Nicole M. Cotter, M.D.
What’s the deal with weight and arthritis?
If you have arthritis and are overweight, you have probably been told that you should lose some of it. On the surface, this seems logical – less weight to bear on your joints, less pain. (Think about carrying a 50 pound sack of rocks in a backpack all day long – you are bound to tire out and be sore the next day.) However, the affect of obesity on arthritis is more complex. Yes, carrying around extra weight puts pressure on the joints of the lower extremities and predisposes you to Osteoarthritis (“wear and tear arthritis”). Being obese also puts you at risk for inflammatory arthritides, such as Rheumatoid Arthritis…and that is not because of extra pressure on your joints. Obesity is an inflammatory state. Excessive fatty tissue stimulates the release of inflammatory mediators, such as TNF-α and IL-6. Interestingly enough, many of these inflammatory mediators are implicated in the perpetuation of Rheumatoid Arthritis. Coincidence? Not likely. Research has shown that obesity is a risk factor for the development of Rheumatoid Arthritis. We also know that patients with Rheumatoid Arthritis who are obese may not respond as well to treatment. This illustrates the importance of an integrative approach to arthritis treatment. In addressing inflammation, we have to look at the big picture. We can use medications to decrease inflammation, but as long as a person is overweight (or as long as there is a driver of inflammation present, like the Standard American Diet) there will be a limit to the effectiveness of these pharmaceutical interventions.