Slower Weight Loss May Affect Osteoarthritis Survival Save

Arthritis & Rheumatology has published a new study that suggests knee or hip osteoarthritis patients who are overweight or obese may have less premature death if slow to moderate rate of weight loss results from anti-obesity medications.

A total of 6,524 overweight or obese, knee or hip osteoarthritis patients from the IQVIA database who were taking weight loss drugs (orlistat, sibutramine, or rimonabant) and they emulated analyses of a hypothetical target trial to assess the effect of slow-to-moderate (2%–10%) or fast (≥10%) weight loss induced by the initiation of anti-obesity medications within one year on all-cause mortality and secondary outcomes over five years’ follow-up.

They found a 5-year death rate of 5.3%, 4.0%, and 5.4% for the “weight gain/stable”, “slow-to-moderate weight loss,” and “fast weight loss” groups, respectively.

Thus only the “slow-to-moderate weight loss” group demonstrated a 28% lower mortality risk; but this was only 1% lower than the “fast weight loss” arm.

A dose–response protective effect of weight loss was seen for incident hypertension, type 2 diabetes, and venous thromboembolism but a slightly higher (nonsignificant) risk of cardiovascular disease.

These data supports prior research demonstrating disappointing outcomes with rapid weight loss. Such data is important in counseling obese patients with knee or hip OA who wish to lose weight.