It's well-known that extra weight places more stress on your joints, especially when you have arthritis. However, studies show that obesity and overweight affect rheumatoid arthritis in other ways as well.

A study conducted in Oslo, Norway found that obesity worsens the quality of life of patients with rheumatoid arthritis (RA) on four key levels including pain, fatigue, physical function and overall utility (quality of life) scores.

Researchers examined 1,041 who had rheumatoid arthritis using key areas of self-reported health in areas such as pain, fatigue and disease activity. Patients were grouped according to body bass index (BMI), and BMI was classified into normal weight, overweight and obesity.

Five hundred and forty-one patients fell into the normal weight category, 316 were considered overweight and 102 were in the obese category. Underweight patients (those who had a BMI less than 18) were excluded from the study.

Obese participants reported significantly increased ratings for pain and fatigue than participants with normal weight. Obese patients also rated significantly worse physical functioning than normal-weight patients.

Extra Weight Reduces Chance of Remission

But there's more bad news when it comes to weight and arthritis. Research presented at the 2007 American College of Rheumatology (ACR) Annual Scientific Meeting revealed that being overweight decreases the chances of rheumatoid arthritis (RA) going into remission. During this period inflammation and other RA symptoms go away for a significant period, which helps to reduce the long-term damage that rheumatoid arthritis causes.

To determine the connection between weight and arthritis, the researchers randomly placed 100 people with different BMIs on combination therapy consisting of methotrexate, sulfasalazine, hydroxychloroquine, prednisolone and either placebo or infliximab (Remicade®).

After 12 months of treatment, 58 percent of patients with normal weight who were on placebo plus combination therapy were in remission. But only 35 percent of patients who were overweight (BMI of 25 to 29.9) and 25 percent of those who were obese (BMI of 30 or greater) were in remission. Being overweight didn't seem to affect those who were taking Remicade plus the combination therapy.

Because fat tissue produces pro-inflammatory mediators (molecules), it puts people who are overweight at increased risk of inflammatory complications, states Dr. Marjatta Leirisalo-Repo, of Helsinki University Central Hospital who led the study. She believes Remicade may act on the inflammatory mediator that is produced by fat tissue, allowing even obese people to go into rheumatoid arthritis remission.

Due to findings like these, health experts advocate reducing obesity in patients with rheumatoid arthritis so they can improve their quality of life. Other researchers recommend lowering the BMI-cut off points for people with rheumatoid arthritis by two kilograms. For people who are overweight the cutoff would be 23 kg/m(2), and for people who are obese it would be 28 kg/m(2). Not only would this reduce complications caused by weight and arthritis, it would also lower the cardiovascular risk these patients face.

Study References

Journal Name: Annals of the Rheumatic Diseases, Vol.66(10), pp. 1316-21

Study Date: October 2007

Study Name: Redefining overweight and obesity in rheumatoid arthritis patients


Authors: Stavropoulos-Kalinoglou A, Metsios GS, Koutedakis Y, Nevill AM, Douglas KM, Jamurtas A, van Zanten JJ, Labib M, Kitas GD



Obesity Exacerbates Rheumatoid Arthritis,

Increasing Body Mass Index Is Associated With Reduced Rate of Remission in Early Rheumatoid Arthritis, American College of Rheumatology 2007 Annual Scientific Meeting Presentation