Expert Q&A: RA and Weight Loss

Question: What should I do if my doctor thinks I'm underweight?

Answer: Being underweight can certainly be a problem for people with RA. The same pro-inflammatory cytokines, such as TNF, that damage the joint tissue in people with RA can also lead to weight loss, muscle wasting and weakness. This condition, referred to as rheumatoid cachexia, is typically seen in those with severe disease, frequently smokers, and is linked to increased infections, osteoporosis and poorer functional abilities. If your doctor has prescribed a TNF inhibitor to control your RA, that may also help you rebuild muscle and gain weight. Other things you can do include consuming a healthy balanced diet, not smoking (if you do) and beginning a regular exercise plan, focusing on resistance exercises using weights or resistance machines to build muscle. Your doctor or physical therapist can recommend a specific exercise plan that will be helpful for building muscle without being hard on your joints.

Susan Goodman, MD

Rheumatologist

Hospital for Special Surgery, New York