SOURCE: Bartels EM, Henrotin Y, Bliddal H, et al. Osteoarthritis Cartilage 2017;25:1641-1646.

It is well-recognized that overweight and obesity are associated with osteoarthritis. Lest one becomes overly simplistic and assigns degenerative joint changes solely to the extra stress of excess weight, one should recognize that osteoarthritis of the hands also is associated with obesity, although it would be difficult to conjure any additional joint-loading burden.

At the same time, data consistently show that for knee osteoarthritis, weight loss is associated with symptomatic and functional improvement. The mechanism of this is incompletely understood, since weight loss has not been shown to affect the progressive degradation of cartilage typical of osteoarthritis.

Bartels et al studied biomarkers of collagen breakdown in persons with knee osteoarthritis who lost weight, wondering whether these potentially more sensitive indicators would corroborate that the symptomatic improvements seen with weight loss were actually reflecting less cartilage degradation that was too subtle to be identified radiographically. At the conclusion of the trial, changes in biomarkers were not found to be associated with symptomatic improvements.