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Stories for Reprint
Living with Lupus and Obesity
By Ferdous Al-Faruque, MARRTC Staff
Obesity is a national problem with a third of Americans considered obese. A recent study found obesity is also a common problem for people with lupus.
Researchers at the University of Chicago collected body mass data from 132 participants with lupus and found that more than two thirds of them were overweight, obese or severely obese. Lupus is a disease in which the immune system mistakenly attacks healthy tissue like the skin or organs.
Though obesity is often associated with unhealthy living, people with lupus may gain weight for a different reason. "Obesity is an issue in lupus patients in part because their medication can induce obesity, such as taking steroids for a long period of time," said Tammy Utset, MD, director of the Lupus Program at the University of Chicago and principal investigator of the study. Steroids are often prescribed to people with lupus to reduce inflammation and pain.
To avoid this unwelcome side effect, rheumatologists may give patients smaller doses of steroids, such as prednisone, and more immunosuppressive drugs, such as methotrexate. But immunosuppressants have their own side effects such as anemia and increased risk of infections. "The question is what's going to be the best thing for a given patient," says Utset. "Giving them less steroids and putting them more on potentially toxic secondary medications (such as immunosuppressant drugs) or leaving them on the steroids and possibly tolerating some weight gain."
According to Utset, it was important to not only know the amount of weight gain by participants, but also the impact the extra weight had on their quality of life. "This can be emotionally a big problem for a lot of patients with their body image," says Utset. In this case quality of life was measured by a person's ability to physically, mentally, socially and emotionally function.
Utset was surprised with their results because she thought obesity would lower quality of life for people with lupus. The study found the only participants who had a substantially lower quality of life were those who were severely obese because they were not able to move around as easily as the other participants. Utset says, though it's always good for people to maintain a healthy weight, the study is an important message for people with lupus who are afraid of gaining weight because of their treatment. "It's reassuring that despite our societal pressure to be as thin as a model, people who gain weight do have good quality of life and good function," she says.
According to Utset, it's important that doctors mentally prepare their lupus patients who are about to start treatment and may gain weight. "Gaining some weight temporarily will not destroy their lives or functioning," she says. "Patients who've gained weight and are heavy seem to have as good quality of life as patients who don't have to go through that." However, she also says that reducing weight-gain from taking steroids is still an important factor to take into consideration. "Lupus patients have an increased risk for premature heart attacks," she says "And being obese may further increase that risk."
An estimated 1.5 million Americans have lupus and 1 in 4 Americans know someone with the disease according to the Lupus Foundation. Though most people with lupus say they cope well with the disease, in some cases the disease can become severe enough to cause organ failure leading to death.
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