Living with Psoriatic Arthritis (PsA)

Starting Simponi and possibly getting bariatric surgery


Hi all, I am getting my first dose of Simponi mailed to me on Tuesday and will start it this coming Friday. I am nervous. I was on Humira for over five years when it just stopped working for me. I have been off biologics totally for over 3 months now and I just want to be on something because it’s been nothing but swelling, pain, just awfulness. It almost seems like the Sulfasalazine is doing nothing at all, but maybe I’m wrong about that. I hope this Simponi does something for me, I am beside myself with how bad this PsA has gotten over the past six months. On another note, I am a big gal (over 300 lbs) and much of that has to do with the fact that I’m inactive (I am restricted to only water exercise but have no access to the water in which to exercise, go figure) and I do have a bit of a problem with food. I am finally taking a big step towards bariatric surgery but I’m kind of scared because I’ve heard of people dying from it and I’ve also heard that many people have either gained the weight back or worse, gotten bigger. I am afraid that I will do that. I want to not do that, I want to be healthy and I want to live a good lifestyle, but my husband is not supportive of it at all - he is also overweight and he is all about eating out like 3 to 4 times a week. I will have to drastically change my life on my own. I am a bit afraid. Plus, there are some mental issues that I have with food. I was severely abused as a child and used my fat as a shelter. And I emotionally eat. I am in therapy, but I fear that I won’t be able to overcome these issues, either. I am hopeful but afraid, I guess. Um, looking for support, maybe. I’m sorry if I am tmi or something with this.


You’re in a tough position but it sounds like you’re doing everything right. Losing weight can only be helpful but things can be tough to change. I’m overweight and having a really hard time getting started. Trying small changes to get started.

Weight gain isn’t uncommon after weight loss surgery but it doesn’t have to be you. You mentioned that your husband doesn’t seem to have much interest in change. He may try to undermine your success as well. Have you talked about doing this together?

I’m cheering for you, however you can best take care of yourself.


Please research how medication mixes with bariatric surgery. You have a chronic condition with chronic pain and inflammation and the surgery may negatively impact your ability to absorb medication.

Here’s the info from just one fact sheet to get you started:

Six weeks after surgery, small pills or capsules can be taken as before. … Also you should avoid aspirin products and anti-inflammatories after surgery as they can cause irritation and ulcers. Oil-based and time-release medications may not be well absorbed after gastric bypass surgery.



Hello there Caradavin.

Good luck with Simponi. I hope it goes well. I wouldn’t read too much into the lack of relief on Sulfasalazine because while it helps some, there are plenty of us who have found it to make little impact, if any. I certainly wouldn’t be worried that it would herald a poor response to Simponi, which is just such a very different drug.

I hear what you say about your relationship with food. It’s not tmi at all. I guess being so aware of that relationship is a very healthy step to have taken. I would be very cautious about embarking on bariatric surgery, for all the reasons Azurelle (ModSupport) mentions. It seems a big thing to put your body through when you already have a chronic condition that takes its toll.

Whatever you decide to do though, we’re all here to offer support. Good to hear from you.


I am so hopeful that your new treatment works and you start to feel better soon.
I would also be cautious about bariatric surgery - it is not going to help your issues with food, just let you eat less. (Plus the issues with meds absorption above) You need help with your issues first to change the way you feel about yourself and relationship with food. Overeating can be an eating disorder just like anorexia, it’s just less recognised. You’ll also need the support of your husband, so much easier if you both try and eat healthily together.
I would recommend a low carb, good fat diet as having worked for me and my husband after many years of different diets. Have now lost nearly 4 stone in 8 months and feeling good. You can do it too, it just helps if you’re not in so much pain!
Good luck xx


I lost 100 pounds effortlessly (no hunger!) when I stopped eating processed foods, sugar, and foods that quickly turn to sugar in the digestive system. Later on I eliminated wheat and most grains from my diet as well. I did not do this all at once, but gradually eliminated foods until I was comfortable without them. It has been about fourteen years, and I have stuck with my diet and I have not regained the excess weight. I am still overweight, but not nearly as badly as before. I may lose more weight since I have recently started tinkering with my diet under the care of an osteopathic doctor. It IS possible to lose weight and maintain the loss without dangerous surgery, but the TYPES of food you consume is what is important, not the calories.


Actually, I am down 160 pounds today. --Nancy F


I did the same and lost two stone using an anti-inflammatory diet and cutting out processed foods, sugar and gluten - based on Paleo/Primal diet. It really works!


I was denied for the surgery for the second time. I don’t know what I’m going to do. I am scared. I don’t think I can do this on my own!