleep) has helped reduce my appetite and cravings a bit more, too.
But, I really wish that all these great books about how dieting doesn't work, and how healthy you can be at any size, would at least mention the fact that sometimes you have to lose weight, because the weight itself is the problem. Some acknowledgement of the existence of this problem — which surely must affect millions of people — it's not like hip and knee osteoarthritis is uncommon — would be nice. Even if all they can say is 'Well, fucking sucks to be you, doesn't it? Ignore everything we've just said, and go on a diet. Forever.'
* Please don't offer me diet or exercise advice, thanks. What I do now works for me, albeit slowly, on my doctor's advice. I'm glad that whatever you're doing works well for you.