Obesity has long been associated with a myriad of health concerns, and a recent prospective cohort study conducted by Lars Alfredsson, PhD, of the Karolinska Institute in Stockholm, Sweden, has shed light on the link between obesity and multiple sclerosis (MS) progression. The findings presented at the ACTRIMS Forum 2024 indicate that obesity in MS patients is not just a matter of physical appearance, but it may also have a significant impact on disability, quality of life, and cognitive decline.
One of the key findings of the study was the association between obesity and faster worsening of disability in MS patients. Specifically, compared to normal weight individuals, those with obesity experienced a faster increase in scores on the Expanded Disability Status Scale (EDSS). This scale, ranging from 0-10, reflects the levels of disability in MS patients, with higher scores indicating greater disability. The study revealed that MS patients with obesity had a 41% higher risk of reaching EDSS 3 and a 31% higher risk of reaching EDSS 4, highlighting the detrimental impact of obesity on disability progression in MS.
In addition to disability progression, the study also found that obesity was associated with a higher risk of declining physical, psychological, and cognitive quality of life in MS patients. Patients with obesity had a 40% higher risk of worsening physical quality of life, a 24% higher risk of psychological quality of life decline, and a 47% higher risk of cognitive disability worsening. These findings emphasize the comprehensive impact of obesity on various aspects of MS patients’ well-being, beyond just physical disability.
Given the significant implications of obesity on MS progression and quality of life, lifestyle interventions have been highlighted as a potential strategy to mitigate these risks. Dr. Robert Bermel of the Cleveland Clinic in Ohio suggested that weight loss can be recommended as a lifestyle intervention for obese MS patients, in addition to standard disease-modifying therapy. Moreover, the study mentioned the potential therapeutic benefits of GLP-1 agonists for weight loss in MS patients, indicating the importance of exploring novel treatment approaches in this population.
The study’s findings underscore the need for healthcare providers to consider the impact of obesity on MS progression and to incorporate lifestyle interventions into the management of MS patients. Recommending weight loss strategies and regular monitoring of BMI may help to address the increased risks associated with obesity in MS. Furthermore, further research on the mechanisms underlying the link between obesity and MS progression is warranted to develop more targeted and effective interventions for this patient population.
Obesity is not just a cosmetic concern but a significant risk factor for faster disability progression, decline in quality of life, and cognitive impairment in MS patients. The findings of the study by Lars Alfredsson and colleagues highlight the importance of addressing obesity as a modifiable risk factor in the care of MS patients. By implementing lifestyle interventions and exploring novel therapeutic approaches, healthcare providers can strive to improve outcomes and quality of life for individuals living with MS.
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