Trajectories of psychological symptoms during an 18-month Diet + Exercise intervention in overweight or obese adults with osteoarthritis

Lily Alomari¹, Daniel Beavers², Kate Queen³, Shannon Mihalko⁴, Gary Miller⁴, Elena Losina⁵, Paul DeVita⁶, david Hunter⁷, Jovita Newman⁴, Sara Quandt⁸, Mary Lyles⁸, Sandra Soto³, Joanne Jordan⁹, Leigh Callahan³, Stephen Messier¹⁰ and Becki Cleveland¹¹, ¹Kansas City University, Raleigh, ²Wake forest university, Winston Salem, ³UNC, Chapel Hill, ⁴WFU, Winston Salem, ⁵BWH, Boston, MA, ⁶East Carolina University, Greenville, ⁷Sydney Musculoskeletal Health, University of Sydney, St Leonards, New South Wales, Australia, ⁸WFU, Winston-Salem, ⁹University of North Carolina at Chapel Hill, Chapel Hill, NC, ¹⁰WFU, Winston-Salem, NC, ¹¹University of North Carolina, Chapel Hill, NC

Meeting: ACR Convergence 2025

Keywords: clinical trial, diet, exercise, Osteoarthritis

Session Information

Date: Tuesday, October 28, 2025

Title: (2079–2105) Osteoarthritis – Clinical Poster II

Session Type: Poster Session C

Session Time: 10:30AM-12:30PM

Background/Purpose: Psychological symptoms (PsySx) have been associated with osteoarthritis (OA), and exercise may improve PsySx. We aimed to identify unique trajectories of PsySx over the course of 18-months,and examine whether randomization to Diet and Exercise (D+E) vs. attention control (AC) was associated with trajectory class.

Methods: We used data from WE-CAN, a randomized trial of overweight/obese individuals aged 50+ years diagnosed with OA. Outcomes were assessed at baseline and at 6, 12, and 18 months. PsySx assessmentincluded Center for Epidemiological Studies-Depression Scale, Pain Catastrophizing Scale, SF-36 MentalComponent Summary, Perceived Stress Scale, and EuroQol Quality of Life Anxiety/Depression. Group-basedmulti-trajectory model analysis (GBMTM) was used to identify subgroups of individuals with similar change patterns across the 5 PsySx measures. Multinomial logistic regression was used to evaluate the association between randomization group and trajectory class. We further explored associations when stratified by social determinants of health (education, occupation, income, area deprivation).

Results: Among 616 participants, GBMTM identified 3 trajectory classes for PsySx: “poor” [GRP 1;REFERENT], “good” [GRP 2], and “excellent” [GRP 3]. Compared with AC, participants in the D+E groupwere more likely to belong to GRP 2 (adjusted odds ratio [OR] 1.57, 95% confidence interval [CI] 1.02-2.43).This association was stronger among individuals with an income less than $50K per year (OR 1.80, 95% CI1.00-3.24) and living in a low deprivation area (OR 1.75, 95% CI 1.00-3.06).

Conclusion: Our results suggest that OA patients with moderate PsySx may experience improved symptomswith a D+E program. However, those who had severe PsySx at baseline (GRP1) may not experienceimprovements with D+E, possibly due to more serious underlying problems that would require treatments beyond D+E. Further, D+E may not have an effect in those mild PsySx, possibly due to little room for improvement.

Disclosures: L. Alomari: None; D. Beavers: None; K. Queen: None; S. Mihalko: None; G. Miller: None; E. Losina: None; P. DeVita: None; d. Hunter: None; J. Newman: None; S. Quandt: None; M. Lyles: None; S. Soto: None; J. Jordan: None; L. Callahan: None; S. Messier: None; B. Cleveland: None.

To cite this abstract in AMA style:

Alomari L, Beavers D, Queen K, Mihalko S, Miller G, Losina E, DeVita P, Hunter d, Newman J, Quandt S, Lyles M, Soto S, Jordan J, Callahan L, Messier S, Cleveland B. Trajectories of psychological symptoms during an 18-month Diet + Exercise intervention in overweight or obese adults with osteoarthritis [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/trajectories-of-psychological-symptoms-during-an-18-month-diet-exercise-intervention-in-overweight-or-obese-adults-with-osteoarthritis/. Accessed .

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