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Obesity is associated with poorer disability in rheumatoid arthritis



(Reuters Health) – People with rheumatoid arthritis and obesity are more likely to be disabled than their peers, who maintain a healthier weight, according to a US study.

Researchers examined data from more than 25,000 patients with rheumatoid arthritis. Most were overweight or obese when they joined the study. Those who were severely overweight were more likely to report disability.

Over the course of the study, up to about 15 years, obesity was associated with more progression of disability.

Her worsening disability "was not explained by a poorer disease activity," said Lead Dr. Joshua Baker from the University of Pennsylvania and the VA Medical Center in Philadelphia. "This suggests that obesity causes disability in patients with rheumatoid arthritis and is another reason for patients to lose a few pounds."

Unlike the more common osteoarthritis that occurs when cartilage wears off at the ends of the bone Over time, rheumatoid arthritis is a disorder of the immune system that causes debilitating swelling and pain in the joints.

Weight loss is also associated with disability in the current study, but it is possible because people are losing weight due to poor health or frailty as they are older, and not because of a conscious effort to eat properly, to do more exercise and in the form speculate researchers in Arthritis Care and Research.

The study was not designed to prove if and how obesity in rheumatoid arthritis patients could directly contribute to disability. Nonetheless, the findings suggest that patients with rheumatoid arthritis may feel better if they lose weight, even if it is not enough to be overweight. Axel Finckh, researcher at Hopital Beau Sejour in Geneva, Switzerland, who was not involved in the study.

"I would tell my patients that they should aim for a slow, progressive weight loss associated with increased physical activity rather than aiming at unrealistic goals such as achieving normal weight," Finckh said via email.

While obesity in patients with rheumatoid arthritis may worsen the disability, it is also possible that some people may become overweight with the immune system disorder due to this condition, said Drs. Predrag Ostojic, researcher at the University of Belgrade in Serbia, who was not involved in the study.

"Due to disability and chronic pain, patients with rheumatoid arthritis are less active, and inactivity can contribute to weight gain," Ostojic said via email. "On the other hand, obesity can cause joint damage independent of rheumatoid arthritis, excessive joint strain, and accelerated articular cartilage degeneration (osteoarthritis), especially on the lower extremities and spine."

"Any weight reduction will have a positive effect on functional ability," Ostojic added. "Healthy weight is ideal, but overweight is also an acceptable target, especially in rheumatoid arthritis patients who are severely overweight."

SOURCE: bit.ly/2HEQD7K Arthritis Care and Research, online April 29, 201

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