Barriers to weight loss in obese patients with knee osteoarthritis

Obesity contributes to the development of knee osteoarthritis and complicates its surgical treatment. The aim of this study was to explore barriers to effective weight management in obese patients with knee osteoarthritis.

A cross-sectional questionnaire study was performed in an elective out-patient setting and on an orthopaedic ward on patients with a body mass index (BMI) of 30 kg/m2 or over and knee osteoarthritis.

Of 47 patients approached, 45 agreed to participate. Forty of 45 patients (89%) had tried to lose weight at some point, 35 of 40 (87.5%) by adjusting their diet. Forty of 45 (89%) patients considered lack of motivation to be the greatest barrier to weight loss and only 13 of 45 (28%) pain in the knee. Patients with a BMI of less than 40 kg/m2 expressed a preference for dietary advice to help with weight loss, compared with those with a BMI of over 40 kg/m2 who expressed a preference for an NHS or other support group.

Obesity is a significant problem for many patients with knee osteoarthritis. Attendance at an orthopaedic clinic is an opportunity to address obesity, by providing information about diet and possibly support groups for morbidly obese patients. Patients may be motivated to lose weight to improve their symptoms.