The Impact of Obesity and Weight Loss on Patients with Systemic Lupus Erythematosus: Is There a Role for Bariatric Surgery?

The problem of obesity continues to grow with epidemic proportions in Western countries. Obesity is a complex metabolic disorder characterized by a positive disequilibrium between energy intake and energy expenditure. The consequent expansion of the adipose organ, and in particular of visceral fat depots, increases the risk of developing obesity complications such as insulin resistance, type 2 diabetes, atherosclerosis, steatohepatitis, and cardio- and cerebro-vascular diseases [1]. Individuals with systemic lupus erythematosus (SLE) have an elevated risk of both cardiovascular disease and disability, but the increase in risk for these conditions that may be conferred by obesity is poorly known [2-4]. Weight loss through lifestyle and dietary modification has been shown to improve the clinical manifestations of lupus [5]. However, the effect of bariatric surgery on SLE disease activity and the perioperative morbidity/mortality of weight loss surgery in this population remain to be determined.