Less pain, better heart health: reasons to lose weight when you have psoriatic arthritis

Unfortunately, no one knows what causes psoriatic arthritis—current thinking is that both genes and environment play a role.

People who have psoriasis, an autoimmune disease marked by scaly red and white skin patches, are prone to psoriatic arthritis. It affects the joints and places where tissues attach to the bone. Joints most often affected are the outer joints of fingers or toes, wrists, knees, ankles and lower back.

Although there are several treatments available for psoriatic arthritis, certain habits, like maintaining a healthy weight, can alleviate symptoms—and boost your overall health, too.

Researchers don’t fully understand why being overweight worsens psoriatic arthritis (PsA) symptoms and raises your risks for other diseases.

One theory: fat tissue releases inflammation-causing proteins called cytokines—which are already overactive in people with PsA.

Chronic, body-wide inflammation is linked to psoriasis, diabetes, heart disease and bowel problems like Crohn’s disease, among many other conditions.

Experts from the Arthritis Foundation suggest that being overweight and having PsA is an “unhealthy mix.” Here’s why: People with PsA who are also overweight have a harder time controlling their PsA symptoms. Plus, when you’re overweight, your PsA tends to be more severe than that of normal weight people.

For American women, being overweight is linked to a higher risk for PsA, notes a 2012 study published in the Annals of Rheumatic Disease. In fact, obese women whose BMIs were 35 or higher were more than six times as likely to develop PsA.

People of normal weight have a BMI of less than 25; a BMI over 25 indicates overweight, and people are considered obese when BMI is over 30.

Obesity is such a major player in PsA-related heart disease that psoriasis symptoms sometimes clear with weight loss alone, says Elinor Mody, MD, an assistant professor at Harvard Medical School and director of the Women’s Orthopedic and Joint Disease Program at Brigham and Women’s Hospital in Boston. “I talk to everyone with PsA about diet,” Dr. Mody told the Arthritis Foundation. She refers her patients to a nutritionist if they’re having trouble sticking to a heart-healthy diet. She also stresses the value of physical activity.

People with PsA are 43 percent more likely to develop heart disease than people without the disease. Plus, people with PsA have a 22 percent higher risk for conditions that affect blood flow to the brain.

According to the Arthritis Foundation, “People with PsA actually have what amounts to a doubled cardiovascular risk, says John M. Davis III, MD, a researcher in the Cario-Rheumatology Clininc at Mayo Clinic in Minnesota.

Having PsA causes body-wide inflammation, which is known to damage blood vessels, notes the Arthritis Foundation.

Your PsA drugs might work better if you lose some weight during your treatment. People who took a TNF-alpha blocker, a type of biologic medication, while they lost weight improved more than the people who just took the drug without dieting, according to a 2014 study published in the Annals of the Rheumatic Diseases.

In the study, 138 overweight people with PsA were divided into two groups. Half were put on a reduced-calorie diets (1500 calories a day) and the others ate normally. They were checked monthly for six months, and then took a final assessment.

Researchers checked their number of tender joints, their degree of pain and the severity of their skin symptoms. Researchers combined the results to determine which patients achieved Minimal Disease Activity, the gold standard for a successful outcome in PsA treatment.

Almost 45 percent of the patients who lost between five to 10 percent of their body weight—and almost 60 percent who lost more than 10 percent—achieved MDA, according to the Psoriasis and Psoriatic Arthritis Alliance.

If you’re struggling to lose weight, talk to your doctor to see if weight loss surgery might be right for you. In a new study, reported in the December 2017 issue of journal, Obesity, gastric bypass surgery was proven to significantly improve the prognosis and lessen symptoms of PsA.

Gastric bypass surgery reduces the size of your stomach so that you feel full eating less food. Your doctor may consider it if you’re 100 pounds or more (BMI of 40 or more) over your ideal weight. A normal BMI is between 18.5 and 25. She may also consider it if your BMI is 35 or more and you also have a serious condition that might improve with weight loss, such as:

• Heart disease
• High blood pressure
• Type 2 diabetes
• Obstructive sleep apnea
• Osteoarthritis