How can obesity affect PsA?

Being overweight or obese is more common among people with psoriatic arthritis (PsA) compared to the general population and has also been shown to be an independent risk factor for the development of psoriasis. Furthermore, numerous clinical studies have identified that there is a clear link between increasing body weight and severity of psoriasis, and this association is true for both adults and children. Being overweight or obese is part of a collection of health issues including high blood pressure and high cholesterol known as the “metabolic syndrome” and the presence of this syndrome increases one’s risk of developing type 2 diabetes mellitus and cardiovascular disease. The good news is that a drop in weight can improve both joint symptoms and psoriasis, reduce your health risks from metabolic syndrome, and increase the effectiveness of your medications.

How is obesity linked to PsA?

Research suggests that fatty tissue produces proteins called cytokines, chemokines and adipokines that contribute to inflammation. Persistent inflammation can contribute to the development of autoimmune diseases such as PsA. Being in the overweight and obese weight ranges can also put pressure on your joints and tendons, particularly the hips, knees, ankles and feet, which can lead to increased risk of injury and joint pain due to reasons other than inflammation from arthritis. To lose excess weight it is important to stay active, which can be challenging for people with arthritis due to pain and stiffness. Understandably, this can make you less motivated to keep active, but not moving can worsen your symptoms. Below, are some tips on exercise and managing your diet. Remember, you should speak with your doctor for information and advice before changing your diet or starting new exercises. This will ensure any lifestyle changes are tailored to your condition and minimise risk of injury.

Can obesity interfere with your medication?

People with PsA who are overweight or obese tend not to respond as well to oral or injectable therapies for their disease, but weight loss has been shown to improve effectiveness of some medications and, in turn help reduce disease activity of PsA.

What can I do?

Here are some tips to help you lose weight, specifically for people with arthritis:

• Try to eat foods that fight inflammation. Vegetables, fruits, wholegrains, nuts, seeds and legumes are good sources of vitamins, minerals and nutrients that help maintain a healthy weight
• Try to Move more throughout the day. Although joint pain and stiffness may limit your movement and make it harder to exercise, moving will help pain and stiffness by lubricating the joints and maintaining joint function. Gentle stretching in the morning to relieve stiffness could be a good place to start. Then build up to moderate exercise, like walking, swimming or low impact aerobics. These exercises are good for people with arthritis, help control weight and give more stamina and energy. You can start by doing small intervals and then increasing when you are more comfortable to do so.

Try to eat foods that contain Omega-3 such as, salmon and sardines. These types of fish help fight inflammation associated with arthritis and also have other health 

• benefits, such as reduced risk of heart disease. Other sources of Omega-3 include chia seeds, flaxseed oil and walnuts. The website, https://livelighter.com.au/ is a good source for healthy recipes.
• Try to eat less fried foods that are high in saturated and trans fats that contribute to weight gain and may promote inflammation.
• Try to eat less sugar. Sugar promotes inflammation and increase cravings for more sugar.
• Drink plenty of water. Drinking water helps to manage your appetite and weight and boost energy.
• Always speak with you doctor before changing your diet, particularly if you are taking medication. You may be restricting your food intake unnecessarily or taking supplements that could interfere with your medication. Your doctor can help you develop a safe and effective weight loss strategy.

This resource has been developed based on the best available evidence. A full list of resources is available upon request.