The Obesity Imperative 

Recent News

  • Good Grief

    Jack Cush, MD
    Dick, Jack

    When it rains it pours, but when it comes to grief, it’s like the rains that just won't let up.

    Just too many deaths this past month. All devastating, all my immediate sphere. All hard to fathom. How can something so inevitable be a recurring, unwelcome, unsolvable bad dream?

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older woman with clasped hands

Beyond Disease Modification: Palliative Care in Rheumatology

Eric Dein, MD

Therapeutic advances have transformed the prognosis of many rheumatic diseases, allowing patients to achieve sustained disease control and avoid irreversible organ damage. For some, however, rheumatology conditions progressively cause decline, damage, loss of function, and ultimately shortened life expectancy. Palliative care is an under-utilized and often misunderstood tool within rheumatology.

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Estimated > 7million Americans (~1/3 US GLP1 Rxs) get GLP-1 drugs from online compounding source- but these are not FDA approved. They maybe cheaper, but dosing/quality is suspect. FDA needs to close the 503B loophole to outlaw these copycat Rxs https://t.co/Xu7MeP0Ytt https://t.co/nYGr3auqzx

Links:

Dr. John Cush @RheumNow (  View Tweet)
Retrospective review of 33 referred pts w/ Recurrent fever w/ MSK & skin Sxs, assessed by NGS. NLRP1 had FMF-like Dz; NLRP recurrent fevers w/ mucocutaneous; NLRP12 periodic fevers w/ MP/EN rash; NLRC4 episodic systemic inflammation GI Sxs & atypical skin rash https://t.co/IWafJVFoaJ
Dr. John Cush @RheumNow (  View Tweet)
Southern Israel study (2009-24) shows fibromyalgia prevalence Incr from 1.04% to 3.88%, esp 30-59 yrs; more males, w/ more Psych comorbidities; fewer hospitalizations & specialist visits but increased imaging. More use of pregabalin, duloxetine, & gabapentin. https://t.co/kgmvdZF9HQ
Dr. John Cush @RheumNow (  View Tweet)
Systematic review of 290 psoriasis pregnancies 211 live births (73%) finds biologic exposure (UST 241, 42 TNFi) during PREG assoc w/ favorable maternal/fetal outcomes. Only 24 cont either CZP or ADA throughout PREG. Rates of miscarriage, LBW, congenital anomalies, comparable w/ https://t.co/H5GLrvxwPv
Dr. John Cush @RheumNow (  View Tweet)
Indian Single center retrospective study of 28 children ≤18 yrs tested w/ 18F-FDG-PET/MR for pyrexia (PUO). 25% Dx w/ pre-stenotic TAKayasu (mean 13.9 yrs), & 20/21 alternative Dxs. All had Sxs & high ESR/CRP; all Rx w/ GC & MMF, 3 w/ biologics https://t.co/6trs1WssjW https://t.co/EOPIarRhY5

Links:

Dr. John Cush @RheumNow (  View Tweet)
It’s almost time. 🔥 Registration for RheumNow Live 2027 opens OCTOBER 1. Two days of practical, engaging rheumatology education designed to challenge how you think and influence how you practice. 📅 Jan 30–31, 2027 📍 Dallas + Online https://t.co/Ju0zzYX8Tl
Dr. John Cush @RheumNow (  View Tweet)
Prescribing New GLP-1-Based Therapies https://t.co/cpxyxBMZ8s https://t.co/9JXmlW2Lj6

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Dr. John Cush @RheumNow (  View Tweet)
New report shows Median total cash compensation increased across all seven specialty groups in 2026; adult medical rose 7.2% - Rheumatology led one-year pay growth at 10.4% https://t.co/iuonfJRsf6 https://t.co/zybCZeNV5I

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Dr. John Cush @RheumNow (  View Tweet)
pills-14550__180_0.jpg

Gabapentin Use Rose as Restrictions Fell, Study Shows

MedPage Today

Gabapentin use jumped quickly in Michigan after the drug was removed from the state's controlled substance schedule in 2024, a cross-sectional study showed.

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notebook, tape measure and food

Obesity and Psoriatic Disease

Mason Arbabi, MD and Juliana S. Simonetti, MD

Obesity is a clinically important comorbidity in psoriasis and psoriatic arthritis. Excess adiposity contributes to systemic inflammation and cardiometabolic risk and may adversely affect disease severity and response to some systemic therapies. Intentional weight loss should be considered an adjunct to appropriate dermatologic and rheumatologic treatment.

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Early RA Referral Clinics Work (9.18.2026) Dr. Jack Cush reviews the news and journal reports from this past week on https://t.co/ofGKCCNQnE https://t.co/fn0L4goAMT https://t.co/F8QKs7261x

Links:

Dr. John Cush @RheumNow (  View Tweet)
QD Clinic: GLP-1s and History of Thyroid Cancer? Daric Mueller, PA-C, St. Clair Shores, MI, presents this case as part of RheumNow's "The Obesity Imperative" campaign, presented in September 2026. https://t.co/rhsUNVIdQ4 https://t.co/mjHEWNIGqU

Links:

Dr. John Cush @RheumNow (  View Tweet)
QD Clinic: Bariatric Surgery "Curing" Arthritis? Dr. Richard Conway, Dublin, presents this QD Clinic as part of RheumNow's "The Obesity Imperative" campaign, presented in September 2026. https://t.co/YwtSkroMta https://t.co/tl8eSrvGhq

Links:

Dr. John Cush @RheumNow (  View Tweet)
Obesity in Rheumatic Diseases: More than just a Comorbidity https://t.co/0QJ188HYSm https://t.co/3L09m2cowl

Links:

Dr. John Cush @RheumNow (  View Tweet)
Metabolomic/proteomics w/ cardiac MRI & longitudinal outcomes in 488079 UK Biobank pts shows chronic systemic inflammation assoc w/ reduced LV volumes, incr CV risk (cytokines, GFs, IL-1, TNF as potential mediators) https://t.co/3woGOttKHz https://t.co/eJLkPyJe6U

Links:

Dr. John Cush @RheumNow (  View Tweet)
Obesity and Gout: An Old Relationship with New Thoughts https://t.co/T71u9Ta4NS https://t.co/B7vUVqIBQE

Links:

Dr. John Cush @RheumNow (  View Tweet)
🚨 Registration opens October 1! RheumNow Live 2027 returns January 30–31 for our 9th Annual CME Meeting. 📍 Dallas + Online 📅 January 30–31, 2027 🎓 High-impact CME. Expert faculty. Real-world rheumatology. The rheumatology meeting that sets the tone for the year ahead. https://t.co/PFZ37DlTQe
Dr. John Cush @RheumNow (  View Tweet)
Systematic review 14 studies assessed Lung ultrasound (LUS) (vs HRCT) to detect RA-ILD (using threshold of ≥ 5 B-lines) found sensitivity was 86.8% (95% CI 80.1–91.4), specificity 75.4% (95% CI 62.3–85.1), and AUC 0.890 https://t.co/GlNpsPBwtS https://t.co/FJ6B5E5CWy

Links:

Dr. John Cush @RheumNow (  View Tweet)

From the Blog

rheumthought

Do You Have to be Overweight for GLP-1s to Work?

Janet Pope, MD, MPH, FRCPC
Pope RT cover still

Are there any data that GLP-1 RA drugs can be effective if a person has a normal BMI? 

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Podcasts

  • Obesity QD Clinics Part Three
  • Obesity Treatment & Safety
  • The Four PIllars of Weight Loss Part 2
  • The Four Pillars of Weight Loss Part 1
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Therapeutic Updates

The Four Pillars of Weight Loss

RheumNow
Nutrition and Weight Management in Rheumatic Disease
Watch our 'Four Pillars of Weight Loss' 6-part series as part of this month's The Obesity Imperative campaign.
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Label update: Structural damage progression in active PsA

Sponsored by Johnson & Johnson Medical Affairs
J&J RX Update
Listen to Dr. Catherine Bakewell’s review of clinical data from a recent label update.
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Daily Gem

Obesity undermines RA. High BMI inflates pain and functional scores, while also dampening therapeutic response.

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