Obesity and RA -- Wait, There's More!

We all know the drill. Excess weight is hard on the joints. It’s estimated that every pound of weight puts four pounds of pressure on your knees (or more, depending on the source). It’s also bad for your heart and lungs which can further complicate some side effects of the many drugs that RA patients take.

But now there’s more. There’s a new study out that indicates that excess weight causes RA to manifest earlier than in people with a normal weight and draws some conclusions as to why people who are overweight respond more slowly to RA treatments. (The study is summarized in a news story here and was originally published here.)

It’s an interesting study and I encourage you to read either the news story or the study itself. This is a simplified explanation but the study was done on mice and the scientists found that the fat cells in joints attracted inflammation, causing the onset on RA sooner. Since the fat cells attracted more inflammation, it took longer for the drugs to resolve it. Even though they were studying mice, the study results are pretty directly applicable to humans.

So yet another compelling argument to lose those excess pounds.

Let me just say this about that. If you have RA, it’s very hard not to have some extra pounds and once you have them, it’s even tougher to get rid of them. As much as I recognize and appreciate the guidance, I’m really tired of hearing it from people (healthcare providers included) who don’t grasp the difficulties we face.

First, joint pain makes it difficult to exercise – particularly the cardio or weight routines recommended for weight loss. I will tell you that during a flare, getting out of bed is sometimes as much “exercise” as I can manage. On those days I might as well try to fly as to try to manage the suggested 10,000 daily steps.

Compounding the pain issue is the fact that some drugs used to treat RA, steroids in particular, actually list weight gain as a side effect. I had recently (finally) lost some pounds I put on while taking prednisone when my scale started to creep back up and I couldn’t figure out why. It turns out that a drug I was temporarily taking for nerve pain also causes weight gain. And just because you stop taking the drug doesn’t mean that the weight comes off. Unfortunately, it doesn’t work that way.

Another weight-related issue is age. While RA can and does strike people of all ages, according to the CDC, the onset of RA is most frequent for people in their sixties. This is the time when menopausal changes occur in women and metabolism slows for both men and women. Both of these factors are related to weight gain.

I’m not saying that losing weight can’t be done or that it shouldn’t be done. Patting myself on the back for a moment, I’ve lost about 25 pounds over the past year. It’s been really good for me in numerous ways. But it hasn’t been easy and I still have some pounds to go before I’m down where my doctor and I would like me to be.

Those of us with RA know how important diet, exercise, and a healthy weight are. All I’m asking is a little compassion and understanding here for those of us who deal with the challenges of this disease on a daily basis.

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