Purpose: It has been established that weight reduction has the ability to decrease pain and disability in knee osteoarthritis (OA) in a doseresponse manner. A greater weight loss causes incremental improvement in disease specific symptoms and function. Whether this improvement leads to commensurate improvements in quality of life remains unknown. This study examined whether there is a doseresponse relationship between incremental weight loss and non-disease specific quality of life measures in knee OA sufferers. Methods: Consecutive participants with knee OA enrolled in a weight loss program, "Healthy weight for life", as part of the full "Integrated Osteoarthritis Management TM Program" were selected. This program is a structured remotely delivered 18 week knee and hip arthritis disease management program that systematically integrates intensive weight loss as part of its tailored interventions in the management of knee and hip OA. This program was conducted with the aim of a 7-10% loss of body weight by dietary intervention over 18 weeks. The participants were provided online and written healthy eating advice and lifestyle education and tools together with targeted telephone motivation and support. The dietary habits were changed over 3 phases: phase 1 -motivational weight loss utilizing low calorie diet meal replacement, with controlled portions, and free foods for 6 weeks; phase 2 -consolidation weight loss for 6 weeks and phase 3 -short term weight maintenance. All participants in this cohort received the same strength / balance / mobility exercise tools, instruction, support and encouragement. All participants were assessed at baseline, 6 weeks and 18 weeks for body weight and non-disease specific measure of quality of life, assessed by SF-12 instrument. The SF-12 measures general health status from the patient's point of view. It includes 8 concepts commonly represented in health surveys: physical functioning, role functioning physical, bodily pain, general health, vitality, social functioning, role functioning emotional, and mental health. Results are expressed in terms of two meta-scores: the Physical Component Summary (PCS) and the Mental Component Summary (MCS). The PCS and MCS scores have a range of 0 to 100 and have a mean score of 50 and a standard deviation (SD) of 10 in a healthy US population. Thus, scores greater than 50 represent above average health status. The dose-response relationships between five weight-change categories (10% weight loss, 9.9-7.5%, 7.4-5%, 5-2.4% and <2.5%) and change in SF-12 scores were assessed using repeated measures ANCOVA and controlled for baseline BMI and gender. Results: 2175 (71% females) persons were enrolled in this study. Mean age, height and weight was 64 years (SD ± 8.6), 1.66m (SD ± 0.09) and 95.3 (SD ± 17.4) respectively. The mean body mass index (BMI) was 34.4 (SD ± 5.2) with 81.7% of participants being obese at baseline. 2002 (92%) of participants had a >2.5% reduction in body weight. 1832 (84.4%) participants completed the final SF-12 questionnaires an...
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