(HealthDay News) — Weight loss is a strong predictor of mortality in patients with rheumatoid arthritis, according to a study published in Arthritis & Rheumatology.

Joshua F. Baker, MD, from the Philadelphia Veterans Affairs (VA) Medical Center, and colleagues identified 1,674 patients with rheumatoid arthritis from the VA Rheumatoid Arthritis Registry and analyzed their medical records to identify BMI at each study visit, as well as date of death, if applicable.

The researchers noted 312 deaths over 9,183 person-years. After adjusting for demographics, comorbidities, BMI, smoking and rheumatoid arhthritis therapies, a loss in BMI of at least 1 kg/m² was associated with a greater risk for death (HR=1.99; P<.001). 

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After adjusting for C-reactive protein and physical function, this association remained significant (HR=1.81; P<.001). The greatest risk for death was seen in patients with weight loss at an annualized rate of ≥3 kg/m² (HR=2.49; P<.001). 

Low BMI (<20 kg/m²) in patients with a history of obesity (>30 kg/m²) was also associated with a greater risk for death (HR=8.52; P<.001).

“These observations may explain the observed obesity paradox and do not support a biologically protective role of obesity,” the researchers wrote.


  1. Baker JF et al. Arthritis Rheumatol. 2015;67(7):1711-1717.