Rheumatoid arthritis and weight gain
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
Click here: Second Opinion Arthritis Treatment Kit
Weight gain can be considered a side effect of rheumatoid arthritis.
Causes include the disease itself which limits the ability to exercise, depression which leads to excessive food intake, co-morbid conditions, and medications.
The pain and limited mobility that rheumatoid arthritis patients have is a major contributor to weight gain. A gentle non-impact aerobic exercise program (examples include swimming, an elliptical trainer, or stationary bicycle) are great forms of exercise. Walking is generally too difficult for patients with active disease. Once the disease is better controlled, low impact aerobic exercise such as walking may be fine.
The aerobic component of exercise should be coupled with stretching. Light dumbbell exercises may also help with toning and maintenance of ideal body weight.
Pain is a difficult thing to live with. Depression can lead to inactivity, sluggishness, and excessive gorging. Patients with RA often benefit from medication to combat depression.Caution must be exercised here because tricyclic drugs (amitriptyline, nortryptyline, trazadone to name a few) often will compound the weight gain situation. Selective serotonin reuptake inhibitors (SSRI drugs) may be a better option.
Corticosteroids which are often used as adjunctive therapy to treat moderate to severe disease may lead to weight gain, particularly if the dose is higher than 7.5 mgs per day of prednisone (or its equivalent). Prolonged high doses of steroids will lead to iatrogenic (medically induced) Cushing’s syndrome and pronounced weight gain.
Non-steroidal anti-inflammatory drugs may lead to fluid retention which can cause weight gain. Pedal edema (excessive fluid in the soft tissues of the legs) is a clue to this problem.
Older patients with rheumatoid arthritis often have co-morbid conditions such as diabetes and heart disease. Patients with diabetes who carry an excessive amount of weight need to be counseled by a dietician and started on an aggressive weight-reducing regimen to aid both the diabetes as well as to lessen the stress on joints. Excessive weight coupled with actively inflamed joints is a sure-fire recipe for disaster since there is a compound destructive effect on the joints.
The first sign of congestive heart failure may be weight gain.
Rheumatoid arthritis is an autoimmune disease. It is often accompanied by other autoimmune conditions. One that may lead to weight gain is Hashimoto’s thyroiditis. This autoimmune endocrine disorder may lead to an under active thyroid gland which then may secondarily cause sluggishness and weight gain.
A corollary to all the above is that maintenance of ideal weight is facilitated by good medical control of the disease.
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