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Body mass index (BMI) and weight loss are topics from which no physician can escape. It is well known that higher BMI is a contributing factor to the metabolic syndrome and cardiovascular risk. Specific risk factors for rheumatic diseases are not as well defined and often a complex interplay of genetic and environmental factors.

In their study recently published in , Karlsson and colleagues estimated the causal effect of BMI on the risk of developing five different rheumatic diseases including rheumatoid arthritis, osteoarthritis, psoriatic arthritis, gout, and inflammatory spondylitis in the UK Biobank cohort of 361,952 participants. Not surprisingly, high BMI increased the risk of all five rheumatic diseases.

This study highlights a modifiable risk factor that all physicians including rheumatologists can target. In my patients with rheumatoid arthritis or early undifferentiated inflammatory arthritis, I always strive to foster abstinence from tobacco and smoke exposure along with dental health, as these are known contributors to those diseases.

Now we can encourage patients further in lifestyle choices to promote healthy weight. Even small amounts of weight loss could contribute to reduced risk of developing rheumatic disease or to delayed progression in those already diagnosed with rheumatic disease.

Emily L. Gilbert, MD, PhD practices rheumatology in Jacksonville, Florida.

Read the study here and a Q&A with the lead author here.