Rheumatoid arthritis (RA) is a crippling disease which progresses and can result in total disability. In a recent study by a team at the Perelman School of Medicine, investigators looked at obesity as well as unintentional weight loss and found that both are a complicating factor in RA.
Those patients who were severely obese experienced a more rapid progression of their disease, according to the results, but weight loss was also an issue. The study was published recently in the journal Arthritis Care and Research.
Dr. Joshua Baker, MD, MSCE at is a professor at Perelman and led the work. There was a tremendous amount of data pulled from the National Databank of Rheumatic Diseases, as well from the Veteran’s Administration’s RA registry. The obesity factor was complex when compared to rates of RA. Those who were severely obese when they were diagnosed with arthritis had a more rapid deterioration of their illness. They became fully disabled sooner and had more severe RA pain and symptoms. Obesity in the patients in the study did not come from their arthritis. While some patients gain weight when their RA hits a certain point in severity because they are no longer able to be as active, the increase progression of disability was not seen in patients who were merely overweight, but rather only in patients with morbid obesity.
Being thin was a problem too. It’s not uncommon in many diseases for patients to lose weight initially, because of how their illness impacts the function of organs, the immune system, and the brain. When patients lose weight without even trying, it’s most likely a sign of their disease becoming worse. Dr. Baker explained, "We believe that this is because when people get older and acquire illnesses, they tend to lose weight. Therefore, the important weight loss in this study is unintentional. So, this study suggests that patients with rheumatoid arthritis and obesity would benefit from intentional weight loss through a comprehensive management strategy; however, when we see that someone is losing weight without trying, it's probably a poor prognostic sign, especially if they are already thin."
The study is critical because rates of obesity are on the rise. Very often doctors must treat patients with RA, who are also obese. It’s a common enough condition that making health care providers aware of the connection between RA and weight is what the researchers recommend. Dr. Baker believes that the results show the necessity of going beyond just the disease and looking for other factors that could indicate a worsening progression of symptoms.
While it’s well-known that obesity raises a patient’s risk for many health problems, sometimes doctors may not notice that unintentional weight loss is also a sign that something isn’t right. Often RA patients will get to the point of full disability that could have been prevented if their providers took their weight loss as an indicator of disease progression, as opposed to just a minor side effect that happens in some illnesses. Check out the video to learn more about the connection between weight and rheumatoid arthritis.