Beyond weight: Exploring the nexus between obesity and osteoarthritis

Obesity is a well-established risk factor for osteoarthritis (OA), traditionally attributed to increased mechanical stress on weight-bearing joints. However, recent research suggests a more complex interplay, involving metabolic, biomechanical, and inflammatory pathways. This review delves into these multifaceted connections between obesity and osteoarthritis, extending beyond the conventional understanding of weight-bearing stress. It explores the role of adipokines such as leptin, visfatin, adiponectin, and resistin in OA pathogenesis and progression, highlighting their potential as targets for novel therapeutics. The review also examines how obesity alters the biomechanics of lower extremities, contributing to changes in joint load and movement patterns. Systemic effects, including inflammation and metabolic factors, are discussed to elucidate their roles in exacerbating OA beyond joint loading. Furthermore, the impact of bariatric surgery and weight loss strategies on OA symptoms and progression is evaluated. This comprehensive review aims to provide new insights into obesity-induced OA, paving the way for more targeted and effective treatment strategies.