Non-Pharmacologic Management
Abstract# 1979 - Weight Loss Messages for Knee Osteoarthritis: Attention-grabbing, Credible, and Non-motivating
Authors: T.J. Brady et al.
Background: Emerging evidence suggests that weight loss reduces pain and improves physical functioning and quality of life among overweight/obese adults with knee osteoarthritis (OA). Brady and associates conducted a qualitative study to assess the value of weight loss messages in motivating people with OA to consider trying to lose weight.
Methods: Six focus groups, segmented by race/ethnicity and gender, were conducted in 3 US cities. Overweight or obese (BMI ≥ 25) adults with self-reported, doctor-diagnosed arthritis or chronic joint symptoms who “some or a lot” of knee pain who were aged 45-70 and who reported some activity limitations were recruited to participate.
Results: A total of 53 adults participated in the focus groups. Proportions of Caucasian, Hispanic, and African-American respondents were comparable and 51% were male, and over half (57%) were aged 45 to 54. Virtually all respondents were aware of the health risks of overweight and many reported being tired of hearing such messages. Many reported believing that there is a connection between bodyweight and OA and about 50% report being told by their doctor to lose weight to benefit their OA. Identified motivators for losing weight included improving general health, improving their appearance, and money. Among those who had lost weight, the primary motivators were the development of another health problem (e.g., diabetes), the desire to improve general health, and the health problems or death of a loved one who was overweight.
Presentation of an arthritis-specific weight loss message (i.e., losing as little as 11 pounds can reduce arthritis symptoms) produced mixed responses from participants. Caucasians were most receptive, African-American and Hispanic women were less receptive, and Hispanic men rejected the message. Over half of respondents reported that they would pay attention to the message and over one-third indicated that they would consider losing weight to help their OA symptoms. Approximately 25% believed that they could successfully lose weight to reduce their knee symptoms. Finally, those in the lower range of the overweight category (BMI = 25-26) were least likely to consider losing weight because they did not consider themselves overweight.
Conclusions: Despite an awareness of the general and arthritis-related benefits of weight loss, arthritis-specific weight loss messages appear unlikely to motivate the majority of overweight persons with OA to attempt to lose weight.
Editorial Comment: Weight loss among overweight/obese adults with OA has been shown to reduce pain, stiffness, and improve functional status and quality of life. Moreover, weight loss produces significant general health benefits. The results of this focus group study indicate that respondents were well aware of the benefits of weight loss, both with respect to the general and arthritis-specific benefits. (Indeed, over half report their doctor suggesting that they lose weight) Although most reported that they would pay attention to an arthritis-specific weight loss message, only about 1/3 indicated that such a message from prompt them to consider trying to lose weight, and only ¼ thought they could successfully lose weight to benefit their knee symptoms. As such, the prospect of improving knee symptoms does not seem sufficiently motivating to undertake the challenging behavioral and lifestyle changes required to lose weight.
Given the difficulty of successfully losing and maintaining weight loss more effective interventions need to be developed to assist overweight/obese persons with OA in losing weight. In addition, weight loss counseling among persons with OA should endeavor to identify individually tailored motivators that might be sufficient to prompt and sustain the effort required to successfully lose weight. It would also be useful to learn about the characteristics and motivators of people with OA who successfully lost weight in efforts to develop more effective OA-specific weight loss treatment strategies.