It’s no secret that maintaining a healthy weight and body mass index are crucial for overall good health.
In terms of rheumatoid arthritis (RA), Healthline has looked into how obesity can make RA harder to diagnose, how obesity can have an impact on RA remission, and how RA can cause low birth weight in babies.
A new study indicates that being overweight or obese can also impact RA disease outcomes and medication efficacy.
New research from a study published in Arthritis Care & Research shows that weight might influence the effectiveness of RA therapies.
The mission of the study was to look at how many overweight or obese patients would achieve RA remission in the early years of their diagnosis.
In order to investigate the effects of weight on RA, researchers examined scientific data from the Canadian Early Arthritis Cohort.
The multicenter observational study looked at people who received an RA diagnosis from a doctor.
What the study revealed
There were 982 patients involved in the study.
Of these, 32 percent had a healthy body mass index (BMI), 35 percent were considered to be overweight, and 33 percent were labeled as obese or morbidly obese.
Over a period of three years, 36 percent of these RA patients experienced what doctors considered to be sustained remission. These were people who had a healthy BMI.
Those who were overweight were 25 percent less likely to experience remission.
Patients who were in the obese category were 47 percent less likely to have sustained remission.
Patients in all weight and BMI categories received similar or identical RA treatments and therapies.
In a statement to the press, Dr. Susan Goodman, a rheumatologist at the Hospital for Special Surgery, an assistant professor of medicine at Weill Cornell Medical School, and the study’s lead researcher, stated, “Our study looks at people with recently diagnosed, early RA, who should have the best outcomes and best responses to treatment, and sees how many are either overweight or obese, and then determines if those who are overweight or obese have worse outcomes than those with healthy weight.”
Regarding the findings, Goodman continued, “These findings have important implications for clinical care since rates of overweight and obesity continue to rise. Our findings highlight the high proportion of newly diagnosed RA patients who are overweight or obese and who may have disease that is harder to treat. For people with RA who haven’t had an adequate response to treatment, this may be another factor to consider.”
However, another study regarding weight and RA published early this month in Arthritis & Rheumatology came to a different conclusion when it comes to mortality issues.
Dr. Jeffrey Sparks, MMSc, a rheumatologist associated with Brigham and Women’s Hospital and an assistant professor of medicine at Harvard Medical School, researched and evaluated the positive and negative effects of changes in weight during the early stages of RA as related to the issue of mortality risk.
The study included 902 women with RA and 7,884 without RA.
Sparks and his colleagues concluded that weight gain in the early RA period wasn’t associated with death for either group.
Health issues with obesity
It wasn’t clear how much lifestyle factors — such as diet, activity level, and exercise — were considered in either of these studies. But that doesn’t mean that nutrition and physical activity don’t play a role.
Kristi Devenyi, a USAKL-certified kettlebell trainer at Pittsburgh Kettlebell & Performance in Pennsylvania, told Healthline, “Exercise, especially low-impact training such as swimming, biking, kettlebell swings, and walking, can reduce joint swelling and help people achieve a healthy body weight, which in turn results in less pressure on the joints.”
Physical therapist Christopher Marrone, MPT, LAT, ATC, of Robinson Physical Therapy and Health Center in Pittsburgh, agrees.
“In my research over the years, I have read many articles on the effects of weight gain on the body. There have been good studies done at Harvard Medical School and various other places that have gone into great detail on the effects of overall health and weight,” he told Healthline.
He continued, “One Harvard study in particular addresses the effects of excess weight and how it puts additional stress on weight-bearing joints in particular. The study also goes on to state that inflammatory factors associated with weight gain can also contribute to trouble in other non-weight-bearing joints, such as hands and wrists. Research has proven that a sustained 10 to 15 pound weight loss in obese young people can translate to a much lower risk of osetaoarthritis later in life. So the take-home lesson here is to get out there and exercise.”
What RA patients think
People with RA seem to have mixed opinions on the impact of weight.
They also struggle with the “Catch-22” that exists.
Many people with RA are aware that losing weight could make them feel better. At the same time, they’re often in too much pain to exercise.
This can leave them feeling stuck.
Darcy Walsh of Oregon told Healthline, “I’ve lived with rheumatoid arthritis since my teenage years, and at first I was advised to avoid exercise. But now I do yoga, water aerobics, and TRX [total resistance exercise]. My muscles and joints feel sore after a workout. And I do not exercise if I am in an RA flare. But overall, I think it makes me feel better, have less pain, feel stronger, and flare less. My weight doesn’t fluctuate much, but I do think it is important to keep moving when I can. There are many days I can’t exercise, though, and on those days I feel guilty for not working out or being active.”
The same goes for Jennifer Grantz in Ohio.
She told Healthline, “I was diagnosed with RA and fibromyalgia a few years ago. I constantly am told to exercise and lose weight even though I am just barely overweight. I don’t think doctors or physical therapists always understand how painful RA and fibro can be, and how depressing it can get to not be able to be as physically active as I want to be. I want to exercise, do household chores, and be more active. But it isn’t easy, and I am often left feeling very frustrated. I might be too hard on myself, but they make it sound like I am doomed if I don’t shed a few pounds. It isn’t as easy as it sounds.”
It might not be easy, but the evidence seems to point clearly toward maintaining a healthy weight for overall health and wellness, especially while living with a disabling and painful autoimmune condition such as RA.
The Arthritis Foundation has resources to help people find ways to exercise despite living with pain.
The organization has also published additional information on how obesity and a high BMI could impact RA drug effectiveness.