I used to be 23 stone and have lost seven stone in seven months, with lots more to go. My problem is I ache. I ache when I get out of bed, when I get up from sitting for a while, and when I walk; I ache in the thighs and the hips, and sometimes the shoulders. Is it the weight loss - or something more sinister? It has only started since I started to lose weight. I am 53 and have always been healthy.
Name and address withheld
You have exceeded the recommended rate of weight loss by a factor of around three! Not just that, but you have likely coupled extreme food restriction with an exacting exercise regimen. The physiology of weight loss is extremely complex: very low-calorie diets are not without risk, and should be undertaken with medical supervision. They can deprive you of important nutrients, and are potentially dangerous: heart and metabolic problems have been reported following them. The food restriction and the exercise programme may well have overstressed your body. Theoretically, if you have been deprived of food, and have exercised hard to burn calories, you may have been hit by a double whammy. Muscle-use has increased, and, as the calorific intake has decreased markedly, your body's reserves are being used to produce energy. In extreme cases, it is not just the fat that is burnt: the actual proteins that build up the muscles are dismantled to allow muscle contraction. In these instances, muscles may be in a state of continuous overuse, and may ache. Muscle contraction is beneficial, but it may disrupt muscle structure, causing chronic muscle soreness.
So while it is unlikely that your aching is sinister, do consult your GP. You may have overused your joints so much that some arthritis is manifesting itself. You may also need to alter your nutrition. Accurate balancing of your diet may go a long way to restore the feeling of wellbeing that your new body deserves.
· Professor Maffulli is a consultant orthopaedic and sports injury surgeon at Keele University medical school
