Weight loss for osteoarthritis

Atukorala, 2016Bannuru, 2019Christensen, 2007Kloppenburg, 2019Kroon, 2014Sakellariou, 2017

Obesity is a risk factor for both the development and progression of knee osteoarthritis. The majority of patients with knee osteoarthritis are overweight or have obesity. In patients undergoing joint replacement surgery for knee osteoarthritis, 60% are reported as having obesity. Obesity also appears to be a risk factor for hip, hand and spinal osteoarthritis; 40% of patients undergoing joint replacement surgery for hip osteoarthritis are reported as having obesity.

Weight loss is recommended for all patients with osteoarthritis who are overweight or have obesity, irrespective of the affected joints or the stage or severity of disease (including for patients awaiting surgery). There is strong evidence that weight loss is beneficial for knee osteoarthritis. Despite no good evidence that it helps hip or other forms of osteoarthritis, weight loss is still recommended because of the general health benefits.

Improvement in osteoarthritis symptoms and physical function is proportional to the percentage of weight loss. Weight loss targets required for a clinically significant improvement have been identified—a reasonable target is a more than 5% weight reduction. Reduction in pain and improvement in physical function are greater if exercise and weight loss are combined. For information on weight loss strategies, see General principles of managing excess body weight. Refer patients to weight management services if appropriate.