Dr Ruth Ann Marrie Highlights the Impact of Obesity on MS Risk and Treatment Responses

Obesity is common in the general population and research has shown it can increase the risk of multiple sclerosis (MS), as well as increase diagnostic delays, explained Ruth Ann Marrie, MD, PhD, director of the Multiple Sclerosis Clinic at the University of Manitoba.

How do comorbidities like metabolic syndrome impact the risk of MS? For instance, what do we know about why metabolic syndrome results in longer diagnostic delays?

So, it's an important question and because obesity is so common in the general population, so we recognize now from a number of studies In the United States and Europe, for example, that obesity does increase your risk of multiple sclerosis. And we think that's in part related to the fact that our fat tissues or adipose tissue is metabolically active, it secretes pro-inflammatory cytokines and free fatty acids. And so, it confers an increased risk of MS. And as you mentioned, it is one of the factors that can increase diagnostic delays.

It has also been demonstrated to affect some of the parameters that clinicians seem to follow when we're following people with multiple sclerosis. So, brain atrophy seems to be greater, and individuals with multi Multiple Sclerosis who are obese than nonobese. If we're looking at the thickness of the retinal layer in the eye that also seems to thin more quickly in individuals who are obese so suggesting some important impacts on outcomes and in children with multiple sclerosis. A less common group but nonetheless an important one. There's at least one study that suggests that the response to disease-modifying therapies may not be as good in children who are obese, which may suggest we need to think differently about their treatment.

So, it's very important, both in terms of you know, confers risks. So what can we do to reduce the risk of MS, we could work on obesity, but once somebody is diagnosed with MS, it will be important to try and help individuals achieve, you know, healthier weight through physical activity, healthy eating and working with them around the strategies to sustain those behaviors and trying to prevent it and people who are not obese at the time of diagnosis trying to head that off from the beginning.