1 "Your weight, your eating habits and even how much sleep you get can impact your health."

If your weight was creating problems for your arthritis or the stress of caring for your aging parents was taking a toll on your health, would your doctor tell you? Most people, even as they watch the needle on the scale creep up, trust their doctors to clue them in when lifestyle issues affect their health. But studies show most doctors stay mum on subjects like obesity, sleep, exercise and nutrition.

Though national statistics suggest as many as one-third of Americans may be overweight, one study found that doctors discuss weight loss with fewer than half of their overweight patients. Other lifestyle issues, including caregiver stress and sleep problems, may get only a cursory mention from your doctor. In some cases, the silence on lifestyle issues is based on mutual assumptions: You believe your doctor will call a problem to your attention, while your doctor may believe that when it comes to some issues, like obesity, the problem and the solution are obvious. And doctors who would never tell a stranger at a party that she's too heavy may feel uncomfortable violating that social nicety even in the examining room. Overweight patients may be too embarrassed to bring up questions about eating and exercise with their doctors, suggest researchers at the Weight and Eating Disorder Management Program at the University of Pennsylvania in Philadelphia. Time is another factor, according to a Duke University study that found that if doctors followed all the recommended preventive care measures -- including lifestyle counseling -- it would leave them only half an hour each day to deal with acute care, usually the reason for visits in the first place.

But for people with arthritis, lifestyle is too important to get short shrift in your doctor's office. Added pounds can increase pain by adding pressure to inflamed joints, causing or worsening OA, and exacerbating RA and other forms of inflammation. Good nutrition and regular exercise help reduce pain and keep joints strong and flexible, in addition to managing your weight. Research is just beginning to unravel the links between pain, stress, sleep and immunity, but studies suggest these relationships are more complex and impact our health more than previously believed. The good news? Little changes can make a difference -- one study found that as little as three hours of exercise over a six-week period improved joint function of people with arthritis -- and it's never too late to start. One 2003 nutrition study suggested that a switch to better eating habits even late in life could make a difference in longevity and overall health.

What can you do? Ask your doctor what your lifestyle management plan should be. Get specific: Do you need to lose weight? Strengthen muscles around a problem joint? Eat more of a certain food group? Speak up if you have trouble sleeping. Ideally, you'll leave with an eating and exercise plan or a referral to a nutritionist or personal trainer.

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