Importance of Weight Loss For Patients of Gout

How Weight Loss Can Improve Your Gout

It’s not a big revelation that being obese or being above your ideal weight can cause you a lot of health problems. Of course, that includes gout. When I got my first gout attack I weighed 240 pounds. This is about 45 pounds overweight from my ideal weight as per my doctor.

I had what is called central obesity, basically carrying weight around my middle, having a pot belly if you prefer.

Uric acid levels in the blood can be reduced simply by losing weight. It can also help prevent hyperuricemia and minimize the number of gout attacks. If you have gout and are overweight, losing weight using whatever method you like is a no-brainer.

In addition, weight loss will also help relieve your joints (knees, feet, hips, ankles, etc…) by reducing the stress from excessive weight, avoiding pain in those joints.

Gout and Weight Loss

Gout is a painful and debilitating inflammatory disease that worsens over time. Hyperuricemia (sUA >6.8 mg/dL) is caused by factors that raise serum uric acid levels (sUA). MSU crystal deposits can build in your joints and soft tissues if your sUA levels remain high. You also increase your chances of developing acute and chronic inflammation.

Hyperuricemia and gout have become more common in recent decades. This is due to an aging population, changes in lifestyle and food, and an increase in gout-related comorbidities.

Chronic gout can cause chronic inflammation and a higher incidence of flare-ups. It can lead to the creation of tophi and structural joint damage if left untreated or poorly treated.

Even when patients are asymptomatic, data shows that continuous inflammation and resultant damage occur both locally and systemically.

Backing up the effect of weight loss for gout with hard data

The effectiveness of weight loss in treating gout symptoms has always been a source of debate. On the surface, it appears that being more physically fit has health benefits, including protection against gout.

The extent of the effect of weight loss on gout had not been examined in a systematic review until recently.

The Annals of Rheumatic Disease published one such systematic review. The goal of the study was to determine the benefits and drawbacks of weight loss in gout patients who were overweight or obese.

Researchers searched six databases for longitudinal studies on the effects of weight loss in overweight/obese gout patients for the review. A longitudinal study is a type of study in which the same variables are observed repeatedly over a short or long period of time.

The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to assess the quality of evidence. The GRADE method is a system for evaluating the certainty of evidence and the robustness of health-care recommendations.

Ten studies were chosen from 3991 potentially eligible studies (including one randomized trial). Diet with or without physical activity, bariatric surgery, diuretics, metformin, or no intervention were all options.

In conclusion, six of the eight studies found that it was beneficial to gout attacks. Almost all studies found that losing weight was beneficial.

Long-term gout treatments

The goal of long-term gout treatment is to lower sUA levels to less than 6 mg/dL. This is below the MSU saturation point of 6.8 mg/dL. These levels would help inhibit new crystal formation and promote dissolution of existing crystals.

Gout treatment should improve disease outcomes by reducing flare-ups. Treatments aid in the long-term resolution of tophi as well as the more effective treatment of comorbidities. These comorbidities are frequently linked to hyperuricemia.

However, people are rarely able to effectively manage their gout symptoms. Much of this is due to a failure to collaborate with a physician and, even more importantly, to adhere to their treatment protocols.

What effect does diet have on gout?

Gout is a type of arthritis characterized by elevated uric acid levels in the blood. Uric acid levels that are too high can cause crystals to form in the joints, causing pain and swelling.

Uric acid is a natural waste product formed during the breakdown of food, specifically compounds known as purines. It is thought that lowering uric acid levels through small dietary changes may help reduce the likelihood of future gout attacks.

There are a lot of myths out there concerning diet and gout. Foods like citrus fruits, for example, are widely assumed to trigger gout. There is no evidence to support this claim.

Gout sufferers, on the other hand, have been shown in multiple studies to be more likely to consume particular foods. Purines, a chemical that can be converted to uric acid in the body, are abundant in these foods. Purine-rich foods include the following:

● Meat — Red meat and offal, such as liver, kidneys, and heart, in particular.

● Seafood — Shellfish, scallops, mussels, herring, mackerel, sardines, and anchovies, in particular.

● Foods containing yeast — Vegemite and beer, for example.

Should I avoid foods high in purine?

There is little scientific evidence that avoiding the purine-rich foods listed above can effectively reduce gout attacks. You may be missing out on important nutrients and vitamins if you eliminate these foods entirely from your diet.

If you notice that certain foods trigger your gout attacks, you may benefit from reducing your intake of those foods. However, it is believed that not all purine-rich foods cause gout.

A number of vegetables, for example (asparagus, mushrooms, cauliflower, and spinach), are high in purines but appear to be less likely to cause gout than diets high in meat and shellfish.

Dairy products, which can contain purines, appear to reduce the risk of gout. A healthy balanced diet, along with uric acid-lowering medications, is all that is required for the majority of people with gout.

Most people who take uric acid-lowering medications find that if they eat purine-rich foods in moderation, they can avoid gout attacks.

Is fructose a gout trigger?

Fruits and vegetables contain fructose, which is a sugar. It’s also high in corn syrup-sweetened items including bread, cereal, soft drinks (but not Australian-made soft drinks) and fruit juices.

Gout was shown to be more common in men who drank five to six servings of fructose-sweetened soft drinks per week, according to an American study. However, there is no evidence that fructose is the cause of gout. It may be helpful to your general health to reduce the amount of food artificially sweetened with high fructose corn syrup.

Natural fructose in fruits and vegetables, on the other hand, has a variety of health benefits and should not be fully ignored without consulting a doctor or dietician.

What diet should I follow in order to lose weight?

If you are determined to lose weight, it is important that you avoid crash dieting at all costs. Losing weight too quickly may increase the risk of gout. Especially if you go hungry for long periods of time. You begin to metabolize body tissues as you lose weight. This increases the number of purines the body needs to cope with, causing uric acid levels to rise.

The key to a good gout diet is to exclude any highly processed foods and beverages. That’s why eating a well-balanced diet is so important in the fight against gout.

A gout-friendly diet should include plenty of fruits and vegetables, reduced meat intake, whole wheat bread, and whole-wheat cereals. You can also include moderate amounts of dairy products, plenty of water, and very little, if any, alcohol.

This will help you control your weight and provide you with all the necessary nutrients required for you to fight this disease.

What does the scientific community have to say about weight loss and gout?

A study by famous gout researcher Hyon K. Choi from Massachusetts General Hospital concluded that the more weight men gained, the higher their risk of developing gout. He came up with these important conclusions after studying 47 150 middle-aged men for a period of 12 years.

Those who did lose weight, on the other hand, had a considerably lower risk of gout. Particularly when they lost more than 10 pounds, which reduced their risk by 40%. Choi also concluded that regardless of their diet, men who gained weight would get gout more often.

The Body Mass Index (BMI) has also been linked to the risk of gout in studies. Gout is more than twice as likely to occur in overweight males with a BMI of at least 25. Obese males are three times more likely to develop it!

BMI was known to have a strong relationship with serum uric acid. Weight loss was commonly advised, but no systematic review had been conducted at the time.

Another short pilot trial on gout and weight loss was conducted with 13 gout patients. All 13 gout patients who experience gout flare-ups at least once a month. After lowering weight through diet, only one patient had less than one gout attack per month after a few months.

Yet another study conducted at the University of Auckland in New Zealand also suggests that gout patients who are obese may benefit from bariatric surgery. Controlling uric acid crystallization in the joints, according to the study, can help prevent gout attacks. In addition, losing weight helps to reduce inflammation.

Weight loss may allow the uric acid in the fatty deposits inside the body to leave or excrete in a consistent manner. If you have a gout attack or swelling in any of your joints, it will help diminish those effects. This is due to the fact there will be fewer fatty deposits in your joints, knees, toes, feet, etc…

If you plan on losing weight, make sure you are losing 1–2 pounds a week and not more. This can help you avoid increasing your uric acid levels abruptly causing a painful gout attack. So tread carefully and do it right!

If you don’t have gout, make sure to maintain a healthy weight in order to avoid getting it. Weight loss is not the only answer when it comes to controlling your gout. However, it is a big piece in the overall pie, that’s for sure.

Remember to begin with small changes. In the beginning, make sure you are losing only 1–2 pounds a week in order to avoid a gout attack. As you progress, keep eliminating whatever foods that are bad for you. Your healthier choices will eventually help you move towards your ideal weight.

Don’t forget to include your doctor’s advice when planning your diet, even consulting with a dietitian can do wonders.

Weight loss surgery

Obesity is a known risk factor for developing gout. It may also result in recurrent gout attacks. Many doctors recommend weight loss programs to gout patients who are overweight or obese.

The problem, however, is that most gout sufferers find losing weight just by diet and exercise challenging if not impossible to do. Their feet can get very swollen during a gout episode, making simple things like walking difficult, much less exercise.

Thankfully, recent clinical data shows a positive link between gout and weight loss surgery which is giving gout sufferers renewed hope to battle this painful condition. In fact, gout and weight loss surgery are increasingly going hand in hand.

As a result, gout and weight loss surgery are topics worth discussing with your doctor. There are many options for gout patients who are looking to lose weight. These include bariatric surgery such as LAP-BAND, gastric bypass, or gastric sleeve surgery.

Bariatric surgery

The most successful treatment method for severe obesity and accompanying comorbidities is bariatric surgery. Early postoperative gout attacks, on the other hand, are substantially more likely in bariatric surgery patients than in individuals undergoing other procedures.

Bariatric patients have been documented to see an increase in gout attacks in the short term. As previously stated, rapid weight loss is known to cause uric acid buildup. As a result, it appears that following bariatric surgery, a very low-calorie diet and rapid weight loss trigger gout attacks.

Over the long term, however, bariatric surgery has been demonstrated to help reduce the risk of gout flares by up to 40%. Needless to say, these kinds of results could easily be considered a dream come true for longtime gout sufferers.

Here are some of the most popular bariatric procedures:

Gastric Sleeve Surgery

This is currently the most popular weight loss procedure, resulting in rapid and dramatic weight loss. Laparoscopic Surgery sleeve gastrectomy, commonly called the sleeve, involves the removal of around 80 percent of the stomach.

Here are some of the advantages of this life-changing surgery:

● Overall, the quality of living has improved.

● Within one year of surgery, patients lost an average of 60–70 percent of their body weight.

● Obesity-related health disorders such as diabetes mellitus type II, hypertension, sleep apnea, fatty liver disease, joint discomfort, and hyperlipidemia remission or improvement.

● The desire to eat lessens.

● Hunger sensation is reduced.

What is the procedure for gastric sleeve surgery?

● The stomach volume is reduced, causing people to feel full considerably faster following surgery.

● People feel less hungry as a result of hormonal changes such as lower hunger hormone output.

● After surgery, increased stomach motility helps food to flow through the stomach and intestine more quickly.

Although the gastric sleeve is now considered a relatively safe bariatric surgical procedure, complications can still occur during and after the procedure.

● Leakage from the staple line is a common side effect of gastric sleeve surgery. Following surgery, the stable line is opened. The majority of leaks can be treated with an endoscopic procedure.

● Stricture/stenosis — a rare complication characterized by stomach narrowing following a sleeve gastrectomy. Endoscopic dilation can be used to treat the majority of strictures and stenosis.

● Bleeding.

● Blood clot.

● Heartburn.

Gastric Bypass

During gastric bypass surgery, your doctor alters the way your stomach and small intestine absorb and digest food.

The stomach is divided into a small upper pouch and a much bigger bottom “remnant” pouch, and the small intestine is then rearranged to connect to both. The stomach is a banana-shaped tubular pouch.

The following are some of the ways that gastric bypass can help you lose weight:

● Limiting the amount of food you can eat in one sitting.

● Limiting the number of calories and nutrients absorbed by your body.

● Changing your gut hormones, which help you feel fuller for longer, can help you lose weight and reverse metabolic syndrome caused by obesity.

The following are some of the benefits of gastric bypass surgery:

● Short-term weight loss is excellent (60 to 80 percent excess weight loss).

● Long-term, long-lasting results. Most patients retain more than 50% of their excess weight loss up to 20 years after surgery, according to the statistics.

● Obesity-related health issues are effectively resolved.

While it offers numerous advantages, it may also have the following drawbacks:

● The complication rate is slightly higher than with a sleeve gastrectomy in the long run. However, complications can be prevented with adequate care.

● After surgery, patients are not allowed to use aspirin or other NSAIDS.

● After surgery, all patients must take vitamins for the rest of their lives. If they don’t, long-term vitamin/mineral deficiencies, particularly in vitamin B12, iron, calcium, and folate, could result.

Gastric Banding

Gastric banding is a type of weight-loss surgery that involves the placement of a silicone band around the top of the stomach to reduce stomach size and food intake. The operation is referred to as LAGB (laparoscopic adjustable gastric banding).

The band is wrapped around the top region of the stomach, and a tube is attached to it. A port under the skin of the abdomen allows access to the tube.

The Food and Drug Administration has approved it for use as a weight loss treatmentTrusted Source (FDA).

LAGB reduces the size of the stomach and the amount of food it can hold in the end. It also delays food digestion in the intestine. As a result, signals from the gut to the brain allow for a feeling of fullness and satiety while consuming less food.

Food intake must be restricted for the first few days after surgery:

● The diet is restricted to water and fluids, such as thin soups, for the first several days.

● Liquids and blended foods, such as yogurt and puréed vegetables, can be consumed until the end of the four-week period.

● Soft meals are offered between the ages of 4 and 6 weeks.

● The client can resume a normal diet after 6 weeks.

The following are some of the benefits of laparoscopic gastric banding:

● Obese people may be able to lose weight in the long run.

● Recovery is relatively quick.

● After surgery, there is a lower risk of wound infections and hernias.

● Diabetes, high blood pressure, urine incontinence, and other obesity-related disorders are all reduced.

● There is no reduction in nutritional absorption.

● In many circumstances, surgery improves one’s quality of life.

The use of a gastric band comes with a number of dangers. The following are some of them:

● Anesthesia can cause allergic reactions, breathing difficulties, blood clots in the legs that might spread to the lungs (pulmonary embolism), blood loss, infection, and heart attack or stroke during or after surgery in some patients.

● When compared to other forms of surgery, weight loss may be slower.

● The band may slip, have mechanical issues, or erode into the stomach, necessitating removal.

● The port may shift, necessitating extra surgery. It is estimated that 15 to 60% of people will require further surgery.

Previously, guidelines recommended gastric band placement only if a person’s BMI was 35 or higher. If they had other obesity-related problems, such as diabetes, hypertension, or sleep apnea, some people with a BMI of 30–34.9 underwent surgery. This was due to the high possibility of complications.

However, advances in surgical techniques have improved the procedure’s safety record, and this recommendation is no longer in effect.

Weight Loss Surgery Results That Are Promising

Many obesity-related disorders and health problems can be reduced, resolved, or cured with weight loss surgery. Although there is no cure for gout, weight loss surgery has also been shown to be effective for diet-related disorders, including gout.

This expands the therapeutic possibilities for serious medical conditions. The findings suggest that for those who suffer from both obesity and gout, bariatric surgery may be worth considering.

The potential of bariatric surgery to treat gout attacks is not surprising given the well-established association between diet and gout.

Obese people have a hard time managing their food appetites and are more likely to experience recurring gout attacks. In these cases, weight loss surgery may be a viable option for maintaining consistent and efficient gout control.

Weight loss is indicated for overweight/obese gout patients. Patients having poor, moderate, and low quality evidence for sUA, achieving sUA target, and gout attacks, respectively.

Negative consequences may occur in the short term. Because the current evidence is based on a small number of low-quality research, it is inconclusive (mostly observational). More rigorous prospective research (ideally randomized controlled trials) are now being conducted.

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Disclaimer: This article is intended for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional for any health concerns.