Connection Between Weight Gain and Psoriatic Arthritis Explored
In the complex world of psoriatic arthritis (PsA), understanding the relationship between the condition and obesity is crucial. Obesity is linked to higher baseline disease activity, greater inflammation, and more severe symptoms in PsA patients [1][3].
The connection between obesity and PsA is multifaceted. Obese individuals with PsA experience elevated disease activity scores, more pain, and higher levels of inflammatory markers compared to their non-obese counterparts [1][3]. Adipose tissue, or fat cells, release proinflammatory proteins called adipokines, which exacerbate systemic inflammation and make PsA harder to control [2]. Additionally, excess weight places additional mechanical stress on weight-bearing joints, accelerating joint damage and symptoms [2].
On the flip side, weight loss has a beneficial impact on PsA symptoms and management. A modest weight loss of about 5% can significantly reduce systemic inflammation, improving disease control and reducing symptoms [2]. This weight loss is associated with decreases in proinflammatory cytokines such as interleukin-23 (IL-23), particularly in women, correlating with lower disease activity and inflammation [1]. Losing weight also improves joint loading, lessens mechanical stress, and can enhance physical function, making exercise and joint mobility easier to maintain [2].
Given these findings, weight management is a critical component in PsA treatment, alongside medication and physical therapy. Strategies include calorie control, healthy dietary choices to minimize inflammation, and regular low-impact exercise like swimming or walking to reduce stiffness and strengthen muscles without overloading joints [2].
Optimal management of inflammation can aid weight management or loss. Short-term weight loss on a very low calorie diet can improve PsA symptoms, but this should not be attempted without consulting a doctor first [4]. Eating mindfully (more slowly and mindfully) may help reduce calorie intake by 300 calories per day [4]. Drinking water before a meal can help people feel fuller quicker, while using a smaller dish may reduce food intake by up to 20% [4].
There is some evidence that people could lose weight when using PDE4 inhibitors, a type of PsA medication [5]. Maintaining a moderate weight may help manage the symptoms of PsA and boost a person's overall health and well-being. However, a lack of sleep can slow the body's production of leptin (a protein that makes people feel full) and increase the production of ghrelin (a hormone that drives hunger) [6].
In conclusion, managing weight is an essential aspect of PsA treatment. By reducing inflammation, improving treatment response, and lessening joint stress, weight loss can enhance symptom control and overall disease management [1][2][3]. Consulting a healthcare professional is always advised when making changes to diet or exercise regimens, especially for those with PsA.
- The link between obesity and psoriatic arthritis (PsA) is complex, with obese individuals experiencing elevated disease activity scores, increased pain, and higher levels of inflammation compared to non-obese PsA patients.
- Adipose tissue, or fat cells, release proinflammatory proteins called adipokines, exacerbating systemic inflammation and making PsA harder to control.
- Weight loss, even a modest 5%, can significantly reduce systemic inflammation in PsA patients, improving disease control and reducing symptoms.
- Losing weight improves joint loading, lessens mechanical stress, and can enhance physical function, making exercise and joint mobility easier to maintain.
- Strategies for weight management in PsA treatment include calorie control, healthy dietary choices, and regular low-impact exercise.
- Maintaining a moderate weight is beneficial for managing the symptoms of PsA and improving overall health and wellness, but a lack of sleep can slow the body's production of leptin (a protein that makes people feel full) and increase the production of ghrelin (a hormone that drives hunger), making weight management more challenging.
