Obesity is a significant health concern worldwide, with numerous associated risks and complications. Recent research has highlighted a potential link between obesity and the progression of multiple sclerosis (MS). A prospective cohort study conducted by Lars Alfredsson, PhD, at the Karolinska Institute in Stockholm, Sweden, presented findings at the ACTRIMS Forum 2024, shedding light on the detrimental effects of obesity on individuals with MS.
The study revealed a concerning association between obesity and faster worsening of disability in MS patients. Compared to normal weight individuals, those with obesity showed a faster increase in scores on the Expanded Disability Status Scale (EDSS), indicating greater disability. The risk of reaching EDSS 3 was 41% higher in MS patients with obesity, and the risk of reaching EDSS 4 was 31% higher. These findings suggest that obesity contributes to the accelerated progression of disability in individuals with MS.
In addition to disability progression, obesity was also linked to a decline in physical, psychological, and cognitive quality of life in MS patients. Those with obesity experienced an increased risk of self-reported physical and psychological quality of life decline. Furthermore, cognitive disability worsening was more pronounced in individuals with obesity. These findings underscore the broad-ranging negative effects of obesity on the overall well-being of individuals living with MS.
The study results have significant implications for the management of MS in individuals with obesity. Dr. Robert Bermel, from the Cleveland Clinic in Ohio, suggested that weight loss should be recommended as a lifestyle intervention for obese patients with MS, in addition to standard disease-modifying therapy. Lifestyle modifications, including healthy eating habits and regular exercise, may help mitigate the negative impact of obesity on MS progression. Additionally, the potential use of GLP-1 agonists for therapeutic weight loss in MS patients warrants further investigation.
While obesity was strongly associated with disability progression in MS patients, the impact of being overweight was less pronounced. However, individuals categorized as overweight still faced increased risks of reaching disability milestones, as well as experiencing physical, psychological, and cognitive decline. The findings suggest that maintaining a healthy weight is vital for optimizing outcomes in individuals with MS.
The study had certain limitations, including the use of self-reported data on BMI and potential confounding factors that were not accounted for. As BMI alone may not provide a comprehensive assessment of body composition, future research should explore other measures of obesity and their impact on MS progression. Longitudinal studies with larger sample sizes are needed to confirm the findings and investigate potential interventions to mitigate the negative effects of obesity in individuals with MS.
Obesity has been shown to have a detrimental impact on the progression of disability and quality of life in individuals with multiple sclerosis. The findings underscore the importance of addressing obesity as part of a comprehensive treatment approach for individuals with MS. Lifestyle interventions, including weight loss and healthy living, may help improve outcomes and overall well-being in individuals with MS. Further research is needed to explore the mechanisms underlying the relationship between obesity and MS progression and to develop targeted interventions to address this critical issue.