Rheumatoid Arthritis and The Obesity Paradox
Through our interactions with medical practices of varying specialties, AMPM Billing has seen that the epidemic of obesity is a contributing factor in many common diseases and ailments. It has been well documented in recent years that patients who qualify as obese or morbidly obese are at a greater risk for developing rheumatoid arthritis (RA). According to RheumatologyAdvisor.com, obesity increases the risk of developing the disease, especially those who are genetically susceptible.
Conversely, those who have already been diagnosed with RA are at a higher risk of developing obesity. This is because exercise and other prolonged activities can be more difficult and even painful for arthritis sufferers. To make matters worse, some medications for RA have the added side effect of weight gain. This perpetuates a cycle that can be very difficult to break out of.
If that weren’t paradoxical enough, studies have also shown that patients who are obese may have a lower risk of mortality due to RA than sufferers of normal weight. RhumatologyAdvisor proposes that “this paradox may be due to rheumatoid cachexia, whereby the ratio of fat to lean body mass is altered by RA disease activity.” In addition, studies show that RA patients who rapidly lost weight saw an increase in the severity of their symptoms, as well as a higher mortality rate.
The Impact on Women
According to an article on MedicalNewsToday, obesity in female patients needs to be considered when testing for rheumatoid arthritis. Women who are severely obese have higher levels of the markers C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Elevated levels of CRP and ESR are indicative of inflammation in the body.
Rheumatoid arthritis is diagnosed by testing the blood for these two levels. However, the study found that in severely obese women the CRP and ESR were higher. This is true even in cases where these women did not have rheumatoid arthritis. This study may suggest that increased levels of CRP and ESR are not due just to rheumatoid arthritis. Therefore, this may suggest that obesity may be the leading factor contributing to the higher levels.
The study urges doctors to factor in obesity with these elevated levels before determining if the female patient has rheumatoid arthritis — and to what degree.
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