Nutrition/Obesity

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 )
Obesity & Inflammation https://t.co/zmZe9YJFvx

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Dr. John Cush @RheumNow( View Tweet )

A Day of Infamy (9.11.2026) Dr. Jack Cush reviews the news and journal reports from this past week on Rheumnow - including obesity, disappointing durability with GLP-1 drugs, AI diagnoses and worries about CV risk in ANCA-associated vasculitis. https://t.co/gzaqNz3i5k https://t.co/c8ShScutqC

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Dr. John Cush @RheumNow( View Tweet )
Metanalysis 11 studies & 104277 gout & hyperuricemic pts shows erectile dysfunction is signif. increased (RR1.37; 1.14-1.65) related to lower testosterone & estradiol. Other factors: obesity, age, DM, CVD. https://t.co/1ufih2E3UN https://t.co/NgQuHt4vR1

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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

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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 )
Together PsA 52 wk data (n 271): ACR50 plus >10% wt loss - 39.2% w/ Taltz & Zepbound vs 1.7% w/ Taltz alone. Together PsO trial results (n 274): PASI100 plus >10% wt loss - 30.6% w/ Taltz & Zepbound vs 4.4% w/ Taltz alone. https://t.co/27TBZyL8l1 https://t.co/VdQJALdoJt

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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 )
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Bariatric Surgery in the Era of GLP-1RA

Satya Dash, MD

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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RheumIQ: In axial spondyloarthritis, obesity reduces TNF inhibitor responses by how much? Test your knowledge at https://t.co/UaXqHKWizt.

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Dr. John Cush @RheumNow( View Tweet )

Osteoarthritis, Obesity and GLP-1s https://t.co/SGnWksQBpT https://t.co/ILP3weScxh

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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 )
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Weight Loss Improves Psoriatic Disease Substantially!

Jack Cush, MD

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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A Day of Infamy (9.11.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on Rheumnow.com - including obesity, disappointing durability with GLP-1 drugs, AI diagnoses and worries about CV risk in ANCA-associated vasculitis. And take this week's RheumIQ quiz

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Osteoarthritis, Obesity and GLP-1s https://t.co/SGnWksQBpT https://t.co/TPxM4aj7bd

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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

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Dr. John Cush @RheumNow( View Tweet )
Scale,weight

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

Antoni Chan, MD, PhD

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

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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 )
Epic Cosmos study of GLP-1RA Rxs in 3.5 million children (8–11 yrs) - very few 0.6% recv a GLP-1RA (20,282 kids) - Rx went from 0.03% (2019) to 9.3% (2026-310-fold incr). More likely in older, girls, obese kids. Most GLP-1 kids had severe obesity (93.7 percent) https://t.co/JW6SXxJjA0
Dr. John Cush @RheumNow( View Tweet )
Swedish study of 1097 #RA pts looked at modifiable healthy lifestyle habits (HLHs: EtOH use, smoking, physical activity). At Baseline, 56% had three HLHs , unchanged (58%) at Yr 3. Nonsmoking incr 77-83%, healthy alcohol from 85%-97%. but healthy PA decr 84-71%. Lifestyle modif. https://t.co/cDyQwiN6Ae
Dr. John Cush @RheumNow( View Tweet )
Join us for the first of four webinars this month! This Journal Club will explore the TOGETHER PsA and STEP 9 trials, and what emerging evidence tells us about the complex relationship between obesity, weight loss and rheumatic disease. The authors and leading experts will: • https://t.co/xpnqim1VKH
Dr. John Cush @RheumNow( View Tweet )
Why does obesity worsen Rheumatic disease?

Dr. John Cush @RheumNow( View Tweet )

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Osteoarthritis, Obesity and GLP-1s

Tom Appleton, MD, PhD

We all know that osteoarthritis is the most common form of arthritis in the world, and that obesity is its most modifiable risk factor. What I really want to focus on is the role that GLP-! receptor agonists might be playing in our management of osteoarthritis. So why does this matter?

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12 mos Danish study of 157 822 first-time semaglutide for obesity management (SOM) intiators. 77 483 discontinued treatment w/in 12 mos. (13% at 3 mo, 27% 6 mos, 39% @ 9 mos. D/C more likely in younger, men, low-income, on GI or psych meds, & pts with comorbididities. Few https://t.co/oJLnrxXFz0
Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

rheumthought

Obesity and Lupus: Coconspirator or Comorbidity?

Alfred Kim, MD, PhD
Dr. Al Kim

Dr. Al Kim, St. Louis, discusses the effects of obesity on lupus activity, organ damage, complement levels and mTor activation.

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Comorbidities in RA: Focus on Difficult-to-Treat Disease

Elena Nikiphorou, MD, PhD
Puzzle pieces
The presence of comorbidities naturally complicates treatment choice, patient adherence to medication and patient outcomes, increasing also the risk of making RA ‘difficult-to-treat’.
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Comorbidities in Rheumatoid Arthritis: A Precarious Stack of Blocks

Cynthia S. Crowson, PhD
stack of blocks

Comorbidities can pile up like a stack of blocks for people with rheumatoid arthritis (RA).  At the time when RA is diagnosed, they already have more comorbidities than their peers, and after RA diagnosis they accumulate comorbidities faster than their peers.

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