Bariatric surgery is recognized for improving obesity-related comorbidities such as diabetes, hypertension, sleep apnea, and cardiovascular disease. Weight loss following bariatric surgery also improves arthritis symptoms and mobility.

Evidence suggests that as body mass index (BMI) increases, the chance of developing osteoarthritis increases as well. Weight loss is among the initial non-pharmacological recommendations for several painful arthritic diseases, particularly knee osteoarthritis. However, maintaining weight loss over the long term is challenging, especially if patients have pain and their movement is limited.

In a new study of positive outcomes following bariatric surgery, arthritis was one of the comorbidities that improved with weight loss following surgery. In this study, patients who had a BMI of 40 kg/m2 or less before surgery were more likely to reduce their weight to a BMI of 30 kg/m2 or less one year later and experience remission with their comorbid conditions.

The study reviewed the records of 27,320 adults undergoing bariatric surgery in hospitals within the Michigan collaborative between June 2006 and May 2015. One year after surgery, patients’ mean BMI was reduced from 48 kg/m2 preoperatively, to 33 kg/m2. Arthritis was among the comorbidities that showed improvement following bariatric surgery, indicating that weight loss has a positive effect.

“The effects of weight loss on arthritis were not evaluated specifically in this study; however, there are clear benefits to weight loss among patients with arthritis pain,” Oliver A. Varban, MD, lead author of the study, told Practical Pain Management. “Our study demonstrates that offering bariatric surgery as a first-line treatment of obesity is more likely to generate the best results and allow patients to achieve a BMI of 30 kg/m2 or less. This in turn allows for the maximal benefit for weight-related comorbid conditions, which may include arthritis.”

A subset of 9,713 patients (36%) achieved a BMI of less than 30 kg/m2 at 1 year, and their mean preoperative BMI was 42.7 kg/m2. These patients were significantly more likely to discontinue medications for hyperlipidemia, diabetes, and hypertension and to experience sleep apnea remission.

Weight Loss of 10% Reduces Arthritis Symptoms

Bariatric procedures included laparoscopic or open Roux-en-Y gastric bypass (RYGB) in 44%, laparoscopic sleeve gastrectomy (LSG) in 38%, laparoscopic adjustable gastric banding (LAGB) in 16%, and biliopancreatic diversion with duodenal switch (BPD/DS) in 1%. Patients who underwent the metabolic procedures LSG, RYGB, and BPD/DS were more likely to achieve BMI < 30 kg/m2 compared with those who had LAGB, a purely restrictive procedure. Among this group, 57% received RYGB.

Dr. Sunil Sharma is specialised in treating obese patients for the last 10 years in Jacksonville, Florida.

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