Major weight loss doesn’t do much to ease gout in patients with obesity: study

A clinical trial conducted in Denmark suggests that weight loss doesn’t actually do much to ease symptoms of gout.This finding runs contrary to international guidelines that recommend weight loss and dietary interventions as strategies to manage gout in people with obesity. The evidence to support these guidelines “is sparse and largely observational,” wrote the authors of the study, which was published in Arthritis & Rheumatology.Gout is a common form of inflammatory arthritis in adults. People with gout typically experience elevated serum urate (SU) levels along with acute and chronic arthritis that causes pain and disability.They also tend to have comorbidities including obesity, hypertension, type 2 diabetes and dyslipidemia.Despite the availability of effective urate-lowering treatments (ULTs), existing strategies for managing gout remain “suboptimal,” the authors wrote.The clinical trial was conducted over 16 weeks, from Dec. 1, 2018 to June 1, 2019. A total of 61 adults with gout and obesity were split into either a “low-energy diet” group or a control group. The participants were overwhelmingly men (97%), with an average age of 60.3.The 29 participants in the diet group were assigned to an intensive, low-calorie diet that consisted of meal replacements, i.e. “ready-to-use meal bars and powders to mix for shakes, soups and porridges.”The 32 participants in the other group were assigned a “control diet” and were given basic nutritional advice.By the end of the trial, the people in the intensive diet group had lost more weight (34 pounds on average) than those in the control group (17 pounds on average).Weight loss was associated with a reduction in serum urate levels, but the discrepancy between the two groups was “not statistically significant.” Patients in the intensive diet group had an SU change of −0.6 mg/dL on average, versus −0.3 mg/dL on average within the control group.Further, there were no significant differences between the two groups when it came to gout symptoms including pain, fatigue and flare-ups, which were measured by means of questionnaires and self-reports.“An intensive dietary intervention was safe and effectively lowered body weight in people with obesity and gout, but the weight loss did not directly translate into effects on SU level, fatigue and pain,” the study declared.The limitations of the trial include a “risk of some selection bias,” the authors noted. The participants had to accept being on an intensive diet and therefore “were more likely to lose weight compared to the average gout population.” Thus, many participants in the control group ended up losing “an impressive amount of weight.”“This made the study deviate from our intended trial aim, comparing a substantial weight loss with little or no weight loss, and hence may have blurred the effects of weight loss on clinical outcomes,” the authors wrote.

Major weight loss doesn’t do much to ease gout in patients with obesity: study

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