The link between obesity and psoriatic arthritis is “very complex and not adequately understood,” says John Davis III, MD, a clinical rheumatologist who specializes in psoriatic arthritis at Mayo Clinic in Rochester, Minnesota. “We believe that [obesity] drives inflammation, providing the link to the joint disease.”
The good news: Weight loss has been linked to an improvement in psoriatic arthritis symptoms, including painful swollen joints and fatigue. “It’s probably reducing the inflammatory burden,” says Dr. Davis.
1. Cut Back on Inflammatory Foods
- Highly processed foods that often contain added sugars and unhealthy fats
- Fatty cuts of meat
- Fried foods
- Some full-fat dairy products
2. Fill Up on Anti-Inflammatory Foods
- 3 or more servings of vegetables a day
- 3 servings of fruit a day
- 1 to 4 tablespoons of extra-virgin olive oil a day
- 3 servings of legumes per week
- 3 servings of nuts per week
- 3 servings of fish or seafood per week
“Make vegetables the star of your meal by filling half your plate with nonstarchy vegetables, and go with a serving of fruit or a serving of a vegetable for snacks,” recommends Prest.
3. Drink More Water
4. Incorporate Low-Impact Exercise
If you’re experiencing a lot of joint pain in your lower extremities, Bhatt recommends swimming a few laps. “Swimming is a good low-impact activity for those who have access to a pool and enjoy it,” says Davis.
5. Use a Fitness Tracker to Count Your Steps
Walking is a great weight loss exercise for people with psoriatic arthritis, says Davis. “Maintaining daily activity and step counts [helps] to increase metabolism,” he says. When combined with dietary changes, walking supports weight loss. Walking can also be especially important for weight loss maintenance.
If you need extra motivation, use a fitness tracker to track your steps. Set small, manageable goals that slightly challenge you. And listen to your body: It’s natural to feel a bit sore or tired the next day, but take it easy if you feel pain.
“The body always has to be challenged. Choose something you like, so you can stick to a long-term plan,” says Bhatt.
6. Lift Weights
Resistance bands are a low-cost alternative to weights, and resistance bands create less tension at the weakest point of the exercise than weights, making them a good option for beginners.
Be sure to review your exercise plans with your doctors and consider working with a physical therapist if you have any joint pain or limitations.
7. Keep a Food Journal
“I have used the journal technique with many clients, and they have had great success in reaching their weight loss goals,” says Prest. Free apps and online tracking tools also give you a helpful estimate of your overall diet, but keep in mind they’re not 100 percent accurate, she adds.
8. Prioritize Sleep
“A good night’s sleep helps with pain sensitization and improves pain tolerance, and therefore, psoriatic arthritis symptoms might be better,” says Bhatt. “When the body rests, it rids itself of toxins, which helps improve inflammation. And good sleep helps with weight loss.” Davis suggests people with psoriatic arthritis aim for at least seven to eight hours of sleep each night.
Try these tips to help you get a better night’s sleep:
- Go to bed and wake up at the same time each day (even on weekends).
- Exercise regularly for better sleep, but not too close to your bedtime.
- Avoid coffee (and other sources of caffeine) in the evenings.
- Have your last meal at least two to three hours before bedtime.
- Keep your bedroom cool, dark, and quiet — use your bed for sleep only, not for watching TV or scrolling through social media.
9. Meet With a Specialist
“If [you’re] struggling, seeing a dietitian is a good idea,” says Davis. A dietitian can help you develop a customized meal plan. “People with psoriatic arthritis may find that they have other food-sensitivity issues that may contribute to problems with weight loss. Working with a registered dietitian-nutritionist is a great way to ensure you’re eating the right amount for weight loss,” says Prest. You can search for a registered dietitian-nutritionist near you at Eatright.org.
If you’re struggling with exercise, meet with a physical therapist or personal trainer. These specialists can develop a fitness routine suited to your needs.
Finally, keep at it, because even small changes can be powerful. “We often overemphasize pharmaceutical therapies and underemphasize lifestyle changes,” says Bhatt, “but lifestyle changes are equally important for all arthritis patients.”
10. Talk to Your Doctor About GLP-1 Drugs
Still, medication might be helpful when it comes to weight loss. Glucagon-like peptide-1 agonists, known as GLP-1 medications, are injectable drugs that help people feel fuller and eat less, resulting in weight loss. If you have PsA and want to lose weight, they may be helpful for you, especially if you also have obesity or type 2 diabetes, which is what the U.S. Food and Drug Administration (FDA) has approved them for (meaning your insurance is more likely to cover them for these conditions).
The Takeaway
- Maintaining a healthy weight is vital for managing psoriatic arthritis, as excess weight can exacerbate symptoms and interfere with treatment efficacy.
- Foods high in sugar and unhealthy fats should be minimized, while a diet rich in fruits, vegetables, and omega-3s can help manage inflammation.
- Regular low-impact exercises, such as swimming or walking, can improve joint function and contribute to weight loss, easing the burden of arthritis.
- If you’re considering medication options like GLP-1 agonists for weight management, consult with your healthcare provider, particularly if you have coexisting conditions like obesity or type 2 diabetes, to understand potential benefits and risks.
Additional reporting by Nina Wasserman.