Weight loss cuts arthritis pain

An intensive programme of weight loss and exercise can reduce pain and joint inflammation among some patients with osteoarthritis of the knee, research has shown.

Patients on weight loss and exercise programme had lower pain scores
Patients on weight loss and exercise programme had lower pain scores

Overweight and obese patients with the joint disorder who followed an 18-month diet and exercise plan lost more than 10% of body weight and experienced less pain than those undertaking exercise alone.

Patients also saw bigger falls in inflammation levels, better function of their knee joints and greater improvements in health-related quality of life, the US study found.

In the 18-month study, Stephen Messier PhD of Wake Forest University in North Carolina and colleagues randomised 454 knee osteoarthritis patients with a BMI of ≥27 to either an intensive diet-induced weight loss programme, an exercise programme, or a combination of the two.

The dietary weight-loss plan saw patients drink meal-replacement shakes for two meals a day and limit calorie intake for the third. For the exercise plan, patients took part in walking and strength training at one-hour sessions, three times a week.

After 18 months, 399 patients completed the study. Those on the diet-only plan on average lost 8.9kg (9.5% of body weight) compared with 10.6kg (11.4%) among those on the combination plan. In contrast, patients on the exercise-only plan lost just 1.8kg (2%).

Peak knee compressive force, a measure of joint loading, was lower after 18 months in the diet group than the exercise group. Levels of plasma interleukin-6, a marker of inflammation, dropped further in the combination and diet-only groups than the exercise-only group.

Similarly, patients on the weight loss and exercise plan registered lower pain scores and better knee function, and walked further and faster in a six-minute walk test than those on the exercise-only programme. Physical health-related quality of life also showed greater improvements.

The researchers concluded: 'The findings suggest intensive weight loss may have anti-inflammatory and biomechanical benefits; when combining weight loss with exercise, patients can safely achieve a mean long-term weight loss of more than 10%, with an associated improvement in symptoms greater than with either intervention alone.'

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