Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2018 Nov;70(11):1569-1575.
doi: 10.1002/acr.23608.

Intentional Weight Loss in Overweight and Obese Patients With Knee Osteoarthritis: Is More Better?

Stephen P Messier  1 , Allison E Resnik  1 , Daniel P Beavers  2 , Shannon L Mihalko  1 , Gary D Miller  1 , Barbara J Nicklas  2 , Paul deVita  3 , David J Hunter  4 , Mary F Lyles  2 , Felix Eckstein  5 , Ali Guermazi  6 , Richard F Loeser  7
Affiliations
Randomized Controlled Trial

Intentional Weight Loss in Overweight and Obese Patients With Knee Osteoarthritis: Is More Better?

Stephen P Messier et al. Arthritis Care Res (Hoboken). 2018 Nov.

Abstract

Objective: To determine the dose response effect of weight loss on clinical and mechanistic outcomes in overweight and obese adults with knee osteoarthritis (OA).

Methods: This is a secondary analysis of the diet-induced weight loss only (D) and diet-induced weight loss plus exercise (D + E) groups in the Intensive Diet and Exercise for Arthritis randomized controlled clinical trial. The 240 participants were overweight and obese older community-dwelling adults with pain and radiographic knee OA. Participants were assigned to 1 of 4 groups according to weight loss achieved over an 18-month period: <5% (<5% group), 5-10% (≥5% group), 10-20% (≥10% group), and >20% (≥20% group).

Results: There were significant dose responses to weight loss for pain (P = 0.01), function (P = 0.0006), 6-minute walk distance (P < 0.0001), physical (P = 0.0004) and mental (P = 0.03) health-related quality of life (HRQoL), knee joint compressive force (P < 0.0001), and interleukin-6 (P = 0.002). Greater weight loss resulted in superior clinical and mechanstic outcomes, with the highest weight loss group (≥20% group) distinguishing itself on all measures compared with the <5% and ≥5% groups; the ≥20% group had 25% less pain and better function compared with the ≥10% group and significantly (P = 0.006) better physical HRQoL.

Conclusion: Long-term weight loss of 10-19.9% of baseline body weight has substantial clinical and mechanistic benefits compared with less weight loss. The value of an additional 10% weight loss includes significantly improved physical HRQoL and a clinically important reduction of pain and improvement in function.

Trial registration: ClinicalTrials.gov NCT00381290.

PubMed Disclaimer

Conflict of interest statement

Competing Interests

All other authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
The distribution of weight change by weight loss group.
See this image and copyright information in PMC

References

    1. Ogden CL, Carroll MD, McDowell MA, Flegal KM. Obesity among adults in the United States--no statistically significant change since 2003–2004. NCHS data brief. 2007;(1):1–8. - PubMed
    1. Ogden CL, Lamb MM, Carroll MD, Flegal KM. Obesity and socioeconomic status in adults: United States, 2005–2008. NCHS data brief. 2010;(50):1–8. - PubMed
    1. Blagojevic M, Jinks C, Jeffery A, Jordan KP. Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthritis Cartilage. 2010;18(1):24–33. - PubMed
    1. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2163–2196. - PMC - PubMed
    1. Messier SP, Mihalko SL, Legault C, Miller GD, Nicklas BJ, Devita P, Beavers DP, Hunter DJ, Lyles MF, Eckstein F, et al. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial. JAMA. 2013;310(12):1263–1273. - PMC - PubMed

Publication types

Associated data