Gout is a inflammatory disorder with an estimated prevalence of 0.08% globally. Overweight/obesity is one of the reason behind the progession of gout. Therefore, weight loss is generally recommended treatment for gout. This report evaluate the risk and benifits of weight loss and revealed that there is urgent need to initiate prospective studies to gain better results.

Weight loss is generally suggested for gout, but the extent of the impact has not been assessed in a systematic review. This systematic review directed to discover the advantages and inflictions linked with weight loss among obese and overweight individuals with gout.

A total of six databases for longitudinal studies, describing the influence of weight loss among overweight/obese gout patients were chosen. The tool Risk of Bias was used within Non-Randomised Studies of Interventions to assess the risk of bias. The Grading of Recommendations Assessment, Development and Evaluation were applied to estimate the quality of evidence.

A total of ten studies were included. Treatments involved a diet with/without physical activity, diuretics, metformin, bariatric surgery, or no intervention. Mean weight losses varied from 3 kg to 34 kg. Zero to 60% patients obtaining sUA target with the impact on serum uric acid (sUA) ranged from −168 to 30 μmol/L. Beneficial effects on gout attacks were presented by six out of the eight studies. Two studies showed dose-response association for sUA, obtaining sUA target and gout attacks. At short-term, short elevated sUA and gout attacks led to appearing after bariatric surgery.

The present evidence is in support of weight loss for obese/overweight gout patients, with low, moderate and low quality of evidence for impacts on sUA, obtaining sUA target and gout attacks, respectively. Unfavourable short-term effects may arise.