Background/Purpose: In clinical trials, weight loss was associated with improvement in knee osteoarthritis (OA) pain and function up to 18 months of follow up. However, clinical trials are performed under highly controlled conditions, and may not be representative of long-term effects in community settings. The aim of this study was to investigate the effects of healthy weight loss on knee pain and function over long-term follow up in a pragmatic cohort setting.

Methods: Participants from the Osteoarthritis Initiative progression cohort with a baseline Kellgren-Lawrence grade ≥2 in either knee, and baseline BMI≥25 were selected. Weight and WOMAC scores were followed for up to 8 years, along with demographic data, depression scores, physical activity indicators, pain medication use, and pain in other joints. Weight loss modality was reported retrospectively at 8 years by participants who lost weight during the study period; subjects who reported unhealthy weight loss were excluded. Linear mixed effects models were used for analyses.

Results: Nine hundred and fifty six patients were enrolled. Over 8 years, weight was stable (within 5% margin) in 60% of subjects, 17% of subjects lost ≥5% of weight, and 24% of subjects gained ≥5% of weight. Weight change trends were gradual and linear for both weight loss and gain. Those who lost ≥5% of their weight had improved WOMAC scores over 8 years compared with the weight stable group: -4.2 points in an unadjusted model (p=0.006), and -3.9 in a fully adjusted model (adjusted for age, gender, race, depression score, baseline BMI, pain medication use, PASE, and pain in other joints, p=0.01). Within the weight loss group, there was no statistically significant difference in WOMAC in ≥10% weight loss vs 5-10% weight loss: -4.8 points in unadjusted model (p=0.2) and -4.4 (p=0.24) in fully adjusted model.

Conclusion: In overweight community adults, healthy, gradual weight loss of ≥5% was associated with improved knee pain and function over 8 years. There was no added benefit for losing ≥10% of weight.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/healthy-weight-loss-is-associated-with-improved-pain-and-function-over-8-years-in-overweight-subjects-with-knee-osteoarthritis-data-from-the-osteoarthritis-initiative/