Abstract Background/Aims This audit was prompted by increasing clinical observations that obesity was contributing to greater complexity in patient management, exacerbating psoriatic arthritis (PsA) symptoms and impairing activities of daily living, including functional transfers, fatigue, and challenges related to maintaining employment, even among younger individuals. These issues raised the question of whether addressing excess weight might offer more sustainable and holistic benefits than reliance on short-term aids alone. Methods We conducted a service audit of 18 consecutive patients with psoriatic arthritis (PsA) referred for occupational therapy at Glasgow Royal Infirmary. The aim was to: 1. Quantify the prevalence and severity of obesity in this cohort. 2. Assess how frequently obesity was documented in clinical correspondence. 3. Evaluate the burden of comorbidities. All analyses were conducted using Excel and via basic statistics packages therein. Results Among the 18 consecutive patients (12 women) with PsA seen in 2025, the mean BMI was 33.5 kg/m² (range: 24-44; Standard deviation 6.3; n = 2 missing), and the mean age was 55.2 years (range: 20-80; SD 6.3). Notably, 38% had a BMI 35, and nearly 1 in 5 had a BMI 40, indicating a substantial burden of severe obesity. Patients had an average of 5.2 comorbidities (range: 1-9; SD 2.3), most commonly hypertension, type 2 diabetes, osteoarthritis, coronary heart disease, and fatigue (reported by 61%). The average number of medications was 6.6 (range: 3-12; SD 2.7). Younger patients generally had fewer comorbidities, likely reflecting shorter obesity exposure and greater physiological resilience, although some had BMIs exceeding 40. Despite this, only around half of rheumatology letters for patients with BMI 30 included a recorded weight, and none discussed weight management plans or referrals. Conclusion Many patients referred to occupational therapy with PsA are living with obesity and multiple comorbidities, resulting in complex clinical presentations that affect both physical and mental health, and often limit their capacity to engage with rehabilitation and achieve meaningful improvement. These findings highlight the need for all healthcare professionals in rheumatology - not just physicians - to receive training on how to sensitively and non-stigmatisingly raise the issue of excess weight, initiate measurements and ensure better BMI recording on all patient-related documents to enable supportive conversations around potential solutions. The emergence of newer, effective lifestyle and medical therapies, expected to become more affordable over time, offers an opportunity to improve patients’ physical function, quality of life, and ability to remain in employment. Disclosure L. Sattar: None. N. Sattar: Consultancies; Abbott Laboratories, AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Carmot Therapeutics, Eli Lilly, GlaxoSmithKline, Hanmi Pharmaceuticals, Menarini-Ricerche, Metsera, Novartis, Novo Nordisk, Pfizer, Roche. Grants/research support; AstraZeneca, Boehringer Ingelheim, Novartis, Roche Diagnostics.
Sattar et al. (Wed,) studied this question.