Investigation of the effect of body weight management and cognitive exercise therapy approach on healing properties in patients with overweight / obese psoriatic arthritis

Obesity is one of the most common comorbidities in Psoriatic Arthritis (PsA), an inflammatory arthritis, and is associated with high disease activity, low quality of life, and unfavorable treatment processes. This study aimed to investigate the effect of diet and cognitive exercise therapy approach (BETY) intervention on disease activity and quality of life in overweight/obese PsA patients. The study included 70 obese/slightly obese patients aged 20-65, who were diagnosed with PsA according to CASPAR (Psoriatic Arthritis Classification Criteria) criteria and applied to Hacettepe University Department of Internal Medicine, Department of Rheumatology between 2021-2022. The patients were randomly divided into three groups (diet, n=23; diet+BETY, n=23; control, n=24) and followed for 12 weeks. While patients in the diet group were applied only to a diet program, patients in the diet+BETY group were applied to a diet program together with a biopsychosocial-based exercise (BETY) program. Disease activity assessments, anthropometric measurements, food consumption records, quality of life scale, and BETY-Biopsychosocial Questionnaire (BETY-BQ) scores were recorded and compared at baseline (week 0) and week twelve. Correlation and logistic regression analyses were used to examine the effects of interventions on disease activity scores. The study was completed with 48 patients. A significant decrease in body weight was observed in the diet+BETY (-6.2±1.3 kg, p<0.001) and diet (-6.6±2.6 kg, p<0.001) groups compared to the baseline. After 12 weeks, the Disease Activity for Psoriatic Arthritis (DAPSA) score significantly decreased in both intervention groups (diet+BETY: -10.7±8.1, p<0.001; diet: -7.6±6.7, p<0.001). Regardless of interventions, weight loss (≥5%) increased the chance of achieving Minimal Disease Activity (MDA) (OR: 6.51, 95% CI: 1.09-38.90). These results showed that weight loss and a biopsychosocial-based exercise intervention, alone or in combination, improved PsA symptoms. Multidisciplinary approaches for obese PsA patients may improve the management of the disease and increase the chances of achieving remission.