A study published in 2011 in Arthritis Care & Research, adds one more piece of information to the obesity-gout puzzle. It found that obese men and women are more likely to develop gout at a younger age than their normal-weight counterparts.  

Previous studies have found that the incidence of gout – a form of inflammatory arthritis caused by crystallization of uric acid inside the joints – has gone up during the past 20 years, and that obesity increases the likelihood of gout in men.

“Our study confirms an increase in the risk of developing gout in obese men and extends these findings to women. We further found that participants who were obese in early adulthood developed gout earlier than those who were not obese,” says lead author Mara A. McAdams DeMarco, PhD, who conducted the study when she was a doctoral candidate at Johns Hopkins University in Baltimore.

The researchers looked at data from 15,533 people, aged 13 to 87 years. The participants were a subset of a larger study, called CLUE II, examining cancer and heart disease. CLUE II was started in 1989 and included people living within or near Washington County, Md. During the 18-year follow-up period, 517 people from the subset reported having developed gout.

At the start of the study, 16 percent of participants were obese, 36 percent were overweight and 48 percent were normal weight. After adjusting for risk factors linked to gout (including sex, age, alcohol intake, blood pressure, cholesterol levels and medication for high blood pressure and high cholesterol), obesity was found to be an independent risk factor for the development of gout in both men and women.

The average age for developing gout was 59.3 years. Compared with non-obese participants, the onset of gout was 3.1 years earlier in participants who were obese at the start of the study and 11 years earlier in those who were obese at age 21. This discrepancy was seen in both men and women. In fact, obese participants were almost twice as likely to develop gout over an 18-year period than non-obese participants.

“This research suggests that it is important to consider the diagnosis of gout in obese patients [with arthritis symptoms] regardless of age. It is unclear from this research whether weight loss would prevent the occurrence of gout or decrease the number of gout flares,” Dr. McAdams DeMarco wrote in an email.

Earlier studies have shown that weight loss can reduce the risk of gout.

“These findings are not surprising. The study confirms the rising incidence of gout is associated with Americans’ eating habits that lead to obesity. The incidence of gout parallels the rising incidence of features of the metabolic syndrome, including obesity, hypertension, dyslipidemia [abnormal cholesterol levels] and glucose control,” says Herbert S.B. Baraf, MD, clinical professor of medicine at George Washington University School of Medicine in Washington, DC, and clinical associate professor at the University of Maryland School of Medicine.  

Others agree. "This study adds to the evidence that the obesity epidemic is killing us. Gout is just the tip of the iceberg. At least gout is treatable and controllable, but obesity also contributes to heart disease and diabetes, which are tightly linked to gout,” says Thomas Geppert, MD, a rheumatologist in private practice in the Dallas area and a previous recipient of Arthritis Foundation grants.

"There is no question that efforts are needed to combat obesity, but unfortunately we have not yet found effective behavioral interventions. My patients who are obese or overweight know that it is unhealthy and know that they should be exercising and dieting,” says Dr. Geppert. But he acknowledges it is easier said than done.