Wellness With PsA: 8 Reasons to Look Beyond the Scaleby Rachel Zohn Health Writer
Swollen joints and body pain are some of the better-known symptoms of psoriatic arthritis (PsA), a form of inflammatory arthritis that affects about 30% of people with the skin condition known as psoriasis. One lesser-known feature of life with PsA? A complicated relationship with the scale. Being overweight can make the disease worse while decreasing your response to treatment, says Kathleen Woolf, Ph.D., associate professor of nutrition and food studies at New York University. On the other hand, the number on the scale is just one piece of the puzzle. Here’s what you should know about PsA and your weight.
Meds Work Better at a Healthy Weight
It’s not just about looking great at your next class reunion. “There are a few trials showing if people lose weight, their medications will work much better and they will be able to achieve a more profound state of disease remission,” says Ana-Maria Orbai, M.D., director of the Psoriatic Arthritis Program at Johns Hopkins Arthritis Center. Experts believe this might be because excess fat cells promote inflammation in the body, says Dr. Orbai. Also, carrying excess weight puts more strain on your muscles and bones, possibly making symptoms worse.
The Scale Can't Tell You Everything
The number on the scale is just one indicator of your overall health. Instead of focusing on your weight, focus on living a healthy life, says Stuart D. Kaplan, M.D., chief of rheumatology at South Nassau Communities Hospital in Hewlett, NY. “Exercise, keep your joints moving, and keep your muscles strong,” he says. Working out can also lower the risk of depression and cardiovascular disease that come with PsA, says Dr. Orbai. Studies show as little as 20 minutes of moderate aerobic exercise, like walking briskly on a treadmill, could have anti-inflammatory effects.
Strong Muscles Can Save Your Joints
One number worth focusing on: How many reps of strength exercises you’re knocking out each week. “The stronger your muscles are, the less wear and tear on your joints,” says Karmela Kim Chan, M.D., a rheumatologist at the Hospital for Special Surgery in New York City. By taking pressure off your joints, you’re able to move comfortably and with a lower risk of injury. Not sure where to begin in the weight room? Check out our guide to the dos and don’ts of exercising with PsA.
A Healthy Weight May Ease Your Pain
When your joints are stiff and swollen, exercise is probably the last thing you want to do. This creates a difficult cycle: You become more sedentary, lose muscle mass, gain weight, and feel even worse. “Avoiding this negative spiral is key to maintaining your overall wellness,” says Dr. Kaplan. “Your goal is to keep pain under control, which means following your treatment plan and exercising to stay in shape as best as you can.”
Staying Fit Can Lower Your Risk for Diabetes
Did you know the risk for diabetes is 50% higher if you have psoriatic arthritis? Inflammation in your body may be one reason why, but lifestyle choices like poor diet or inactivity can also play a role, says study author Daniel Solomon, M.D., from the division of rheumatology at Brigham and Women’s Hospital in Boston. Consider that another nudge to stay active or talk to your doctor if pain is making it difficult to exercise.
A Healthy Diet Matters
The same inflammation that attacks your skin and joints and increases risk for diabetes may also hurt your heart. Some proteins related to inflammation may affect the fatty deposits, called plaque, that can build up inside blood vessels. This narrows the vessels so your heart has to work harder to move blood. Sometimes the plaque breaks off and causes a clot, which can trigger a heart attack or stroke. Regular exercise can decrease the risk, as can eating a heart-healthy diet rich in fruits, vegetables, and healthy fats (think cold-water fatty fish like salmon, avocado, and nuts), Woolf says.
Don’t Ignore Gastrointestinal Issues
Do you regularly experience belly cramps or diarrhea? That’s something you want to mention to your doctor. People with psoriasis and psoriatic arthritis share similar genetic changes—a.k.a. mutations—with people who have Crohn’s disease, an inflammatory bowel disease (IBD) that causes inflammation in your digestive tract. Certain medications for PsA drugs can cause IBD or make it worse. That’s why it’s important to talk to your doctor if you notice gastrointestinal issues, including abdominal pain or bloody stool.
Weight Can Impact Your Mental Health
Living with a chronic illness inevitably comes with some bad days. But feeling down occasionally is different from depression, a serious illness that negatively affects the way you feel, think, and act for ongoing periods of time. Patients with PsA are twice as likely to be depressed as those with psoriasis alone. And being overweight is also correlated with feelings of depression. Squash the proverbial two birds with one stone by committing to regular exercise, which has been shown to ease depression and, of course, help you reach a health weight.