VIDEO: Understanding the relationship between rheumatoid arthritis, obesity

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It is not clear whether obesity is a risk factor for rheumatoid arthritis, but certainly some studies have shown that patients who are obese are more likely to be diagnosed with rheumatoid arthritis, particularly with serum negative types of rheumatoid arthritis. What we also see is that patients that have rheumatoid arthritis that are obese have poor outcomes, including things like poor response to therapy. And it's unclear why that is, and whether it's really related to more severe inflammation or whether it's because some of the symptoms of arthritis are worse. And when you're obese, obesity can be associated with poor function or joint pain, and those things are really important in patients with arthritis. So sometimes it's difficult to tell whether somebody's not doing well because their arthritis is poorly controlled, or whether it's because the obesity itself and related comorbidities related to obesity are influencing symptoms. So, but it's very important, and I think very relevant to patients that are experiencing arthritis and something that's really appropriate to deal with as much as possible. There are obviously a lot of comorbidities that are developed out of obesity as well that are relevant for patients with arthritis. We published a study a couple years ago looking at whether we can use obesity to inform how to treat patients with arthritis, and that has proven difficult. So, while we see that obesity reduces response rates to therapies, it seems to be that that's true for most therapies and not specific to one therapy or another. So, at this point, it's not really useful to define your treatment strategy based on the presence of obesity, but one may expect that the response to whatever therapy that started is going to be reduced. And I think that's important for rheumatologists to recognize. They also want to consider other alternative approaches to managing pain and function that might not be covered by rheumatoid arthritis therapies alone.