Obesity is never healthy, and that may be especially true for people who also develop multiple sclerosis.
Obese people with MS are likely to see the disability linked to the disease rapidly worsen, according to German researchers who followed more than 1,000 patients in a new study.
Weight loss, they suggest, might help slow the progression of the disease.
The link between obesity and MS
MS is an autoimmune disease that affects the central nervous system. It can cause permanent disability or even death, and there is no cure. Symptoms usually start in the 30s or 40s.
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"The findings from this study raise important questions about the role of elevated BMI (body mass index) on mechanisms that drive neurologic disability in MS," says Dr. Fiona Costello, a professor of neurology at the Cumming School of Medicine at the University of Calgary in Canada.
Obesity correlates with a higher risk of developing MS, she adds. "What has not been clear is how obesity is linked to disease severity and disability progression in individuals with MS. But a large body of published literature has shown that deleterious disease associations with obesity are not unique to MS."
Obesity already has been linked to an increased risk of heart disease and type 2 diabetes, as well as cognitive impairment and dementia, Costello notes.
This study can't prove that obesity speeds up greater disability in patients with MS, only that the two seem to be connected, the researchers note.
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How obesity impacts MS patients
Obesity can impact MS patients in the following ways:
- Disability. People with MS who are overweight are more likely to have higher scores on a EDSS assessment of disability This can reduce mobility and make it can be harder to get effective exercise.
- Bladder problems. Being overweight can cause bladder problems. Excess weight puts pressure on your pelvic floor and can result in stress incontinence.
- Pain can also be made worse by obesity. If your pain has a musculoskeletal cause, then losing weight may help relieve stress on your body. Losing weight has been shown to reduce pain symptoms in MS, including nerve pain.
- Mood and emotions. Feelings of shame, stigma or worthlessness surrounding your weight can make it hard to feel positive about life with MS, and hard to stick to healthy habits. The good news, however, is that with support and making healthier lifestyle choices, you may find your general outlook improving.
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Weight loss can help
Still, "obtaining a normal weight is likely beneficial for people with MS," says Dr. Asaff Harel, director of the multiple sclerosis center at Lenox Hill Hospital in New York City. He played no role in the research.
The study team was led by Dr. Jan Lunemann, a professor of neurology at the University of Munster. The researchers collected data on 1,066 patients with relapsing-remitting MS who took part in a German nationwide MS study.
When their MS was diagnosed, 15% of the patients were obese, meaning they had a BMI of 30 or higher. Almost 7% also suffered from type 2 diabetes or high blood pressure -- conditions linked to obesity. The researchers checked participants' disability levels every two years over six years.
Although obese patients didn't have a greater relapse rate or more nerve damage over the course of the study, they had greater disability at the time of diagnosis. And their levels of disability grew faster than those of people who weren't obese, the researchers found.
Obese patients reached a higher level on the Expanded Disability Status Scale in just under 12 months, compared with nearly 18 months for those who weren't obese. Patients with obesity were also more than twice as likely to reach this higher level of disability within six years, regardless of which drugs they were treated with, the researchers found.
Patients who were overweight but not obese did not face a higher risk of disability. "Our finding that obesity, but not overweight in MS patients, is associated with a poorer outcome suggests a threshold effect of body mass on disability accumulation in MS," the researchers wrote.
"These data suggest that dedicated management of obesity should be explored for its potential merit in improving long-term clinical outcomes of patients diagnosed with MS," they add.
Weight management should be explored as a potentially modifiable risk factor for disability progression in MS patients, Costello says.
"It stands to reason for any individual with or without MS, working to achieve the best possible BMI will benefit their overall health, particularly since motor disability and cognitive decline, which independently co-associate with obesity, are challenges and concerns for people living with MS," she adds.
If you would like to reduce your weight, talk to your doctor about finding support for weight loss.
