Lupus is an autoimmune disease that causes inflammation throughout the body. It affects around 1.5 million Americans, mostly women. There is no cure for lupus, but treatment focuses on managing symptoms and reducing flares.
Losing weight could potentially help some people with lupus for several reasons:
Reducing inflammation
Being overweight or obese leads to increased inflammation throughout the body. Adipose tissue (fat) secretes hormones and cytokines that promote systemic inflammation. Losing weight reduces overall inflammation. Since lupus is an inflammatory condition, decreasing inflammation could improve symptoms.
Improving lupus symptoms
Carrying excess weight puts strain on the joints, which could worsen pain and swelling in people with lupus. Losing weight reduces pressure on the joints, potentially easing joint pain and swelling.
Obesity also contributes to fatigue and low energy levels. Shedding excess pounds can increase vitality and stamina.
Weight loss can also help other health conditions related to lupus. Obesity worsens conditions like high blood pressure, diabetes, and heart disease, which often accompany lupus.
Reducing medication doses
Some lupus medications, like corticosteroids, can cause weight gain as a side effect. This weight gain can worsen inflammation and symptoms, requiring higher medication doses, resulting in a vicious cycle. Losing weight may allow doctors to prescribe lower drug doses while still controlling lupus.
Research on weight loss and lupus
Several studies have looked at the impact of losing weight on lupus symptoms and markers:
Improved disease activity scores
A 2015 study had 10 obese women with lupus follow a 6-month supervised diet and exercise program. Participants lost an average of 5% of their body weight. The women experienced improvements in systemic lupus erythematosus disease activity index (SLEDAI) scores, indicating reduced disease activity.
Decreased inflammation
A 2016 study put overweight and obese adults with lupus on a 25-week diet and exercise program. Participants lost 8% of their body weight on average. The study found significant decreases in inflammatory markers like high-sensitivity CRP, leptin, and interleukin-6.
Better quality of life
A small 2012 study examined the effects of a 12-week diet combined with exercise program in 20 women with lupus. Participants lost an average of 5 pounds and reported improvements in physical function, pain levels, vitality, social function, and mental health scores.
Lower medication doses
A 2014 study looked at obese lupus patients who lost at least 5% of their body weight through diet and exercise. Around 20% of participants were able to reduce their corticosteroid dose, on average, by 20% while maintaining disease control.
How losing weight can help lupus
Weight loss may improve lupus through several mechanisms:
Reducing adipose tissue
Fat cells produce hormones and immune signaling proteins called adipokines. Some adipokines like leptin and cytokines directly promote inflammation. Trimming down fat mass decreases circulating levels of pro-inflammatory adipokines.
Correcting metabolic abnormalities
Obesity creates metabolic disorders like insulin resistance, hypertension, and dyslipidemia. These metabolic disturbances exacerbate inflammation and the autoimmune response. Weight loss can improve metabolic health.
Lowering mechanical stress
Carrying excess weight places extra mechanical stress and strain on the joints and bones, which may worsen pain, inflammation, and damage in people with lupus. Losing weight reduces this mechanical stress.
Increasing exercise capacity
Obesity contributes to poor cardiovascular fitness, low muscle strength, and reduced mobility. Weight loss coupled with exercise improves exercise capacity, which has broad benefits for health.
How much weight loss is needed to improve lupus?
Research suggests that losing even a modest amount of weight can benefit lupus:
– Losing just 5-10% of body weight may be enough to reduce inflammation, improve symptoms, and lower medication requirements. This amounts to 10-20 pounds for someone weighing 200 pounds.
– Studies show that losing more weight leads to greater improvements. But even smaller amounts of weight loss can make a difference.
– Larger weight loss above 10% of body weight may lead to substantial reductions in inflammation and disease activity scores.
– Losing enough weight to move from obese to overweight or overweight to normal weight offers optimal health benefits. However, any amount of weight loss appears helpful.
Best weight loss tips for lupus
Losing weight with lupus poses challenges due to fatigue, joint pain, and medication side effects. Here are some tips for safe, gradual weight loss:
Focus on mild calorie deficit
Cutting calories too severely can worsen fatigue. Aim for a modest daily calorie deficit of about 500 calories below your needs for 1-2 pounds per week of weight loss.
Lower simple carbs
Decreasing sugar, refined grains, and processed foods can help regulate blood sugar and insulin resistance while supporting weight loss.
Increase protein intake
Getting 0.5-1 gram of protein per pound of body weight preserves muscle mass when losing weight. Choose lean proteins like chicken, fish, beans, nuts, eggs, and low-fat dairy.
Prioritize exercise as tolerated
Build physical activity gradually, starting with short, gentle workouts to avoid flares. Try walking, water exercise, stretching, and strength training. Avoid high-impact activities.
Make dietary changes slowly
Gradual changes are easier to sustain long-term. Make small swaps, like switching from white to whole grain bread, choosing leaner proteins, and adding veggies to meals.
Allow occasional treats
The occasional slice of pizza or dessert won’t sabotage weight loss. Rigid restriction leads to binge eating. Satisfy cravings in moderation.
Get support from healthcare team
Ask your doctor to recommend a dietitian who understands lupus needs. A dietitian can provide meal plans tailored for your preferences and restrictions.
Safe rate of weight loss with lupus
Losing weight too quickly can be harmful with lupus. Very low calorie diets, extreme calorie restriction, and rapid weight loss can:
– Worsen fatigue and weakness
– Increase risk of gallstones
– Cause electrolyte imbalances
– Trigger lupus flares
– Lead to loss of muscle mass
A safe rate of weight loss for lupus patients is:
– 1-2 pounds per week
– Slow and steady
– Using mild calorie deficit of 500 calories/day
– With guidance from healthcare professionals
This gentle pace allows the body to adapt and promotes loss of fat mass while preserving muscle. Quick fixes and crash diets should be avoided. Gradual weight loss paired with exercise is optimal.
Foods to eat and avoid with lupus
While no specific “lupus diet” exists, some foods appear better tolerated than others:
Foods to eat more of:
– Fish high in omega-3s like salmon, tuna, mackerel
– Colorful fruits and vegetables
– Whole grains like oats, quinoa, brown rice
– Beans and lentils
– Nuts and seeds
– Olive oil
– Green tea
– Low-fat dairy
Foods to limit:
– Added sugars and refined carbs
– Saturated and trans fats
– Excess sodium
– Alcohol and caffeine
– Processed and fried foods
– High-mercury fish like swordfish
– Gluten, if sensitive or allergic
A balanced, unprocessed diet focused on anti-inflammatory foods may help manage lupus symptoms. Work with a dietitian to find the optimal eating pattern for your needs.
Exercise guidelines with lupus
Along with weight loss, regular exercise provides benefits like improved cardiovascular fitness, muscle strength, joint health, and mental well-being. Below are tips for safe, effective exercise with lupus:
Low-impact activities
Choose gentle workouts that minimize stress on the joints like walking, swimming, cycling, yoga, Pilates, and strength training with lighter weights.
Moderate intensity
Aim for moderate intensity where you can still hold a conversation during exercise. Vigorous activity may trigger flares. Build up slowly.
Listen to your body
If a workout significantly worsens fatigue, joint pain or other symptoms, take a break or decrease intensity. Adjust your regimen as needed.
Adequate rest and recovery
Balance exercise with rest days to avoid overtraining. Get enough sleep and allow proper recovery between workouts.
Gradual progression
Increase duration, frequency and intensity slowly over time. Sudden surges in exercise can exacerbate symptoms. Build fitness gradually.
Stay hydrated
Drink plenty of fluids before, during and after exercise to prevent dehydration which can worsen flares.
Sun protection
Use sunscreen and protective clothing since sun exposure can trigger rashes and flares. Schedule outdoor activities for early or late when UV exposure is lower.
Dealing with weight gain from lupus medications
Corticosteroids like prednisone frequently cause weight gain in lupus patients. Strategies to minimize this include:
Lower calorie intake
Create a 500 calorie per day deficit through diet to promote weight loss and offset medication effects. Reduce portion sizes of calorie-dense foods.
Choose low energy density foods
Fill up on foods like fruits, vegetables, lean proteins, whole grains and low-fat dairy which provide fewer calories per gram. Avoid fried and sugary foods.
Increase activity as tolerated
Add whatever exercise is possible within limitations to burn more calories. Even light activity counts.
Take calcium and vitamin D
These nutrients help prevent bone loss from steroids. Consult your doctor about supplements.
See a dietitian
Dietitians can provide meal plans and advice to manage weight, nutrition needs, and medication side effects.
Discuss medication adjustments
If significant weight gain occurs, talk to your doctor about adjusting steroid doses to minimize side effects. Never change dosages without medical supervision.
Managing expectations with weight loss and lupus
While weight loss may improve lupus, it’s important to have realistic expectations:
– Losing weight is not a cure for lupus and will not put the condition into remission. Medications and lifestyle management will still be needed.
– Symptoms may fluctuate regardless of weight due to the nature of the disease. Flares can still occur.
– Weight loss may need to be slow and steady to prevent triggering flares. Drastic drops are not advised. Patience is required.
– Some symptoms like joint damage may not improve with weight loss depending on severity.
– Other existing conditions like hypertension and diabetes may also need continued medication and management.
– Losing weight through fad diets may do more harm than good. Any program should be approved by your healthcare team.
– Work closely with your doctor and dietitian to set realistic goals and create a safe, sustainable plan.
Conclusion
Research shows that losing weight can benefit some people with lupus by decreasing inflammation, improving symptoms, enhancing quality of life, and potentially lowering medication doses. While not a cure, weight loss serves as a useful complement to the overall treatment plan. Losing just 5-10% of body weight may be enough to see results. Gradual weight loss coupled with gentle exercise, under medical guidance, is the safest approach for lupus patients. As with any chronic disease, setting reasonable expectations is important. But for many patients, losing some excess weight can be a worthwhile endeavor that improves disease management.
