Researchers at Brigham and Women’s Hospital recently revealed that weight loss in patients with rheumatoid arthritis (RA) after undergoing bariatric surgery improves disease activity. The study was recently published in the journal Arthritis Care & Research and is entitled “Impact of bariatric surgery on patients with rheumatoid arthritis.”
RA is an autoimmune disease that leads to chronic inflammation of the joints and other parts of the body due to an overreaction of the body’s own immune system, resulting in an attack on healthy tissues. The disease can cause painful deformity and immobility of the fingers, wrists, ankles and feet. In the United States, it is estimated that about 1.5 million people suffer from the disease, with women having a significantly higher susceptibility.
Obesity is considered a serious public health problem; it causes a systemic inflammatory state in the body associated with several chronic diseases like diabetes, hypertension and cancer. Obesity has also been associated with an increased risk of developing RA, disease severity and a decrease in treatment efficacy.
Bariatric surgery is a weight loss surgery where the size of the stomach is reduced through a gastric band or through removal of part of the stomach. This surgery can result in substantial weight loss and has been shown to contribute to health improvement in obese patients with diabetes and hypertension. The impact of bariatric surgery, and the consequent weight loss, has however not been evaluated on patients with inflammatory rheumatic diseases.
In the study, researchers conducted a retrospective study to analyze the effect of weight loss after bariatric surgery on 53 RA patients at two medical centers. Patient data was collected prior to the surgery (baseline) and at six and twelve months after the surgery.
Researchers reported that at baseline, the mean body mass index (BMI) of the patient cohort was 47.8 kg/m2 and the mean weight 128.2 kg. In total, 57% of the patients were found to have moderate/high RA disease activity. Twelve months after surgery, patients lost a mean of 41 kg corresponding to 70% of the excess weight. Regarding RA, only 6% of the patients were found to have moderate/high disease activity in comparison to the 57% reported prior to the surgery, showing that RA disease activity had significantly improved in this patient cohort. In follow-up visits at a mean of 5.8 years after surgery, 74% of the patients were found to be in remission compared to 26% at baseline, and reported having reduced their RA-related medication.
The team concluded that substantial weight loss after bariatric surgery in RA patients could improve their disease activity, decrease serum markers of inflammation and RA-related medication usage. The authors believe that weight loss might be an important non-pharmacologic approach to decrease RA disease activity in obese patients.