Obesity

Both obesity and arthritis, alone or in combination, increase disability among older people. Association between these two conditions is well recognized. Obesity increases risk of osteoarthritis by mechanical overloading as well as due to chemicals produced by fat cells (adipocytes). Increased levels of uric acid in blood (leading to gout), too, are associated with obesity. Risk of osteoporosis is less in obese individuals. Risk of joint damage in rheumatoid arthritis is likely to be lower in obese individuals although response to drugs may be inadequate. Immobility and use of drugs such as steroids tend to increase weight in rheumatology patients. Obesity is associated with other risk factors such as heart disease, diabetes, gall stones, urinary incontinence and gynecological problems.
Obesity is measured by body mass index (BMI) and waist circumference (cms). BMI is calculated on the basis of height and weight of an individual using following formula:
BMI = Weight (Kg)/Height2 (Meters)
Association of Physicians of India has issued a consensus statement on obesity and related issues.

Highlights of this document are summarized below:

\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
Men > 78 cms Women > 72 cmsAvoid weight gain Maintain physical activity
Men > 90 cms Women > 80 cmsSeek medical help Consider drug therapy
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BMI (kg/sqm) in cases without associated diseases
Normal = 18.0 - 22.9; Overweight = 23.0 - 24.9

\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
> 25Obesity
> 27Initiate treatment
> 37.5Consider surgery
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Management of obesity is a life time effort. Diet, physical activity and exercise are essential components of treatment. Avoidance of fatty foods and reduction of caloric intake by 500-1000 calories (calculators available on net) per day is desirable. Patients with arthritis as well as obesity must remain physically active. At least an hour of physical activity is recommended daily. Brisk walking as well as Yoga postures are good initial exercises. Medical advice is necessary for initiation of drug therapy.
Weight loss of 5% will have at least some benefit in obese patients whereas 10% weight loss will have definite benefits. Set your goal and start working today.