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Obesity Imperative
Join us for Tuesday Nite Rheumatology on September 22 for: Obesity Treatment & Safety Experts will tackle: • GLP-1/GIP therapies • Lifestyle & bariatric interventions • Treatment selection & safety • Cost & compounding concerns • Sarcopenia & bone health • The future of https://t.co/BCSOUot5FL
Dr. John Cush @RheumNow( View Tweet )

Early RA Referral Clinics Work (9.18.2026)

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com

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Bariatric Surgery in the Era of GLP-1RA Overweight/obesity is a chronic multi-system disease that can impair physical and mental health. It now affects almost 1 in 3 Canadians. Multiple recent guidelines have therefore suggested using waist measurements, in addition to BMI, to https://t.co/RaXnQ2d9Yr
Dr. John Cush @RheumNow( View Tweet )
Obesity and Rheumatic Disease Presented as part of RheumNow's "The Obesity Imperative" campaign. https://t.co/d2fl4EJX8Q https://t.co/DpihLZz5Ch
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/uob8RlMV14 https://t.co/f42gB0IXl1
Dr. John Cush @RheumNow( View Tweet )
Obesity management goes far beyond the number on the scale. Watch our Four Pillars of Weight Loss video series, part of this month’s The Obesity Imperative campaign. What Are the Four Pillars of Obesity Management? Building a Multidisciplinary Program for Obesity & Arthritis https://t.co/16v4JFVWWs
Dr. John Cush @RheumNow( View Tweet )

Obesity and Gout: An Old Relationship with New Thoughts

Current recommendations are that obesity management is an integral component of gout treatment and that, in parallel, gout awareness is an important component in the treatment of the metabolic syndrome.

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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/M6nKr9EShU https://t.co/6JX5bCYzfo
Dr. John Cush @RheumNow( View Tweet )
Obesity Journal Club: Tuesday Nite Rheumatology The Obesity Journal Club explores the TOGETHER PsA and STEP 9 trials and what emerging evidence tells us about the relationship between obesity, weight loss, and rheumatic disease. Panelists discussed the results of these trials, https://t.co/3C1RLyRj0b
Dr. John Cush @RheumNow( View Tweet )

ACR Updates Osteoarthritis Guidance

ACR

The American College of Rheumatology (ACR) has released updated clinical guidance for the treatment and management of osteoarthritis (OA) of the knee, hip, and hand. The evidence-based recommendations update the 2019 ACR/Arthritis Foundation guideline and are designed to support individualized,

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Discussing Weight Loss: 3 Minute Script Dr. Jack Cush's 3 Minute Script as discussed in his Introducing Weight Loss video. https://t.co/JRWAPc5if5 https://t.co/NUpxPT4bdo
Dr. John Cush @RheumNow( View Tweet )
Weight Loss Improves Psoriatic Disease Substantially! Even before the introduction of incretin therapy and bariatric surgery, many randomized and interventional studies (2019–2026) have consistently showed that weight loss produces clinically meaningful, dose-dependent https://t.co/BWeW7fzSC8
Dr. John Cush @RheumNow( View Tweet )
In 2022, Overweight & obesity affect 65.8% of Swiss PsA pts (vs gen pop.= 43%) and has increased since 2007. Obesity was assoc w/ elevated CRP (56% vs 37%), Inc Pt global assess (3.2 vs 2.8), & MD global (2.5 vs 2.1) & lower EQ-5D-3L(0.7 vs 0.8). https://t.co/xPoy4dgvlD https://t.co/aeB5N6LgCd
Dr. John Cush @RheumNow( View Tweet )
Obesity in Axial Spondyloarthritis: what are we missing beyond the scale? Obesity in axSpA is not a minor comorbidity. While obesity is more often discussed in psoriatic arthritis (PsA) due to the psoriasis-adipose tissue link which is mechanistically better studied and https://t.co/bFkoPmc0pC
Dr. John Cush @RheumNow( View Tweet )
JAMA Surgery analysis showed that between 2022-2024 bariatric surgery fell 34.1%, While GLP-1 use rose more than 140% over the same period. (SELECT trial showed semaglutide reduced major adverse cardiovascular events by 20% in overweight or obese adults without diabetes.) https://t.co/s3NRFY2R5w
Dr. John Cush @RheumNow( View Tweet )
Waist size matters! Using NHANES data (1999-2018) the weight-adjusted waist index (WWI) calculated on 5582 CKD pts. WWI was signif assoc w/ all-cause mortality (adj HR  1.17) & CV (1.24); these assoc partially mediated by NLR (inflammation) ~6.6%, showing both central adiposity https://t.co/kNf4nqiD2a
Dr. John Cush @RheumNow( View Tweet )

Bariatric Surgery in the Era of GLP-1RA

Weight loss with lifestyle changes alone is difficult to sustain for most people. One reason for this is the weight loss associated endocrine milieu, which can decrease energy expenditure and increase the drive to eat. Therefore, we frequently use medications and/or bariatric surgery.

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Osteoarthritis, Obesity and GLP-1s https://t.co/SGnWksQBpT https://t.co/ILP3weScxh
Dr. John Cush @RheumNow( View Tweet )
QD Clinic: Weight Loss Changed the Course of RA Dr. Bella Mehta, New York, presents this case which highlights that obesity may be a target for disease modification in rheumatoid arthritis, as part of RheumNow's "The Obesity Imperative" campaign, presented in September 2026. https://t.co/KNNS0cHmA4
Dr. John Cush @RheumNow( View Tweet )

Weight Loss Improves Psoriatic Disease Substantially!

Even before the introduction of incretin therapy and bariatric surgery, many randomized and interventional studies (2019–2026) have consistently showed that weight loss produces clinically meaningful, dose-dependent improvement in both psoriasis and psoriatic arthritis.

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Osteoarthritis, Obesity and GLP-1s https://t.co/SGnWksQBpT https://t.co/TPxM4aj7bd
Dr. John Cush @RheumNow( View Tweet )
QD Clinic: Obesity: Escalate or Reassess? Dr. Mrinalini Dey, London, presents this QD Clinic as part of RheumNow's "The Obesity Imperative" presented in September 2026. https://t.co/wt5N6RZmg6 https://t.co/3EyRa1WC9U
Dr. John Cush @RheumNow( View Tweet )

Obesity in Axial Spondyloarthritis: what are we missing beyond the scale?

Obesity in axial spondyloarthritis (axSpA) is not a minor comorbidity. Beyond the scale, there are several factors that need to be considered with obesity in axSpA.

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Treating Obesity is Disease-Modifying (9.4.2026) Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow. New drugs approved, new drugs halted and some drugs out of control. https://t.co/ojBOosSWMX https://t.co/K4DvUK24Pb
Dr. John Cush @RheumNow( View Tweet )
High BMI decreases the odds for MDA in PsA, esp w/ TNFi Rx (but not Inflx, IL-17i, IL-12/23i, IL-23i, JAKi). Longitudinal PsA cohort 1291 pts (mean BMI 29); Higher BMI independently assoc w/ signif. lower odds for MDA (OR 0.97), also female, age, smoking, FM & Xray damage. https://t.co/zAJ8Pmk1HY
Dr. John Cush @RheumNow( View Tweet )
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