Among older white women, losing weight did not prevent hip arthritis from developing or from getting worse.

Clinicians often recommend that overweight patients who have knee or hip arthritis lose weight, and guidelines support this suggestion (Arthritis Rheumatol 2020; 72: 220-233). However, although weight loss is clearly associated with improvement in knee arthritis, little evidence supports its efficacy for improving hip arthritis.

Researchers analysed prospective data on 5000 older white American women (age, 65 years and older) who were evaluated at baseline and eight years later with plain film x-rays of both hips. At the second evaluation, about half of participants weighed within 5% of their study entry weight, whereas 18% had gained weight and 32% had lost weight. Among those with hip arthritis at baseline, the rate of radiological progression was unaffected by weight loss. Similarly, the rate of radiological development of disease among those with no arthritis at baseline also was unaffected by weight loss. The same applied to the subset of participants who were overweight at baseline and whose weight loss was intentional.

Comment: These findings add to an expanding body of evidence that suggests very little benefit from weight loss for preventing or treating radiologically confirmed hip osteoarthritis (NEJM JW Gen Med May 1 2023 and Arthritis Care Res (Hoboken) 2023; 75: 860-868). However, this study does have limitations: its data apply only to white women, and they fail to address weight fluctuations during the study period. Further, because no clinical data were collected, it is impossible to tell how closely the radiological changes tracked here reflected actual disability.

Abigail Zuger, MD, Former Associate Clinical Professor of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai; former Senior Attending Physician, Mount Sinai Roosevelt and Mount Sinai St. Luke’s Hospitals, New York City, USA.

Salis Z, et al. Investigation of the association of weight loss with radiographic hip osteoarthritis in older community-dwelling female adults. J Am Geriatr Soc 2023; 71: 2451-2461.

This summary is taken from the following Journal Watch titles: General Medicine, Ambulatory Medicine.