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#Episode 17:

Arthritis & Weight

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Episode Description:

It is very common for people with arthritis to have difficulties managing their weight.

Arthritis can affect energy levels, mood, sleep, ability to move, as well as habits such as grocery shopping, preparing healthy meals and exercising. Medications used to treat inflammation, such as prednisone, can also cause weight gain.

“For many, managing arthritis and weight is a relentless journey,” said Dr. Derin Karacabeyli, a rheumatologist and research trainee at Arthritis Research Canada. “Obesity is not a person’s fault or a willpower deficiency. It’s caused by a complex interplay of genetic and environmental factors.”

Carrying extra weight with arthritis can also lead to higher disease activity and serious complications such as sleep apnea, cardiovascular disease, liver disease, diabetes, and fertility issues.

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Episode Content:

Arthritis Research Canada’s scientists are conducting research to help people manage weight challenges and lead healthy lives. Learn more about this research and the relationship between arthritis and weight in Episode 17 of the Arthritis Research Education Series, which includes information about popular weight loss medications.

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Content and Topic of Research

Recent estimates show that about 30% of adults in Canada have obesity. By 2040, it is estimated that 12 million people will have osteoarthritis in this country.

High rates of both arthritis and obesity indicate a need for more research, especially as the world turns to drugs like semaglutide (branded as Ozempic or Rybelsus for diabetes and Wegovy for obesity) to aid weight loss efforts.

“There is a lot of weight-related stigma and bias in healthcare and the public, and shame about carrying excess weight is common,” said Dr. Derin Karacabeyli, a rheumatologist and research trainee at Arthritis Research Canada. “As someone with training in obesity and arthritis, it’s my job to challenge the narrative that people with obesity simply don’t exercise enough or prioritize nutrition.”

Dr. Derin Karacabeyli has conducted extensive research in the area of arthritis and obesity – including the use of popular weight loss medications – and hopes to establish an interdisciplinary clinic that provides care for patients with rheumatic diseases and obesity.

Weight Loss Medication Research

Obesity Research

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Research Scientist

Dr. Derin Karacabeyli, MD, PhD Student — Rheumatologist | Research Trainee | PhD Student, UBC

Dr. Derin Karacabeyli is a rheumatologist enrolled in the Clinician Investigator Program at the University of British Columbia. His undergraduate studies were in kinesiology at UBC, where he finished Head of Class in his first, second, and third years, and was awarded three Premier Undergraduate Scholarships and the distinction of Wesbrook Scholar. He developed an interest in obesity, which he continued to pursue through his Medical Doctorate and Internal Medicine Residency at UBC. He completed his Rheumatology Residency at UBC in 2024.

Dr. Karacabeyli is enrolled in a PhD in Experimental Medicine under the supervision of Dr. Diane Lacaille, studying the effects of treating metabolic comorbidities like obesity and type 2 diabetes on patients with immune-mediated inflammatory diseases. His goal is to establish an interdisciplinary metabolic-rheumatology clinic in order to better characterize and manage the unique needs of patients with excess adiposity and inflammatory arthritis.

Additional Resources

Are you living with arthritis? Does managing your weight feel out of your control? You’re not alone.

  • Fatigue can impact the ability to maintain healthy habits like grocery shopping and meal preparation.
  • Arthritis can affect mental health and lead to emotional eating.
  • Medications used to treat arthritis, such as prednisone, can cause weight gain.
  • Symptoms can affect sleep, and getting less sleep can impact levels of various hormones, increasing appetite.

Obesity is a chronic disease, just like diabetes or high blood pressure. Like other chronic conditions, obesity is treatable. There are options that we can explore to help with weight loss, but I like to focus more on general health.

Dr. Derin Karacabeyli

Frequently Asked Questions

What is the connection between arthritis and body weight?

Carrying extra fat tissue, or having what’s labelled as overweight or obesity, is a major risk factor for arthritis. It increases the risk of developing osteoarthritis (the most common type of arthritis) and gout, and also increases the risk of rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis. Once someone develops arthritis, obesity is associated with higher disease activity. People with obesity often don’t respond as well to certain treatments like TNF inhibitors. Obesity itself is inflammatory — excess fat releases molecules that cause inflammation, and research suggests carrying excess fat results in increased sensitivity to pain signals not only at the joint, but in the brain as well.

Reduced Physical Activity: Joint pain, stiffness, and swelling from arthritis often impact a person’s ability to function and remain physically active. With less movement, people burn fewer calories per day.

Life-Changing Diagnosis: While adapting to life with arthritis, it can be hard to maintain healthy habits. People may turn to ready-made or processed foods, which are often more calorie-dense and less healthy.

Mental Health: Conditions like depression and anxiety are seen more commonly in people with arthritis as well as obesity. Emotional eating can occur in response to the difficulties of living with arthritis or obesity.

Medications: Some drugs used to treat arthritis can cause weight gain. Prednisone, for example, can cause weight gain.

Sleep: Symptoms of arthritis can affect sleep, and getting less sleep can affect levels of various hormones, increasing appetite.

Obstructive Sleep Apnea, Cardiovascular Disease, Metabolic Dysfunction-Associated Steatotic Liver Disease (formerly non-alcoholic fatty liver disease), Type 2 Diabetes, and Fertility Issues. 

People are at the highest risk for heart attacks, strokes and blood clots in the first year after an arthritis diagnosis, when inflammation is at its peak.

It’s more common for people living with arthritis to experience conditions like depression and anxiety. The same is true for individuals who have obesity. Mental health, arthritis, and weight management are highly interrelated and influence each other in many ways — some individuals use food to cope with mental health challenges, leading to further weight gain, which can worsen arthritis symptoms and mental wellbeing.

Obesity is a chronic disease, just like diabetes or high blood pressure. Having obesity is not a person’s fault or a willpower deficiency. Studies show that genetics account for 40-70% of obesity risk. It’s important to challenge the narrative that people with obesity simply don’t exercise enough or don’t prioritize nutrition. Like other chronic conditions, obesity is treatable.

There are three main pillars to obesity management: (1) behavioural changes (like optimizing physical activity and nutrition); (2) medications; and (3) surgery.

Physical Activity: Data shows that exercise alone is not a particularly effective strategy for long-term, sustainable weight loss. However, physical activity helps with weight maintenance and has many other health benefits beyond weight loss.

Nutrition: The best approach is to find healthy, long-term nutrition strategies. Prioritize whole foods, mostly plants, and lean protein sources. The diet with the best evidence to improve health overall is a Mediterranean-style diet. Research trials show about 3-5% weight loss long term from diet alone.

Medications: GLP-1 receptor agonists like semaglutide (Ozempic/Wegovy) lead to about 10-15% body weight loss on average. Tirzepatide (Mounjaro/Zepbound), a GIP/GLP-1 receptor co-agonist, leads to even more weight loss of around 15-20%.

Surgery: For more severe forms of obesity, bariatric surgery typically leads to 25-40% body weight loss.

Dr. Karacabeyli first surveyed practitioner views on weight management in rheumatology — most rheumatologists felt it was at least partly their responsibility to help patients with weight but lacked confidence. He then conducted a scoping review with Dr. Diane Lacaille on GLP-1 receptor agonists in rheumatoid arthritis and psoriasis, finding apparent anti-inflammatory effects. Working with Dr. Lacaille and Dr. Antonio Aviña-Zubieta, he used BC administrative health data to show that adults with autoimmune rheumatic diseases derived cardiovascular benefits from GLP-1 receptor agonists. He’s wrapping up work on whether GLP-1 receptor agonists reduce risk of developing autoimmune rheumatic diseases.

Dr. Karacabeyli hopes to establish an interdisciplinary clinic providing comprehensive assessment and weight management strategies for patients with rheumatic diseases and obesity — working collaboratively with physiotherapy, dietetics, nursing, and social work.

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12 Weight Loss Tips that Can Specifically Help If You Have Arthritis

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Arthritis Research Canada Review Points to Potential Benefits of Weight Loss Medications for People Living with Arthritis & Obesity

Arthritis Research Canada review finds weight loss medications may hold wide-ranging benefits for people living with arthritis and obesity, identifying a need for further research. Read More

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Helpful Links

Obesity Canada

Obesity Canada is the leading national organization dedicated to improving the lives of individuals living with obesity through advocacy, education, and research. Learn More

24-Hour Movement Guidelines

Canada’s first ever 24-Hour Movement Guidelines for Adults offer clear direction on what a healthy 24 hours looks like for Canadian adults aged 18-64 years and 65 years or older. Learn More

Just One Move

Good days start with one move. This resource seeks to empower people living with arthritis to stay active and do more of what they love. Learn More

I START Tool

The I START Tool was developed by Arthritis Research Canada scientists and is an education and conversation tool for co-developing muscle-strengthening exercise prescriptions for people with rheumatoid arthritis. Learn More

Canada’s Food Guide

Canada’s food guide is Health Canada’s guidance on healthy eating for people in Canada two years of age and older. Learn More

OsteoArthritis Service Integration System (OASIS)

OASIS is an education program that helps people with arthritis self-manage their condition. Learn More

2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis

These are guidelines on exercise, diet, and more, for people living with rheumatoid arthritis. Learn More

HealthLink BC 8-1-1 Services

Registered Dietitians at HealthLink BC can answer your healthy eating and nutrition questions. Dietitian services are available from 9am to 5pm, Monday to Friday, or you can email a dietitian. Learn More

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