Question:
Is Rheumatoid Arthritis considered a comorbidity?

I'm in the researching phase of my WLS journey. I signed up on my Surgeon's waiting list for consultations that is booked through the end of the year, which gives me a lot of time to research :). My BMI is 38 which is below the usual borderline of 40. Is Rheumatoid Arthritis considered a comorbidity? I've seen osteoarthritis on lists, but wasn't sure about RA. Thanks in advance for any info!    — Debbie P. (posted on July 25, 2003)

July 25, 2003
No, only osteoarthritis because of the stress the extra weight puts on your joints. RA is an autoimmune disease and is not caused by being overweight. Sorry.
   — cjabates

July 25, 2003
It depends on how severe the joint deformities are....I have RA and OA and was in need of a total knee replacement. The orthopedic surgeon and the rheumatologists said I was too heavy to have the replacement making WLS necessary. It was listed on my letter as a comorbidity, but since I had so MANY others I don't know how much pull the RA diagnosis had. ALso interesting is that my RA has pretty much been in remission since losing the weight....a pleasant surprise to everyone!
   — Linda 1.

July 25, 2003
This is actually in response to Amanda's response to your question. Though being overweight does not cause RA, it does indeed aggravate it. As a victim of juvenile RA and having been overweight since the age of 7, I can attest to this personally. Therefore, yes, I would certainly consider RA a comorbidity since the less weight that your joints have to carry, the greater your chances of reducing your pain when RA is active. On the same note, there are several problems that obese people endure that being overweight did not necessarily "cause", this however doesn't mean that losing weight would not help ease the symptoms and suffering of those problems.
   — Jennifer J.

July 25, 2003
I have RA, and the extra weight was making it worse. It mainly affected my knees at first but then my hips, ankles, and feet began to be involved. I am a nurse, and I could barely walk at the end of a 12-hour shift because of the pain. My primary doc and surgeon used my RA as a cormorbidity because of the joint pain. I also have sleep apnea (on CPAP, pressure of 13), and GERD. I was approved after the first letter. I had surgery 4 weeks ago, and I am down 32 pounds. It has helped my joint pain tremendously!!! My doc once told me that every extra pound on your body is like an extra 5 pounds on your joints. I would think that they would consider RA a cormorbidity because of the accompanying joint pain/problems and look at the fact that weight loss can help that. Good luck! I feel better now physically than I did before surgery!!
   — DebT

July 25, 2003
Don't count on WLS ending your arthritis. It may or may not. Thankfully it ending my joint pain (knees especially). But I still have my arthritis. Thankfully it is'nt bothering my knees anymore, but it has now spread into my shoulders, neck and as of this year in my hands and fingers. It is progressisly getting worse in my hands and fingers. Can't take those great acting pain meds like Vioxx, Arthrotec 50 or Celebrex anymore because of stomach pains (ulcer?). So I suffer with it. It may or may not be a co morbid, but do know, after wls you may get lucky and not suffer with it. Or you may be unlucky and have it spread.
   — Danmark

July 25, 2003
Thank you so much for your replies! Unfortunately I don't expect to ever not have RA. I'm 27 and was diagnosed at age 15 with total joint involvement and was experiencing symptoms since I was in grade 4-5.I've been on DMARD'S pretty much since my diagnosis. I'm confused as to some information I've seen. I've seen conflicting answers about asthma, too. Asthma is an autoimmune disease as well which is affected by extra weight and weight gain. Some consider it a comorbidity and others do not. I've seen conflicting evidence also as to what defines a comorbidity. Certainly Rheumatoid Arthritis is a more "morbid" disease than osteoarthritis because it involves organs and systems after it finishes attacking joints. I've seen some definitions that say that a comorbidity is anything that is worsened/aggravated by weight gain and then I've seen others that say a condition that is directly caused from weight gain. Guess I'll find out more when I have my consult! Thank you again for your responses. I appreciate your time and thoughts on the matter!
   — Debbie P.