From the Guidelines
Yes, Systemic Lupus Erythematosus (SLE) can cause weight loss, as the disease's chronic inflammation and associated symptoms can lead to increased metabolic rate, reduced food intake, and other factors contributing to unintentional weight loss 1.
Key Factors Contributing to Weight Loss in SLE
- Chronic inflammation increasing metabolic rate and energy expenditure
- Gastrointestinal symptoms such as nausea, abdominal pain, and loss of appetite reducing food intake
- Fatigue making meal preparation and consumption difficult
- Potential side effects of certain medications used in SLE treatment
Importance of Monitoring Weight Loss in SLE Patients
Weight loss, especially if rapid or severe (more than 5% of body weight in a month), should be promptly addressed with a rheumatologist, as it may indicate active disease requiring treatment adjustment or signal a complication 1.
Non-Pharmacological Management Recommendations
According to recent guidelines, non-pharmacological management of SLE should be tailored, person-centered, and participatory, including education and support for physical exercise, smoking cessation, and avoidance of cold exposure, as well as photoprotection and psychosocial interventions 1.
Clinical Considerations
While medications like corticosteroids can cause weight gain, other immunosuppressants might contribute to weight loss, highlighting the need for personalized treatment plans and regular monitoring of SLE patients' weight and overall health status 1.
From the Research
Systemic Lupus Erythematosus (SLE) and Weight Loss
- SLE can lead to weight loss, as evidenced by a study that found significant weight loss in patients with stable SLE who were on low-dose prednisolone and followed a low glycaemic index diet or a calorie-restricted diet 2.
- However, another study found that different protocols of exercise intervention or diets were not effective in reducing body weight in patients with SLE 3.
- A survey of SLE patients found that those who undertook new eating patterns with increased vegetable intake and/or decreased intake of processed food, sugar, gluten, dairy, and carbohydrates reported benefiting from their dietary change, including weight loss 4.
- Cachexia, a disorder characterized by involuntary weight loss, is a common syndrome in SLE patients, with 56% of patients developing cachexia within 5 years of cohort entry 5.
- Obesity, on the other hand, is independently associated with worse patient-reported outcomes in women with SLE, including disease activity, depressive symptoms, pain, and fatigue 6.
Factors Associated with Weight Loss in SLE
- Low glycaemic index diet or calorie-restricted diet can lead to significant weight loss in patients with stable SLE 2.
- Dietary changes, such as increasing vegetable intake and decreasing processed food, sugar, gluten, dairy, and carbohydrates, can lead to weight loss and improvement in SLE symptoms 4.
- Cachexia is associated with risk factors such as low BMI, current steroid use, vasculitis, lupus nephritis, serositis, hematologic lupus manifestations, positive anti-double-stranded DNA, anti-Sm, and anti-RNP 5.
Lifestyle Interventions and Weight Management in SLE
- Dietary manipulation may significantly improve fatigue in subjects with SLE 2.
- Plant-based dietary changes may improve symptoms in patients with SLE, including weight loss, fatigue, joint/muscle pain, and mood 4.
- Lifestyle interventions, such as exercise and dietary changes, may not be effective in reducing body weight in patients with SLE, but may improve other symptoms and outcomes 3.