How Excess Weight Affects RA

Nearly two-thirds of the people who have RA are overweight or obese. Carrying extra weight increases your odds of heart disease, stroke, and other chronic problems. It takes an added toll on your health if you have RA.

It can:

  • Ramp up your RA symptoms
  • Keep your meds from working the way they should
  • Put more stress on already damaged joints

RA has no cure. Getting to a healthier weight can lead to fewer complications and a better chance of remission.

More Fat, More Inflammation

Dealing with RA means dealing with chronic inflammation. Most treatments focus on easing that. It not only damages the lining of your joints, inflammation can also cause problems with other parts of your body, like your:

Having more fat cells brings more inflammation. That’s because fat cells release proteins called cytokines. When they build up, they start the inflammation process. The more fat cells you have, the more cytokines you’ll have. The more cytokines you have, the more inflammation you have. That makes RA symptoms worse and causes more damage to your body.

Your Meds

Doctors often prescribe biologics like infliximab (Remicade) or it’s biosimilars, infliximab-abda (Renflexis), Infliximab-dyyb (Inflectra), as a treatment for RA. These drugs target parts of your immune system that cause inflammation. When you’re overweight, the effectiveness of these drugs goes way down. Studies show they work for only about half of overweight people, compared to 75% of people at a healthy weight.

Some disease-modifying antirheumatic drugs (DMARDs) like methotrexate (Otrexup, Rasuvo, Trexall) also don't work as well when you’re overweight. Doctors aren’t sure why. It may be because the cytokines that fat cells add to your system keep inflammation going, no matter how you treat it.

What they do know is slimming down makes it more likely that DMARDs will help you feel better.

Your Joints

Whether you have RA or not, adding pounds to your frame puts pressure on your joints. The ones that bear weight feel the most strain, like your:

When you add that to a disorder that wears down your joints with constant inflammation, you have double trouble.

WebMD Medical Reference Reviewed by Minesh Khatri, MD on September 16, 2019



Medscape: “Excess Weight Linked to Poor Rheumatoid Arthritis Outcomes.”

Mayo Clinic: “Rheumatoid Arthritis.”

Annals of the Rheumatic Diseases: “The impact of obesity on the development and progression of rheumatoid arthritis.”

Current Rheumatology Reports: “The Obesity Epidemic and Consequences for Rheumatoid Arthritis Care.”

Arthritis Foundation: “How Fat Affects Rheumatoid Arthritis.”

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