Obesity: a barrier to achieving remission in rheumatoid arthritis?

This study investigated if body weight negatively affected the chance of achieving disease remission in patients with rheumatoid arthritis.

They found that patients that were overweight or obese were less likely to achieve disease remission. 

Rheumatoid arthritis (RA) is an autoimmune condition. This occurs when the body produces chemical mediators that cause excessive inflammation in the joints leading to pain and reducing mobility. To treat RA a patient will be prescribed disease modifying anti-rheumatic drugs (DMARDs) that reduce inflammation.

Reducing inflammation can improve symptoms significantly; however, RA cannot be cured completely. Doctors use a disease activity score (DAS28) to assess RA disease severity.  Doctors and patients aim to reduce the clinical symptoms to a level where damage to the tissue and pain levels are minimal. This is called disease remission.

Obesity is a significant risk factor for a number of conditions including heart disease and diabetes. Studies suggest that high body mass index (BMI, a measure of body fat that takes height and weight into account) can also prevent a patient with RA achieving remission. 

This study investigated whether patients that were overweight or obese had greater difficulty in achieving RA remission.

This study included 982 patients with RA. Patients were classified depending on their BMI – normal (18.5-24.9), overweight (25-29.9) and obese (greater than 30). Patients in the obese category were further subdivided into obese I (BMI 30-34.9) and obese II/III (BMI greater than 35) categories. Disease activity was assessed in all patients over a 3-year period.

Obese patients were least likely to achieve remission (26%) compared to overweight (37%) and healthy weight patients (45%). Patients that were in the higher obesity category (BMI greater than 35) were 53% less likely to achieve remission compared to those in the healthy weight category. Patients in the lower obese category were 43% less likely. 

This study concluded that patients that were overweight or obese were less likely to achieve disease remission.

This study included a majority of females and patients were predominantly white. The results may not represent the clinical scenario in men or other ethnicities. BMI is just one measure of bodyweight, it does not account for percentage body fat. 

If you have any concerns regarding weight management and RA treatment please consult with your physician.