The Inflammatory Effect of Obesity on Gout
— By Andrea M. Pampaloni, Ph.D.
Nearly one quarter of American adults have arthritis, and the most common form of inflammatory arthritis is gout. Uric Acid (UA) crystals, caused by hyperuricemia, build up in joints and tissue and cause severe pain for more than eight million adults. There are several risk factors for gout, but the strongest modifiable risk factor is obesity. Gout can’t be cured — so helping patients reduce and maintain low levels of UA is key to treatment and pain management.
Gout is also associated with hypertension, dyslipidemia, stroke, diabetes and cardiac, renal and peripheral arterial diseases. These comorbidities often are associated with obesity and are likely the reason why gout also is an independent predictor of premature death. Some of these factors, including obesity, more than double the risk of gout compared to those who don’t have them. It is more likely to affect middle-age and older men, though post-menopausal women are also at high risk.
Weight loss and reduction in Body Mass Index (BMI) are associated with decreased attacks of gout, while weight and BMI gain increase the likelihood. As such, a weight loss program should be a priority among recommendations for treatment.
Research supports weight loss for patients with gout who have overweight and obesity, though there may be some short-term challenges. This is because serum UA typically elevates during the first weeks of using a Very Low Calorie Diet (VLCD). However, increased water and unsweetened fluids can help dilute uric acid and increase excretion, and natural or pharmacological xanthine oxidase inhibitors may also be used to decrease UA accumulation.
When patients with gout and other related health conditions, such as renal issues, are carefully monitored, a VLCD can spur the needed weight loss. A VLCD is an effective weight loss option, as reported in a recent (2020) study on their use for those with chronic kidney disease, which affects many who have gout. The medically-supervised New Direction weight management program, for example, helps reduce other comorbid conditions associated with gout, such as hypertension, dyslipidemia, stroke, diabetes and cardiac, renal and peripheral arterial diseases. What’s more, the New Direction program includes medical supervision and support structures that provide the monitoring that is critical to patients with gout.
Because gout can only be diagnosed during a flare, it may be underdiagnosed. This is problematic not only because of the pain patients experience as flares increase and symptoms worsen, but because it compounds so many other conditions people with obesity experience. This iterates the need for early diagnosis and treatment, including weight loss and dietary changes, as a means to help manage pain and improve quality of life.
About the Author: Dr. Andrea Pampaloni has over 20 years of communication experience across corporate, academic, nonprofit and government sectors. She provides research and writing services on a range of business issues and industry-specific topics to prepare white papers, articles, proposals, presentations, technical content, and speaking points, as well as marketing-communications content such as blogs, website content, newsletters, news releases and award submissions. Dr. Pampaloni’s research findings have been presented at national and international conferences and published in peer-reviewed journals, and she is a ghostwriter for three books, a Forbes article, and several corporate blogs.