Expert Answers: Weight Loss and Surgical Considerations for Patients with Rheumatic Diseases

Dec 2, 2021 | Tara Schmidt, Mayo Clinic registered dietitian nutritionist | @taraschmidt

Written by Andrea R. Pauly, APRN, C.N.P.. Andrea is an advanced practice provider in Rheumatology. 

Will weight loss help with my rheumatic disease?

Yes, excess weight is understood to have it’s own pro-inflammatory characteristics that can be reduced with weight loss even in patients who are not experiencing joint pain as part of their rheumatic disease. The benefit of weight loss are generally more noticeable in patients who do have joint pain associated with their rheumatic disease by not only reducing the inflammation but also reducing the load on the weight bearing joints. Even modest weight loss will lead to noticeable improvement.

How will my rheumatic disease and medications interact with my weight loss goals?

It is important to have ongoing conversations with your rheumatology care team if you are actively trying to lose weight and not having success. Some of the medications that we prescribe in rheumatology can promote weight gain but may be critically necessary to your health in the certain stages of your rheumatic disease. Other times we may be able to adjust medications or switch to alternative medications which do not contribute to weight gain. Additionally, if joint pain is part of your rheumatic disease and is actively keeping you from being able to be physically active you may benefit from visiting with your rheumatology care team. Perhaps your disease is more active and keeping your from being physically active, perhaps the exercise you have chosen is aggravating your joints, or there may be other alternative explanations.  There may also be other symptoms of your rheumatic disease that you are experiencing that keep you from being able to be physically active, these are also important to share.  All of these things are important to keep in mind and discuss with your rheumatology care team at regularly scheduled visits.

Should I let my rheumatology providers know if I am considering weight loss surgery?

Yes, there can be surgical implications for several of the medications that we prescribe.  We will often collaborate with the surgical team and our anesthesia colleagues to determine how to manage these medications.  Some medications may need to be increased around the time of surgery and some medications may need to be held.  Much of this will depend on the rheumatic disease process, the type of surgical intervention being pursued, and other surgical or anesthesia considerations.  We will often take a team approach working with surgical and anesthesia colleagues with patient's best outcome in mind.

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