Clinical Pearls for Nutrition and Weight Loss in PsA

"Clinical Pearls for Nutrition and Weight Loss in PsA" gathers the concrete, practical pearls Dr. Perkins wants colleagues to take away.

Dr. Perkins closes out the clinical discussion with specific, practical pearls for colleagues prescribing incretin therapy in psoriatic arthritis. She recommends avoiding fatty foods, alcohol, soda, sweets, and processed foods, noting these both interfere with the medication and independently drive weight gain and inflammation. She stresses that patients often feel better even before substantial weight loss occurs, which she attributes partly to reduced inflammation from adipose tissue itself. She recommends pacing weight loss at no more than one to two pounds per week and watching closely for gastrointestinal side effects, adjusting hydration and nutrition if they appear. She also flags the risk of sarcopenia, or loss of lean muscle mass, during rapid weight loss, recommending two to four days per week of weight-bearing exercise to counter it. She encourages colleagues not to take on too much in a single visit. Some rheumatologists reasonably prefer to refer patients out for obesity management, while others successfully involve advanced practice providers who often bring a specific passion for nutrition and wellness. Dr. Bakewell reflects that the field sometimes gets lost in the routine grind of charting and documentation. That can mean losing sight of what matters most: every patient has one life and one chance to live it well. She calls this combination approach one of the biggest advances of her career. She credits the underlying immunology and newer peptide science together for the shift. Dr. Perkins agrees that pausing to focus on the person in front of you is worth the extra time it takes, rather than chasing the volume of patients seen in a given day.

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