recent X-ray results showed that my hip is now bone on bone. Orthopaedics will not look at me due to my weight. Doctor cannot provide anything more in the line of pain relief. I can’t put one leg in front of the other. I take methotrexate, amgevita and others meds and feeling totally useless.
any advice would be helpful
Weight is an absolute B**£( “#. But sadly it does make a difference to your joints.
I guess you have tried everything and anything to shift weight? What was the most successful for you, and do you have a anyone at home who would help be a coach? And distract you when you want to eat…
The only advice I have is to keep trying - not trying to diet as they are useless, but to change the way you live to have less food in your life. My only successful approach is only to eat during a 7 hour window.
I halved my body weight by dropping 10.5 stone, and have been maintaining the weight loss for a number of years now, so I know what it is to be on the very big end of big and needing to do something. I also have a medically proven slow metabolism, and metabolic syndrome, meaning I gain weight very easily, and the weight I gain sits around my middle, which has all sorts of health consequences associated with it. Exercise helps with losing weight, but it isn’t the be all and end all, and there are things you can do even if you’re completely immobile in terms of walking. Losing weight will also improve your joints more generally.
With the caveat that I’m not medically qualified, and this is purely my own experience and understanding. The first thing I’ll say is that when people are significantly overweight, it’s not about the food. It’s actually about the mental relationship with food, and usually a good degree of underestimating how much they’re eating. One of my guilty pleasures is watching a US reality show called my 600lb life, which follows a year in the life of super morbidly obese people, many of whom are completely bed-bound, as they try and lose weight. The doctor on the show, Dr. Now, won’t offer bariatric surgery to anyone that won’t go to therapy entirely because he knows that the biggest obstacle to eating less is almost always mental and emotional. Once you crack that bit, losing weight becomes a lot easier, and will set you up for keeping the weight off long-term. In the UK, we know that many people that have weight-loss surgery quite quickly regain the weight due to not having dealt with the reasons they were eating too much to begin with. They haven’t changed their mindset: the reality for any significant weight loss and subsequent maintenance is that the word diet needs to be binned in favour of understanding you’re making permanent lifestyle changes.
The second thing I’ll say is that any diet that leaves you feeling excessively hungry is not helpful. I tried absolutely all sorts over the years with little joy, including intermittent fasting. In conjunction with realising the emotional patterns to why I was eating excessively, what worked for me was a high protein, lower carb diet. Protein will fill you up, carbs won’t. We also know that the more carbs we eat, the more carbs we want, so reducing the amount of carbs also helps to reduce cravings and hunger. But I didn’t actually cut anything out, in part because if you tell me I can’t have something, it’ll only make me crave it more. What I did do was strictly calorie count and focus on portion control, which meant weighing things, but that was actually really enlightening when you begin to understand the calories you are actually consuming versus how much you thought you were having. I can safely tell you that I was not consuming the recommended portion of anything I ate, at all, ever. It was a real eye opener to see what 100g of oven chips looked like. Cooking from scratch also makes accurate record keeping and tracking of what you’re eating more straightforward. With strict calorie counting and recording what I was eating via an app (I still use MyPlate to keep me honest some 4 years after getting into a healthy range), I could have a chocolate bar if I really wanted it, or proper cheese, but it meant I made sure I didn’t exceed my calorie limit to have it. Which brings me to my third point.
If you don’t buy it, you can’t eat it. It really is that simple. Rather than a large bar of chocolate, or a multi-pack, I would buy a single small bar. Once that was gone, it was gone. I also bought lower fat alternatives of some things, but you have to be careful as lower fat doesn’t always mean better for you. Yogurts are always an oft-cited example, where zero fat actually often translates to extra sugar, but there are lots of other potential traps and pitfalls, and sometimes you’re better off with a little bit of full fat over a reduced fat option, particularly as fat in and of itself isn’t the enemy. Saturated fat is unhealthy, but fat as a whole is vital for our bodies to function correctly. I got into the habit of reading packets and comparing products to find the healthiest and highest protein/lowest carb options I could, and doing so became another real eye opener. Some products that are better for you will be more expensive, but that should be offset by buying less junk, or if you’re not eating rubbish, by eating smaller volumes of food more generally. If you have to have bread (as a carb fiend by nature, I couldn’t go without it completely), go for something like Nimble, or a specialty high protein loaf: they’re smaller slices for starters, but also lower carb and high protein as standard. Nimble in particular is stocked by many supermarkets.
Make sure you’re drinking enough. Scientifically, we know the brain can and does misinterpret thirst for hunger. If you’ve not long eaten and are still feeling hungry, bear in mind that a) it takes about 20 minutes for the full signal to reach our brains, and b) it could well be thirst rather than hunger. As a rule, it’s said we need about 2L of non-caffeinated, non-alcoholic fluids a day, but in practice, the bigger you are, the more fluids you’ll need. There is a fluid intake formula that takes weight, height, gender and age into account to generate your ideal volume a day: I need about 2.1L a day now, but when I was up at 21 stone, I would have needed about 3.2L. Two other tips would be to eat more slowly, generally, and chew each bite for longer. This will reduce the chances of over-eating - or wanting to overeat - due to the processing delay between being physically full and our brains getting the message.
When people ask me how I lost the weight, they look at me gone out when I say eat less, move more, and often follow it up with ‘no, really, how did you do it?’, but that is the reality. However, the moving part could just be using tins of beans to do arm curls: it doesn’t actually matter what movement you’re doing, all that matters is that you are. As I said before, many of the people in my guilty pleasure show are bed-bound. Some haven’t been out of bed for years, and will need to lose several stone before they’ll be able to do so again: upper body movement counts. You can also google for YouTube videos of seated exercise routines. My hips are currently wrecked as a result of OA and some missed congenital stuff, and when my IA is flaring on top, I’m barely able to walk, but I can usually manage some seated static biking: you should obviously check with a medical professional to make sure it’s appropriate for your specific condition, but my understanding is that as long as the seat is correctly set for your height, there is very little impact on the hips. Water based exercise is also good. At my very biggest, swimming was the only thing I could do with any relative ease, so that’s where I started.
For me, I know I will always have a tendency towards an unhealthy relationship with food: once you’ve been big, it’s very easy to get big again. I have to be vigilant as to my eating behaviours, but it’s no longer the challenge and battle it has been previously. With any weight loss journey, it also pays to remember that a bad day is just that, a bad day - it’s not the end of the world, and it doesn’t mean you’ve failed and should just give up, or you can’t try again tomorrow. I’m a firm believer that anyone can lose weight naturally, entirely because I did it in spite of medical problems and medications that make it harder, it’s just about having the understanding, tool set, and support to do so. You absolutely have this, but if I can help at all, or you have any questions about what worked for me, please just shout.
Well said
Excellent advice 👍
Love your reply because you hit the nail on the head the whole weight thing starts with understanding your relationship with food. very much a psychological matter needing to be addressed. Said this for decades 
Oh I feel for you! Both my ankles are bone on bone. Awful. Last year I had a fusion on my right one which failed so I have decided only weight lose is going to help I decided to cut out all carbohydrates- ALL! I’ve lost over 10 kilos and it has made a big difference. It’s easy because you don’t have to restrict yourself in anything else - I wouldn’t eat a biscuit or a slice of toast now if you paid me! I wish you the best.
If you can, take Charlie_G’s excellent advice and do your very best, however foul you feel about it, to lose as much weight as possible in order to have a hip replacement. The pain from osteoarthritis in the hip is second to none and totally restricts your mobility. I’ve had both hips replaced and have had to wait for replacements both times - not due to weight, luckily, but waiting lists and the pain is excruciating and indescribable. That goes the minute you have the problem removed so aim for that goal and look forward to being fitter all round. All the very best of luck - it won’t be easy or simple but do it for you and a much healthier future as soon as you can.
Feel for you suffered like this for some years, but was fortunate in the GP (locum) referred me to the Orthopaedic Dept.Once my x-ray was done i was in the system and had both hips replaced, no pain now.
Difficult if they're concerned about your weight, tbh I tried to keep my weight down to avoid
pressure on my joints, your weight will add to the pain.
Has anyone discussed sensible ways to achieve a weight they'd be happy with?
Agree with others don't turn to diets that are fads, not healthy etc.
Maybe look at portion size, healthier snacks if you tend to snack etc.
Easy to say lose weight but a catch 22 when limited in moving around.
Wonder if exercises in a chair , lying down, I had to do them post surgery and started in bed, till able to do then in a chair then standing.
I'll stop here cos you've got lots of great input from ones who know better than me.
All the best
Hip pain
Hip and groin pain .
Hip pain and RA
Amgevita 
