While weight loss in an obese person can improve psoriatic arthritis, what about enough to achieve a low body fat percentage?

When people hear “low body fat percentage,” they may mistakenly think that this necessarily means a stick-thin body.

However, a 5’9 man who weighs 180 pounds could actually have a low body fat percentage.

Over 40 percent of people with psoriatic arthritis are obese – meaning, at least 20 percent over their ideal weight range for their gender and height.

Suppose a woman of 5’5 weighs 200 pounds and has PsA. She’s obese at this weight.

If she loses 40 pounds via cutting back on processed foods and large portions, this should improve the autoimmune disease’s symptoms.

But what if she decides to get down to 125 pounds – not by severe caloric restriction but by creating a metabolic furnace through building lean muscle from strength training?

Since her first phase of weight loss, the 40 pounds, has relieved joint pain, she can now take up lifting weights.

She might end up with a low body fat percentage of, say, 15 percent, which is in the “athletic” range.


With lean muscle mass built up from strength training, she’ll have the look of a “gym body” rather than a scrawny body.

Though this change would provide many other health benefits such as increased bone density and a higher resistance to type 2 diabetes, would it also provide additional benefit to her PsA?

“My deduction is that the more fat is lost, the better,” says Stella Bard, MD, a board certified rheumatologist with 20+ years of experience.

“My reasoning is as follows: Obesity is defined as an excessive accumulation of fat.

“Obesity is not only a risk factor to develop PsA but also a result of having PsA; people are unable to exercise when their joints are swollen or hurting.

“Fat cells have been shown to drive inflammation, by releasing pro-inflammatory mediators (Il-6 and TNFalpha).

“So having less fat cells around to release these inflammatory mediators allows for decreased levels of inflammation and disease activity.

“Patients with a higher BMI are less likely to reach minimal disease activity.

“Reducing weight has been shown not only to decrease disease activity but also diabetes, hypertension and coronary artery disease, so it actually extends the lifespan.

“Having a higher (BMI) is a risk factor for developing PsA — and not only increases disease activity but also response to treatments, (DMARDs) and TNFi.”

But remember, this isn’t about getting as skinny as possible. That 5’9, 180 pound man may actually have a much lower body fat percentage than another 5’9 man who weighs 165.

A “skinny fat” man may have a higher body fat percentage than a heavier-weight man of the same height but with more lean muscle mass. Sean S/Unsplash

It’s about body composition, too. Increasing lean muscle mass will raise one’s resting metabolic rate, creating the so-called metabolic furnace.

The weight on the scale may not drop much, but a body fat analysis will show a reduction in body fat and an increase in lean muscle.

A body fat test can be given at a gym by a personal trainer using a skin-fold caliper tool.

Dr. Bard is an ABMS board certified rheumatologist with 20+ years’ experience. Rheumatologists often deal with whole-body problems due to the diseases they treat; patients find solutions to problems they didn’t originally come in for such as body aches and poor sleep. Dr. Bard uses cutting edge and natural remedies to achieve remarkable results with her patients.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer. 


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