Does WEIGHT influence rheumatoid arthritis risk?

While I like to blame being overweight and obese for most of what ails you, there’s one thing I have never associated with either…

Rheumatoid arthritis (RA).

If you or someone you know has RA, you already know how debilitating it can be. The disease is no joke—and the medications to treat it have worrisome side effects.

But now, new research reveals your weight might actually predict risk and severity of this troubling condition…

Inside-out effects

RA is an autoimmune disorder. It occurs when the immune system attacks healthy cells by mistake, resulting in inflammation and swelling (primarily in the joints).

And now, researchers analyzed data from the Nurses’ Health Study to look at the effect of long-term weight changes on RA. The study lasted about 26 years and data on body weight was collected every two years.

Weight change was categorized into five categories:

  • Weight loss under 2 kilograms (kg) (~4.4 pounds [lb])
  • Stable weight (remaining within 2 kg above or below baseline weight; this served as the control group)
  • Weight gain of 2-10 kg (~4.4-22 lb)
  • Weight gain of 10-20 kg (~22-44 lb)
  • Weight gain of 20 kg or more

In addition, data on diet was collected using the Alternative Healthy Eating Index (AHEI). This calculates diet quality based on the following components: vegetables, fruit, whole grains, sugar-sweetened beverages and fruit juice, nuts and legumes, red/processed meats, trans fat, long-chain omega-3 fatty acids (EPA and DHA), poly-unsaturated fatty acids, sodium, and alcohol.

(The higher the AHEI score, the better the diet.)

And here’s what they found…

Long-term weight management is key

Ultimately, long-term weight gain of any kind was associated with a significantly increased risk of RA. Not to mention, those with the greatest weight gain (20 kg or more) saw a near four-fold increased risk.

This makes sense, as fat cells are a known source of inflammatory cytokines, leading to systemic inflammation.

Now, while this study was quite fancy and looked at many different variables, the takeaway message is pretty clear…

Long-term weight management will extend your life. It may even ward off RA! And adhering to a healthy, balanced diet will help you get there.

In fact, I often say that it’s “easy” to lose weight, but much harder to maintain it. But clearly, that maintenance is of utmost importance.

So, cut the crud once and for all. Instead, enjoy a healthy, whole foods diet full of lean protein, fresh produce, and healthy fats. For some guidance, check out my very own A-List Diet.

And last thing before I go…

Don’t fall victim to the false narrative that gaining weight as you get older is normal or healthy. It has hazardous consequences to your health at any age!

And allow me to let you in on a little secret… my oldest patient, who’s still actively maintaining a healthy weight, is 91. (Not only is she my oldest patient, but she’ my oldest dieter… and she’s a true marvel!)


“Long-term weight changes and risk of rheumatoid arthritis among women in a prospective cohort: a marginal structural model approach.” Rheumatology (Oxford, England), 2022. (