Nutrition/Obesity

Obesity and Gout: An Old Relationship with New Thoughts https://t.co/T71u9Ta4NS https://t.co/B7vUVqIBQE

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Dr. John Cush @RheumNow( View Tweet )
Study of 119 Rheum pts on GLP-1 Rx (65% T2DM, 35% obesity; mean BMI 35). @ 12 mos wt loss −7.7 kg & 56% improved ≥1 BMI category. Signif decr in A1c, FBS, lipids, LDL, TG, ESR & CRP. GLP-1RAs useful cardiometabolic benefits https://t.co/fdNtvGu8Vb~ https://t.co/EdAqXfsjW0

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Dr. John Cush @RheumNow( View Tweet )
Advance growth

Endocrine Society - State of Obesity Science and Management

Jack Cush, MD

The Endocrine Society has published a scientific statement reframing obesity as a heterogeneous, chronically dysregulated fat-mass disorder, the biology of which is being tested effectively by GLP-1/GIP receptor agonists. Is this precision-medicine? We await long-term safety data, while

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Lifestyle and Incretin Therapy Advice for Rheumatologists

Jack Cush, MD

As GLP-1/GIP receptor agonists become standard co-management tools for obese patients with RA, PsA, axSpA, and gout, this JAMA Insights perspective by Kushner, et al. reframes lifestyle counseling as an adjunct to pharmacotherapy - a reversal of the traditional model. This has with direct

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True or False: According to a metanalysis of 87 studies, higher BMI and smoking were linked to reduced methotrexate efficacy in rheumatoid arthritis. Check your knowledge in the latest RheumIQ quiz at https://t.co/LHFv1P6XZe.

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Dr. John Cush @RheumNow( View Tweet )

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Early RA Referral Clinics Work (9.18.2026)

Jack Cush, MD

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

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Metanalysis of 87 studies shows predictors of #MTX response: early Dz, low dz activity, early MTX initiation, and absence of erosive disease. Smoking and higher BMI were linked to reduced efficacy. https://t.co/OfB09aHNOS https://t.co/4UiOgfW940

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Dr. John Cush @RheumNow( View Tweet )
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Obesity and Gout: An Old Relationship with New Thoughts

Willa Hsueh, MD

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

Links:

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, guidance, guidelines

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

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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 )
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

Links:

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.

Links:

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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Recent Blogs

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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Obesity in Rheumatic Diseases: More than just a Comorbidity

Marina Magrey, MD
Magrey RT cover image
A few years ago, when I would see a patient with rheumatic disease and increased BMI, I would often document it as obesity as a comorbidity, recommend weight loss and exercise, and then move on. My approach has changed.
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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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