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Stories for Reprint
Arthritis: More Weight, More Disability
By Ferdous Al-Faruque, MARRTC Staff
A recent study by investigators at Johns Hopkins University has found that more body fat and less muscle mass can lead to greater disability in people with rheumatoid arthritis or RA.
Jon Giles M.D., the lead author in the study and an assistant professor of rheumatology at Johns Hopkins, says that lower muscle mass reduces people's ability to do everyday things. "They can't do the things they want to do," he says. "They may have difficulty getting out of the bathtub, or trouble lifting things and they may have difficulty walking." However, Giles adds that an even bigger factor for disability in people with RA was increased body fat. People in the study who had more body fat, particularly fat located in the arms and legs compared to muscle mass, had less mobility.
The study looked at 154 people between the ages of 45 and 84 with RA, and 3 out of 5 were women. Researchers measured the participants' body fat and lean muscle mass, and had them answer questions about the extent of their disability. In conclusion, the study found that chances of disability in a person with RA increased proportionally, as they were more overweight and had less muscle mass.
Giles says the physical condition of people with RA in this study was comparable to older people without the disease. He also suggests that people with RA may be aging faster than normal. Previous studies have found that people with RA live shorter lives. In severe cases, their longevity is 10 to 15 years less than the average person.
Giles and fellow researchers were not able to determine why people with higher body fat had more disability. He says there are a number of factors that may contribute to a person's disability such as medications, physical activity, inflammation, and severity of the disease. "I don't think there is any one thing that we can say (that explains why this is the case)," he says.
The Johns Hopkins study suggests that doctors need to consider a patient's body fat when prescribing treatment. Giles says doctors should make sure that the exercise message hits home, especially for those who need it the most. Though it is easy to tell a person with RA to eat healthy and exercise, sometimes it's very hard for them to actually follow through. According to Giles, motivating the average American to exercise is difficult, but getting a person with RA who has stiffness, pain, joint deformity, and fatigue to be more active is even harder. "If you can get a person to be active, they may increase their physical capacity and perhaps live longer," says Giles. "No matter how active their RA is." He adds that controlling RA disease activity, altering body composition, and making lifestyle changes may improve mobility.
Recent studies have found that even small changes in daily habits, such as walking a bit extra and changing to a healthier diet can be very effective in helping people lose weight. There are also exercise and aquatic programs designed for people with RA that can help them lose the extra pounds without hurting their joints. For some, exercising in water can be easier because there is less stress on the joints. These exercise programs and self-management courses for people with arthritis can be found on the Arthritis Foundation Web site at www.arthritis.org or the Johns Hopkins Arthritis Center Web site at www.hopkins-arthritis.org. Before choosing an exercise program, always consult your doctor first.
Rheumatoid arthritis or RA is a debilitating disease where the body's immune system attacks the joints and causes pain, stiffness, and swelling that may lead to joint damage. A disease that affects over two million Americans, rheumatoid arthritis affects more women than men.
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