Hip Osteoarthritis Treated with Exercise plus Weight Loss Diet

Jack Cush, MD

Oct 01, 2025 9:00 am

An exercise and diet intervention study showed that while exercise improved hip pain, adding a weight loss diet to exercise did not change hip pain but improve most secondary outcomes.

This was a community superiority randomized open label trial (ClinicalTrials.gov: NCT04825483) of 101 adults with hip osteoarthritis (OA) who were overweight or obese. Both groups were given exercise instruction but one group received very-low-calorie diet (VLCD) plus exercise via a 6-month home exercise program via 5 telehealth consultations. The VLCD plus exercise group also received a VLCD via 6 telehealth consultations. The primary outcome was 6-month change in hip pain severity (11-point scale; range 0 to 10). Secondary end points included other measures of hip pain, physical function, quality of life, body weight, body composition, and adverse events. Although VLCD plus exercise lost 8.5% more weight than exercise only, VLCD plus exercise was not more effective for change in hip pain severity (mean difference, −0.6 units [95% CI, −1.5 to 0.3]) at 6 months.

For other secondary outcomes at 6 months VLCD plus exercise was superior except Hip Disability and Osteoarthritis Outcome Score (HOOS) pain and function. At 12 months, weight, body mass index, HOOS pain and function, and overall hip improvement, but not quality of life and physical activity, favored VLCD plus exercise.

Adding a weight loss diet to exercise did not change hip pain but improved most secondary outcomes.

Efficacy of a Very-Low-Calorie Weight Loss Diet Plus Exercise Compared With Exercise Alone on Hip Osteoarthritis Pain: A Randomized Controlled Trial