Weight Loss Intervention Improved Health-Related QoL in People With and Without PsA

A structured weight loss intervention improved health-related quality of life (HRQoL) in people with psoriatic arthritis (PsA) as well as other outcomes in patients and controls.1

“Obesity is common in PsA and adversely affects HRQoL, anxiety and depression. Weight loss in obese patients with psoriasis (PsO) has been demonstrated to improve HRQoL.2 However, the effect of weight loss on HRQoL in PsA is to our knowledge largely unexplored, although we have previously reported on positive effects on disease activity in the rheumatic disease and on summary physical aspects of HRQoL and on the health assessment questionnaire (HAQ) twelve months after a structured weight loss intervention with very low energy diet (VLED) in patients with PsA and obesity and matched controls,” lead investigator Anton J. Landgren, MD, from the department of rheumatology and inflammation research, institute of medicine, Sahlgrenska Academy at University of Gothenburg in Sweden, and colleagues wrote.1

This interventional weight loss study enrolled 39 patients with PsA between 25 and 75 years of age, with body mass index (BMI) of at least 33 kg/m2 and 39 matched control participants with obesity (who were already planned for very low energy diet [VLED] treatment). Participants completed a weight loss intervention with a VLED diet for 12 or 16 weeks depending on baseline BMI (< 40 or ≥ 40 kg/m2). They completed the 36-item short-form health survey (SF-36) to assess HRQoL and the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression at baseline, month 3 (M3), M6 and M12.

Landgren and colleagues found that participants with PsA had physical HRQoL improve, as seen on the physical component summary (PCS) of SF-36, from a median of 34 (IQR, 25-45) at baseline to 43 (IQR, 34-50) at M12 (P = .009). They did not see any significant effects on mental HRQoL as seen on the mental component summary (MCS) score. In controls with obesity, PCS also significantly improved from a median of 44 (IQR, 36–50) at baseline to 52 (IQR, 44–55) at M12 (P <.001), with no significant improvement seen in MCS. Anxiety and depression decreased significantly in both PsA patients and controls.1

Although baseline levels were already low, anxiety did significantly decrease in both participants with PsA from a median of 3 (IQR, 1-7) at baseline to 2 (IQR, 1.7-5; P = .045), and controls from 5 (IQR, 2-8) to 2 (IQR, 1-5; P = .002) as measured on HADS. Similarly, depression significantly decreased in both participants with PsA, from a median of 2 (IQR, 1-7) to 1 (IQR, 1-4; P = .045), and controls from 3 (IQR, 1.3-5.8) to 2 (IQR, 0.3-3.8; P = .002).1

“In this study, we show positive effects of weight loss on physical HRQoL, anxiety, depression, and fatigue in patients with PsA and obesity and matched controls,” Landgren and colleagues wrote.1 “While limited by a small sample size, this study shows the positive effects on HRQoL that can be achieved by weight loss and support for physical activity in obese PsA patients.”

REFERENCES

1. Landgren AJ, Bilberg A, Eliasson J, et al. Health-related quality of life significantly improved in obese patients with psoriatic arthritis one year after a structured weight loss intervention. Adv Rheumatol. 2025; 65(13). doi: 10.1186/s42358-025-00444-9

2. Farias MM, Achurra P, Boza C, Vega A, de la Cruz C. Psoriasis following bariatric surgery: clinical evolution and impact on quality of life on 10 patients. Obes Surg. 2012;22(6):877–80.