Once the medical community sees you’re obese they can’t get past that. My Dx of PsA was delayed 15 years due to a weight bias! My mother has a severe case of psoriasis for as long as I could remember. At 40 I kept telling my Drs that I know a lot of fat boys that don’t hurt this much but oh no u have osteoarthritis from ur weight. So for years NSAIDS until the Percocet. Even then 2 yrs before my PsA diagnosis a rheumatologist from St Louis did all the appropriate tests and said I still think it’s osteoarthritis from your weight. Thank God I finally found Dr from Washington University that said with your history and ruined shoulders that aren’t weight bearing and bad SI joints in your shoulder have been on biologics ever since you’ve turned 40. Now all the damage is done and hip and shoulder replacements are ur fate! I was a 30+ year paramedic. I was devastated. So I went on SSDI and replaced both hips and Right shoulder but need the other done. As soon as I could I stopped the Percocet which was Hell!! I gained a lot of weight. Was down for the hip surgeries. The Dr said if you don’t lose weight you will b in a wheelchair within 5 years. Again devastated!! Now for the light. Realizing I’m a carb/sugar addict I stated the Ketogenic diet. What a Godsend for me. April 1st I was 440#. Today I’m 282#. Free of narcs. Inflammation way down. Able to exercise 4X per wk. Started working PRN as a medic again. I have hope again. So that’s for the experts that rated it the worst diet!!! My cholesterol is 116 and fasting glucose 92 at the 8 month mark. Now I feel like my PsA is manageable. Thanks to Keto!!!