DEAR DR. ROACH: Over the past year of pandemic lockdown, I have worked hard at reducing calories to lose weight and increasing my exercise on an elliptical trainer. I am 5 feet, 7 inches tall and age 70. I went from 202 pounds to 149.3. My weight goal is 145. My waistline is 25.5 inches. I have achieved a size 14 in clothing, which is what I wore in 2002. According to my digital scale, my BMI is now 23.4, and according to the BMI chart, I am now in the good “healthy weight” range.

Also, in May 2019 I had total knee replacement surgery and believe that reducing my weight would be beneficial to my hips, knees, ankles and feet. Because of my continued physical therapy exercise, as well as losing the extra pounds, I feel steadier on my feet than I have felt in years.

I recently read that “older adults have a [BMI] of between 25 and 27, not under 25,” or they run the risk of osteoporosis. My last bone density scan showed that I had significant improvement of my bone density, and I would think that with all this walking on the elliptical trainer (30-60 minutes daily), it will prove to be at least as good. In addition, I do some exercises with small hand weights. I have no reason to think I am amongst the 24% of “older” women who have osteoporosis of the spine, etc.

Should I be content with a weight of 149? Should I gain back some fat? — P.R.

ANSWER: I think healthy diet and regular exercise are much more important than the weight or BMI, at least for people who are not very obese. It is true that carrying some extra weight protects to some extent against osteoporosis, and very thin women are at higher risk. However, I am so impressed with your activity and accomplishments over the past year that I would recommend you continue your exercise and let your weight stay where it is. You should continue to get bone density scans as recommended, but you are quite right that regular weight-bearing exercise is particularly good at maintaining bone health, along with a diet including adequate calcium and ensuring good vitamin D if you are at risk for low vitamin D.

DEAR DR. ROACH: I am a 58-year-old male. I had COVID and was given monoclonal antibody treatment as an outpatient two months ago.  I recovered from COVID with mild to moderate symptoms. How do I determine if I am protected from getting COVID again? I’d like to know if I should get a vaccine and if so when I should get it. — J.D.

ANSWER: Even people who have had COVID-19 may get the disease again, so they do benefit from the vaccine. However, because of the monoclonal antibody you got, it is recommended you wait 90 days from the monoclonal antibody treatment to vaccine administration. You should be able to take the vaccine in about another month.

There is some partial immunity that comes from getting the disease, and you are at low risk for 90 days after infection. It appears that the vaccine adds benefit, and I would recommend the vaccine.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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