Is obesity a risk factor for gout? Why? (Obesity is often accompanied by metabolic disorders, affecting uric acid metabolism.)

Yes, obesity is absolutely a significant risk factor for gout, and the relationship is very close.

You can understand it this way: our body is like a chemical factory, and uric acid is a "metabolic product" produced by this factory. Under normal circumstances, the factory produces as much as it can excrete, maintaining a balance. However, if a person becomes obese, this balance is easily disrupted.

There are two main reasons:

Increased "source" of uric acid (increased production): Uric acid is metabolized from a substance called "purine." Every day, a large number of cells in our body are renewing, and this process produces endogenous purines. Obese people have a larger body mass, more cells, and a higher overall metabolism, so they produce more purines themselves. This leads to an abundant supply of "purines" as raw material, and naturally, uric acid production rises.
Narrowed "outlet" for uric acid (impaired excretion): More than two-thirds of the uric acid in the body is excreted through the kidneys, along with urine. Obesity often leads to "insulin resistance" in the body (body cells become insensitive to insulin, which is a precursor to type 2 diabetes). This condition affects kidney function, causing the kidneys to reduce uric acid excretion. Simply put, the body's "drainage system" becomes less efficient, or even somewhat blocked.

So, you see, for obese individuals, the situation becomes very tricky:

On one hand, the body's factory is overproducing uric acid; on the other hand, the kidneys responsible for waste removal are "slacking off," and less uric acid is being excreted.

This imbalance between input and output leads to increasingly high concentrations of uric acid in the blood. When it reaches a certain level, these uric acid will crystallize in joints with lower temperatures (such as toes, ankles, knees, etc.), forming needle-like small crystals. These crystals irritate your joints, and the immune system launches an attack, leading to acute gout attacks characterized by redness, swelling, heat, and pain.

Therefore, weight control is a fundamental and crucial step for both preventing and treating gout.