In #PsA, obesity isn't just a comorbidity, it's a disease modifier. Pooled SPIRIT trials (n=1284): 43% had obesity. BMI≥30 vs normal: joint counts ↑, function ↓, fatigue ↑, CVD 55% vs 18%, HTN 52% vs 11%, DM 19% vs 3%. @RheumNow #EULAR2026 POS0460