Both obesity and arthritis, alone or in combination, increase disability among older people. Association between these two conditions is well recognized. Obesity increases the risk of osteoarthritis by mechanical overloading and chemicals produced by fat cells (adipocytes). Increased levels of uric acid in the blood (leading to gout) are associated with obesity. The risk of osteoporosis is less in obese individuals. The risk of joint damage in rheumatoid arthritis is likely to be lower in obese individuals. However, response to drugs may be inadequate. Immobility and the 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 based on the height and weight of an individual using the following formula:
BMI = Weight (Kg)/Height2 (Meters)
The Association of Physicians of India has issued a consensus statement on obesity and related issues for the Asian Indian population (Misra et al., 2009).
| Men > 78 cms Women > 72 cms | Avoid weight gain Maintain physical activity |
| Men > 90 cms Women > 80 cms | Seek medical help Consider drug therapy |
BMI (kg/sqm) in cases without associated diseases
Normal = 18.0 - 22.9; Overweight = 23.0 - 24.9
| > 25 | Obesity |
| > 27 | Initiate treatment |
| > 37.5 | Consider surgery |
Management of obesity is a lifetime effort. Diet, physical activity, and exercise are essential components of treatment. Avoidance of fatty foods and reducing caloric intake by 500-1000 calories (calculators available on the internet) 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 the initiation of drug therapy.
Weight loss of 5% will benefit obese patients, whereas 10% weight loss will have definite benefits. Set your goal and start working today.