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About.com Health's Disease and Condition content is reviewed by Kate Grossman, MD

Many patients, especially rheumatoid arthritis patients, become concerned because they gain so much weight over the course of the disease. It can be due to a more sedentary lifestyle, or prednisone, etc.

What advice do you have for arthritis patients who are unhappy with their weight gain, and who make some effort to diet and exercise when possible, but there is little or no progress made?

A. Diet is the key to weight control. Many patients tell me that they eat nothing but still cannot lose weight. In fact, many patients, once they gain the weight find it is difficult to lose it. In addition, they often will say that they eat well and eat the right foods. They don't realize that even eating 1 cookie daily can add a pound after one month.

I recommend my patients have a consultation with a dietician to formulate a plan. Some have had benefit from Weight Watchers. Limiting simple carbohydrates(such as white breads, pasta, cookies and cake) appears to be benefical. Taking corticosteroids makes losing weight more difficult because it increases appetite and may also cause fat to accumulate in the body.

A new medication to help with appetite control and weight reduction is currently under development by Sanofi-Aventis. If approved by the FDA, it may be available to patients with obesity by early 2006.

It takes fairly rigorous exercise to shed weight. Still, aerobic exercise can help prevent additional weight gain as well as contribute to cardiovascular health and improve your energy. Don't give up! If you can be successful in maintaining an ideal weight, you will reap many health benefits in the future.

Answer provided by Scott J. Zashin, M.D., clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas, Texas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano. He is a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association. Dr. Zashin is author of Arthritis Without Pain - The Miracle Of Anti-TNF Blockers. The book is a must-have for anyone on one of the biologic drugs (Enbrel, Remicade, Humira) or considering the biologic drugs. Read my review of the book.