Feature
Early weight change has no special effect on mortality in RA
The so-called obesity paradox does not stand up to new evidence looking at the timing of weight change near the time of RA diagnosis.
“Therefore, while intentional weight loss might be expected to have direct beneficial effects with regard to physical functioning and disability, these benefits are likely to be outweighed by the more common scenario of unintentional weight loss in association with greater severity of chronic illness,” they wrote. Indeed, one of the two registries used in the study had previously found a strong correlation between weight loss and early risk of death.
They argued that this therefore still supported – rather than refuted – the accepted view that intentional weight loss was an important way to limit disability in people with rheumatoid arthritis.
One limitation of the study was the use of BMI to measure adiposity, which the authors suggested may not have been an accurate surrogate in people with chronic disease. They also acknowledged that measures of disease activity may be different between obese and nonobese patients, and adjusting for this was challenging.
Three authors acknowledged receiving grand awards from the U.S. Department of Veterans Affairs. No conflicts of interest were declared.
SOURCE: Baker J et al. Arthritis Care Res. 2018 Apr 30. doi: 10.1002/acr.23579.
