Quick answer: Exercise helps weight loss with arthritis most when combined with healthier eating. Choose low-impact activity such as walking, cycling or swimming, build towards at least 150 minutes a week, and add strength exercises twice a week to protect muscle. Start where you are, increase gradually over 12 weeks, and ask your GP about NHS weight management support.
If you have arthritis and are carrying extra weight, you have probably been told that losing some would help your joints. That is good advice: NICE guideline NG226 recommends weight loss for people with osteoarthritis who are overweight, alongside exercise. But exercise can feel hard when your joints hurt, and it is easy to start too hard and give up. This guide gives you a realistic, joint-friendly exercise plan to support weight loss, explains how to pair it with eating changes, and shows where to get NHS help.
Why weight matters for arthritis
- Load on joints. Weight-bearing joints such as the knees, hips and feet carry more load with every step when you weigh more. Losing weight reduces that load.
- Inflammation. Body fat is active tissue that produces substances linked to inflammation, which may affect joints throughout the body, including the hands.
- Pain and function. NICE advises that any amount of weight loss is likely to help people with osteoarthritis who are overweight, and that losing more (such as 10% of body weight) is likely to bring more benefit.
- Treatment and surgery. A healthier weight can make treatments, including joint replacement surgery and recovery, easier.
Our guide to arthritis and weight loss covers the reasons in more depth.
What exercise can and cannot do
It is worth being honest: exercise on its own usually leads to modest weight loss, because it is easy to eat back the energy you use. Weight loss is mainly driven by eating fewer calories than you use. But exercise matters a great deal because it:
- helps you keep weight off once you have lost it
- preserves and builds muscle while you lose fat, which protects your joints and keeps you strong
- reduces arthritis pain and improves function in its own right
- improves mood, sleep, blood pressure and blood sugar
So the best approach combines the two: eating changes for weight loss, and exercise for joints, muscle, health and keeping the weight off.
Before you start
- Speak to your GP first if you have heart problems, chest pain, uncontrolled blood pressure, diabetes on insulin or tablets that can cause low blood sugar, or you are very inactive and have several health conditions.
- Choose supportive, cushioned footwear and comfortable clothes.
- Decide how you will track progress: steps, minutes of activity, or a simple diary.
- Set a realistic goal. A loss of around 0.5 to 1 kg a week is a common safe target.
The best low-impact activities for weight loss with arthritis
| Activity | Joint impact | Why it helps | Tips |
|---|---|---|---|
| Walking | Low to moderate | Free, easy to build into daily life | Start with short walks on flat ground; use poles or a stick if helpful |
| Cycling (outdoor or stationary) | Low | Uses large leg muscles; easy to adjust effort | Set the seat height so your knee is slightly bent at the bottom |
| Swimming and aqua aerobics | Very low | Water supports body weight | Good if weight-bearing is painful; warm pools are often more comfortable |
| Cross-trainer | Low | Works arms and legs without impact | Start at low resistance for short bouts |
| Rowing machine | Low to moderate | Whole-body exercise | Avoid if back or hands are painful |
| Seated exercise | Very low | Option for limited mobility | Seated marching, arm work and band exercises |
| Strength training | Low to moderate | Builds muscle and protects joints | 2 to 3 times a week, see below |
If your joints are painful when weight-bearing, water is a great place to start. See our guide to water-based exercise.
How hard should you work?
Most of your activity should be at a moderate intensity: you breathe faster and feel warmer, but can still talk. Use the "talk test" rather than chasing a high heart rate. As your fitness improves, you can include short spells of vigorous effort, where you can only say a few words, if your joints and health allow. Joint pain during exercise should stay at a level you find acceptable (often around 4 out of 10 or lower) and settle within 24 hours.
Your 12-week plan
Choose the starting level that suits you. Each week, do the aerobic minutes shown (spread over most days) and two strength sessions. If a week feels too hard, repeat it before moving on.
| Weeks | Level A: very inactive or very painful joints | Level B: some activity | Level C: fairly active |
|---|---|---|---|
| 1–2 | 5–10 minutes a day (seated, pool or short walks), total 40–60 minutes a week | 15 minutes, 5 days (75 minutes) | 25 minutes, 5 days (125 minutes) |
| 3–4 | 10 minutes, 6 days (60 minutes) | 20 minutes, 5 days (100 minutes) | 30 minutes, 5 days (150 minutes) |
| 5–6 | 15 minutes, 6 days (90 minutes) | 25 minutes, 5 days (125 minutes) | 35 minutes, 5 days (175 minutes) |
| 7–8 | 20 minutes, 5 days (100 minutes) | 30 minutes, 5 days (150 minutes) | 40 minutes, 5 days (200 minutes) |
| 9–10 | 25 minutes, 5 days (125 minutes) | 35 minutes, 5 days (175 minutes) | 45 minutes, 5 days (225 minutes) |
| 11–12 | 30 minutes, 5 days (150 minutes) | 40 minutes, 5 days (200 minutes) | 50 minutes, 5 days (250 minutes) |
Minutes can be broken into shorter bouts, such as three 10-minute walks. UK guidelines recommend at least 150 minutes of moderate activity a week for health; for weight loss and keeping weight off, many people find they need more, built up gradually.
Strength sessions (twice a week)
Do 1 to 2 sets of 8 to 12 repetitions of each exercise, slowly and with control, resting a minute between exercises.
- Sit-to-stand from a firm chair, using your hands if needed.
- Wall press-up with hands on a wall at shoulder height.
- Step-ups on the bottom stair, holding the banister.
- Seated row with a resistance band around your feet.
- Bridge lying on your back, knees bent, lifting your bottom.
- Heel raises holding a support.
- Side leg raise standing and holding a support.
Make it harder over time by adding repetitions, then a second set, then light resistance. Our strength training guide explains progression in detail.
A sample week (Level B, weeks 7–8)
| Day | Activity |
|---|---|
| Monday | 30-minute walk (or 3 × 10 minutes) |
| Tuesday | Strength session, plus 10 minutes on a stationary bike |
| Wednesday | 30-minute swim or aqua class |
| Thursday | 30-minute walk |
| Friday | Strength session, plus 15 minutes of walking |
| Saturday | 30–40 minutes of cycling, gardening or a longer walk |
| Sunday | Rest, or gentle mobility and a short stroll |
For a step-by-step walking programme, see our guide to walking with arthritis.
Tips by joint
- Knees: cycling and water exercise are often the most comfortable. Avoid deep squats and lots of stairs early on; build thigh strength with sit-to-stands and step-ups.
- Hips: walking, cycling with a slightly higher seat and swimming usually suit. Strengthen your buttock muscles with bridges and side leg raises.
- Feet and ankles: choose non-weight-bearing options such as cycling, rowing or swimming, and wear well-cushioned footwear for walking.
- Back: walking and swimming are often helpful; keep strength exercises controlled and avoid heavy lifting.
- Hands: use padded handles, cuffs or wrist loops for band exercises, and choose leg-based cardio.
Keeping the weight off
Staying active is widely recommended to help keep weight off over the long term. Once you reach your goal, keep your activity minutes at the level you built up, keep strength training twice a week, and keep weighing yourself weekly so you can act early if your weight starts creeping back. Planning ahead for holidays, illness and flares, with a simpler "minimum" routine, helps you stay on track.
Add everyday movement
Activity outside planned exercise adds up and is easier on joints than one long session. Ideas:
- Stand up and move every 30 to 60 minutes.
- Get off the bus a stop early or park further away, if your joints allow.
- Do housework and gardening in short bursts, using joint protection.
- Walk while on the phone.
- Use a step counter and aim to add 500 to 1,000 steps a day each week or two.
Pairing exercise with eating changes
A few changes make the biggest difference:
- Use the NHS Better Health resources, including the free NHS Weight Loss Plan app, which helps you set a calorie goal and plan meals.
- Base meals on vegetables, fruit, wholegrains, beans and pulses, with lean protein such as fish, chicken, eggs or tofu. A Mediterranean-style diet is a good model.
- Include protein at each meal to help preserve muscle while losing weight.
- Cut down on sugary drinks, alcohol, and high-fat, high-sugar snacks.
- Watch portion sizes; smaller plates can help.
- Do not "reward" exercise with extra food. A 30-minute walk uses less energy than many snacks contain.
NHS weight management support
You do not have to do this alone. Options include:
- Your GP practice can check your weight, discuss your options and refer you to local weight management services.
- Local weight management services, which may offer group or one-to-one support, sometimes free through the NHS or your council.
- The NHS Digital Weight Management Programme, available by referral for adults with a high BMI who also have diabetes or high blood pressure.
- Medicines may be offered in some situations under NICE guidance, usually alongside a diet and activity programme. See our guide to weight loss injections and arthritis.
- Exercise referral schemes at local leisure centres, which your GP or practice nurse may be able to refer you to.
Overcoming common barriers
| Barrier | Try |
|---|---|
| Joints hurt when I walk | Start in water or on a bike; walk shorter distances more often |
| I feel self-conscious | Exercise at home, join a beginners or weight management group, or go at quiet times |
| I am not losing weight | Review your eating; exercise alone rarely leads to big losses. Look at non-scale changes too |
| I am too tired | Short bouts help; regular activity often improves energy over time |
| Flares stop me | Scale back to gentle movement rather than stopping completely, then restart gradually |
Track more than the scales
Weight can go up and down from day to day. Weigh yourself once a week at the same time, and also track your waist measurement, your weekly activity minutes, how far you can walk, how easily you manage stairs, and your pain levels. These often improve before the scales move much.
When to get medical help
- Call 999 if you have chest pain, severe breathlessness or feel faint during exercise.
- Stop and see your GP if you get chest discomfort, palpitations or unusual breathlessness with activity, or dizziness.
- Call NHS 111 or go to A&E if a joint suddenly becomes hot, red, swollen and very painful.
- See a physiotherapist if exercise keeps making your joint pain worse despite reducing it.
- See your GP if you are losing weight without trying, or if you have diabetes and your blood sugars change as you become more active.
What is the best exercise to lose weight with bad knees?
Low-impact activities such as cycling, swimming, aqua aerobics and the cross-trainer are often the most comfortable. Walking is also good if built up gradually. Add strength exercises twice a week to support your knees.
How much exercise do I need to lose weight?
Aim for at least 150 minutes of moderate activity a week, building towards more if you can, plus strength exercises twice a week. Combining exercise with eating changes is the most effective way to lose weight.
How much weight do I need to lose to help my arthritis?
NICE advises that any weight loss is likely to help people with osteoarthritis who are overweight, and losing more, such as 10% of your body weight, is likely to bring more benefit.
Can I lose weight with arthritis if I cannot walk far?
Yes. Eating changes are the main driver of weight loss, and you can exercise in water, on a stationary bike or seated. Short, frequent bouts of activity add up.
Will exercise make my arthritis worse?
Exercise is a recommended treatment for arthritis. Some extra ache when starting is normal, but it should settle within a day. Building up gradually reduces the risk of flares.
Can I get help to lose weight on the NHS?
Yes. Your GP can discuss options, including referral to local weight management services, and you can use free NHS Better Health resources such as the NHS Weight Loss Plan app.
Sources and further reading
- NICE NG226: Osteoarthritis in over 16s
- NHS Better Health: Lose weight
- NHS: Managing your weight
- NHS: Obesity – treatment
- NHS: Physical activity guidelines for adults aged 19 to 64
- UK Chief Medical Officers' Physical Activity Guidelines (2019)
Educational information for people in the United Kingdom — not a diagnosis or personal medical advice. Charity no. 1218461. Pending clinical review. Everyone's situation is different, so always follow the advice of your own GP, pharmacist or rheumatology team. If you feel very unwell, call 999 or go to A&E. For urgent advice, contact NHS 111.
Continue with related help
- Arthritis and weight loss — how it helps joints
- Weight loss injections — Wegovy and Mounjaro
- Water-based exercise — pool options
- Strength training — beginner programme
- Exercise hub — exercises by joint