title: Weight loss as treatment for knee osteoarthritis symptoms in obese patients: 1-year results from a randomised controlled trial.
abstract: OBJECTIVE
  To evaluate 1-year symptomatic improvement in obese patients with knee osteoarthritis (OA) on an intensive low-energy diet (LED) maintained by frequent consultations with a dietician compared to minimal attention.
  
  
  METHODS
  The LED programme consisted of group therapy with dietary consultations and two periods of a low-calorie diet of 810 kcal/day during weeks 0-8 and weeks 32-36. The control group only received dietary instruction and attention for 2 h at baseline, and at weeks 8, 32, 36 and 52. The primary end point (total Western Ontario and McMaster Universities (WOMAC) index) was assessed as the mean group difference during and after 1 year.
  
  
  RESULTS
  The study population consisted of 89 patients, 89% women, average age 63 years. After 1 year, mean weight loss in the LED group was -10.9 kg (11%) versus -3.6 kg (4%) in the control group (p<0.0001). There was no difference between the groups in total WOMAC index (p=0.11), although both groups improved. However, the LED intervention resulted in less WOMAC pain (7.7 mm), with a group mean difference of 7.2 mm (95% CI 1.0 to 13.4, p=0.022). After one year 14 (32.8%) responded to LED versus 7 (15.6%) to control, with an absolute benefit of 16.3% (-1.1& to 33.6%, p=0.066).
  
  
  CONCLUSIONS
  Continuous reinforcement of a weight loss programme can be successful over a year in obese knee OA patients. Weight loss was statistically reflected only by a reduction in pain. However, the overall clinical benefits of the intervention on health should lead to a strong recommendation of weight loss in this group of patients.
authors.affiliation: The Parker Institute, Copenhagen University Hospital, Frederiksberg, DK-2000F, Denmark. henning.bliddal@frh.regionh.dk
authors.forename: Henning
authors.initials: H
authors.lastname: Bliddal
authors.forename: Anthony R
authors.initials: AR
authors.lastname: Leeds
authors.forename: Lise
authors.initials: L
authors.lastname: Stigsgaard
authors.forename: Arne
authors.initials: A
authors.lastname: Astrup
authors.forename: Robin
authors.initials: R
authors.lastname: Christensen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D004038:Diet, Reducing / Q000009:adverse effects / Q000379:methods*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000178:diet therapy* / Q000503:physiopathology; D020370:Osteoarthritis, Knee / Q000178:diet therapy* / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome; D015431:Weight Loss