Episode Description:
Between 20 and 40% of people with arthritis experience a mental health disorder at some point.
Individuals diagnosed with arthritis often describe a profound sense of loss tied to social relationships, the ability to work, attend school, perform daily tasks and be the person they used to be. Dealing with chronic pain and fatigue can also take a toll on mental wellbeing.
Yet, research reveals around 50% of people in British Columbia who live with arthritis – and experience depression or anxiety – do not receive adequate care for their mental health. Even when someone is ready to seek help, they face barriers such as long waitlists and significant costs.
While there is often a focus on treating the physical side of arthritis, the mental side is just as important. It can impact how someone responds to medications and their ability to achieve remission.
Episode Content:
In Episode 16 of the Arthritis Research Education Series, discover how our scientists are finding answers to help people manage the physical and mental aspects of arthritis.
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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
- Target Trial Emulations of Sodium-Glucose Cotransporter 2 Inhibitors in Systemic Lupus Erythematosus
- Mortality and Major Adverse Cardiovascular Events After Glucagon-Like Peptide-1 Receptor Agonist Initiation in Patients with Immune-Mediated Inflammatory Diseases and Type 2 Diabetes: A Population-Based Study
- Glucagon-Like Peptide 1 Receptor Agonists in Patients With Inflammatory Arthritis or Psoriasis: A Scoping Review
- Effects of Weight-Lowering Medications in People With Obesity and Rheumatic Diseases
Obesity Research
- Glucagon-Like Peptide-1 Receptor Agonists, Sodium-Glucose Cotransporter-2 Inhibitors, and Risk of Autoimmune Rheumatic Diseases (Dec 2025)
- Glucagon-Like Peptide-1 Receptor Agonists in Arthritis: Current Insights and Future Directions (Oct 2025)
- The Range of Outcomes and Outcome Measurement Instruments Collected in Multisectoral Community-Based Obesity Prevention Interventions in Children: A Systematic Review
- Rheumatology Health Care Providers’ Views and Practices on Obesity and Smoking Cessation Management in Rheumatoid Arthritis
Related Research
- Recommendations for Physical Activity and Exercise in Persons Living with Systemic Lupus Erythematosus (SLE): Consensus by an International Task Force
- 2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis
- Feasibility and Preliminary Efficacy of a Physical Activity Counseling Intervention Using Fitbit in People with Knee Osteoarthritis: The TRACK-OA Study Protocol
- Overweight and Obesity Reduce the Likelihood of Achieving Sustained Remission in Early Rheumatoid Arthritis: Results from the Canadian Early Arthritis Cohort Study
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.
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.
What are the factors that cause weight gain in arthritis?
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.
What complications can people living with arthritis and obesity face?
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.
What is the connection between arthritis, mental health and weight?
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.
What advice do you have for people living with arthritis who are struggling with weight?
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.
What are the options for treating obesity?
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.
What research have you done in this area?
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.
What are your future goals in arthritis and weight management/obesity?
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.
Articles
Rethinking Physical Activity with Arthritis
How I Get Started Exercising With Rheumatoid Arthritis
12 Weight Loss Tips that Can Specifically Help If You Have Arthritis
Excess weight can make inflammatory arthritis even worse. This advice can help you shed unwanted pounds and make your joints feel better too. Read More
Does Obesity Cause Arthritis? The Facts Arthritis Patients Must Know
The conversation around obesity and arthritis is complicated. Here’s what rheumatologists and weight loss experts want you to know. Read More
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
GLP-1 Drugs Reduce Rheumatoid Arthritis Symptoms, Study Suggests
Patients with rheumatoid arthritis who used GLP-1 receptor agonists had less disease activity and improved cardiovascular biomarkers, a small retrospective study indicated. Read More
Helpful Links
Obesity Canada
24-Hour Movement Guidelines
Just One Move
I START Tool
Canada’s Food Guide
OsteoArthritis Service Integration System (OASIS)
2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis
HealthLink BC 8-1-1 Services
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Arthritis & Mental Health Survey
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