A recent retrospective study has shown that the loss of 10% of body weight by obese patients slows the degeneration of their knee cartilage. As reported by Kristina Fiore, staff writer for MedPage Today, those who lost the most weight had the greatest reduction in the rate of cartilage damage.
10% Weight Loss = 56% Less Cartilage Degeneration
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Fiore quoted Alexander Gersing, M.D. of the University of California, San Francisco, who said, “Substantial weight loss not only slows knee joint degeneration, it also reduces the risk of developing osteoarthritis. The studies show there is a protective aspect of weight loss on knee cartilage. Weight loss may slow or prevent osteoarthritis.”
The study enrolled 506 patients with a mean age of 62 and a body mass index of 30.2 kg/m. Sixty percent of the patients were women. Over the four years of the study 177 patients lost between 5% and 10% of their body weight. Seventy-six patients lost more than 10%; 253 patients, who did not lose any weight, served as the controls.
Researchers found that those who lost the most weight had less cartilage damage. The patients who did not lose weight had a 0.9-point increase in T2 measurements over four years. Those who lost 5% to 10% of their body weight had about the same increase. But, according to Gersing, the patients who lost at least 10% of their body weight had an increase of less than 0.4 points ion their T2 score which meant a 55.6% reduction in the rate of cartilage layer damage.
“Degenerative joint disease is a major cause of pain and disability in our population and obesity is a significant risk factor, ” Gersing warned “Once cartilage is lost in osteoarthritis, the disease cannot be reversed.”
Fiore quoted Salomao Faintuch, M.D., of Beth Israel Deaconess Medical Center in Boston, who was not involved in the study:”Even though we like prospective studies better to provide scientific evidence, the retrospective design is not really a problem in this study.It is obvious and well known that losing weight helps people in so many different ways. The real novelty of this study is showing that how much weight you lose really makes a difference. Losing a little bit can make things better, losing even more makes it even better than that. It is important to be able to quantify that, if you lose weight, your joints are going to do better.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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